One Health for One Planet: Ecocentric Policy for Personal and Planetary Wellbeing

This article is part of a series, in collaboration with the Civic Paths working group at the University of Southern California.

Shortly after the first COVID-19 cases were diagnosed in Wuhan, the Chinese government shut down the Huanan Seafood Wholesale Market, where many of the patients worked or shopped before dying. The market was extensively swabbed, and the collected samples were genetically sequenced to determine whether the disease might have been transmitted to humans from feral animals sold as food.

Several weeks ago, scientists analyzing the dataset released evidence suggesting that the disease might have come from wild raccoon dogs.

Concerns about the source of COVID-19, as well as other zoonotic diseases such as Ebola and SARS, have galvanized interest in the One Health Initiative first proposed by the American Veterinary Medical Association in 2008 and subsequently endorsed by organizations ranging from the CDC to the World Health Organization.

The One Health Initiative calls for "the collaborative efforts of multiple disciplines — working locally, nationally and globally — to attain optimal health of people, animals, and our environment." The founding report recognizes One Health not only as "a professional imperative" but also "a moral obligation."

These goals and sentiments are laudable. The fact that the health of humans is related to animal and environmental health is evident in shared threats ranging from habitat loss to global warming, yet has still not been taken seriously by most doctors and policymakers. The widespread recognition of the risk posed by zoonotic diseases provides an opportunity to implement One Health as more than an empty promise.

However, like "ecosystem services," One Health might easily be operationalized to serve humans alone. The belief that animals and the environment pose a threat may even amplify human efforts to assert control over planetary systems, and to eradicate any lifeform or phenomenon deemed "unhealthy" to humans. Given the growing momentum to enforce the principles of One Health through an international pandemic treaty, it's urgent now to define One Health from an ecocentric perspective. From this point of view, "people, animals, and our environment" must be construed as nested systems. People are animals, and animals are constituents of the environment as a whole. In other words, One Health is the health of the environment, which is imparted on all who comprise the environment, including people.

This shift in perspective has both methodological and political implications.

If human medicine is a specialized branch of ecology, then doctors must first be trained as ecologists (much as cardiologists are first trained as doctors). Medical textbooks must begin with geography before addressing anatomy. Human ailments must be diagnosed as ailments of the environment.

Although healing acts may be localized (as heart surgery is a local intervention), the treatment needs to extend outward to the surrounding ecology (much as treatment of heart disease also includes changes in diet and exercise). A healthy diet puts the body in good shape to repair and maintain damaged tissue. A healthy ecosystem puts the environment in good shape to restore and sustain the person as a whole.

There is a notable precedent for this point of view. As early as the 5th century BCE, Hippocrates posited that "nature is the best physician." Even the word "physician" has natural connotations: The Greek root phusikós means "pertaining to nature."

As Hippocrates recognized, and as his followers believed for the next two millennia, even the wisest doctors have their limitations. The wisdom of non-human healers should therefore also be consulted in healthcare. Plants, for instance, should not only be administered as medicine but also respected as medical practitioners.

Plants dispense the medicinal substances needed for the survival of other organisms including humans because they depend on the health of those organisms for their own wellbeing. In its purest state, medicine is a product of symbiosis, a chemical trace of caretaking. Instead of merely extracting and refining the chemicals, we should observe the conditions in which they are offered as instructions for use, and we should symbiotically reciprocate as caretakers of the beings who take care of us.

More broadly, the reciprocal relationship can provide a basis for interspecies diagnosis. Ecologists routinely assess the health of a biome by observing indicator species. The wellbeing of these organisms indicates the wellbeing of the entire living system to which they belong. The trees in our gardens and our houseplants are likewise indicators of our domestic ecosystem and all beings within, including ourselves. We need to learn how to interpret the suffering of a rosebush in terms of what is not well with us — and we can come a long way toward healing ourselves by healing the shrub.

But we cannot turn inward at the expense of the world. This is especially the case when considering preventative medicine, which must extend out from the individual to the whole planet. Keeping in shape must be reframed as a collective effort to do good in the world.

As a political matter, One Health requires a refocusing of public health to maximize the wellbeing of life. Factors such as biodiversity need to be taken into consideration. Practices that support biodiversity must be prioritized with input from every organism, setting health policy by consensus.

The challenge of attaining consensus is nontrivial, but the importance of doing so exceeds the difficulties. Humans have assumed too much for too long, leading the planet from extraordinary habitability to anthropogenic climate change and mass-extinction.

The conditions of wellbeing on Earth are best understood as conditions that support planetary biodiversity through deep time. Biodiversity is best understood to encompass multiple dimensions of difference, such as genomics, niche, and biological complexity.

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Crucially, there is no universal optimum that endures over the long term. Before humans came to be predominant, biodiversity was constantly negotiated. Consensus emerged as a matter of self-organization, which had to be dynamic because planetary conditions were unstable. We might take initial steps toward reviving that process of collective self-governance by convening a planetary wellbeing convention in which the expressed and observed needs of all species are considered communally, to assess whether their common interests are being met and to negotiate terms for maximal habitability in the environmental conditions of the moment. As an annual event, the convention could decide environmental policy.

Given all the evidence that people are healthier in a healthy environment — as the scientifically-trained heirs to Hippocrates recognize today — the human benefits of planetary wellbeing are undeniable. But departments of health and the World Health Organization should not be guided by those secondary advantages. One Health must remain oriented toward one patient.

That patient is Earth.