ABSTRACT
Progress in global health have been taken at the expenses of many threats, interconnected with the triple planetary crisis of climate change, pollution, and biodiversity loss. In response, the One Health initiative has consolidated as an operational framework that integrates human, animal, plant, and environmental health. A poor acknowledgment of ecosystem health and an absence of engagement of private sector organizations in One Health initiatives have been reported. The financial sector and policymakers have long underestimated the economic significance of ecosystem services, many of which are neither traded in markets nor directly assigned a monetary value. Appropriate economic evaluation frameworks and decision-making tools are therefore urgently needed in this area.
Keywords: One Health concept; global health risks and impacts; economics of global health, Benefits of adopting Blue Health principles; Economics of Blue Health; Investing in scientific approaches to Blue Health; Policy integration of Blue Health; Conservation and ecosystem restoration
KEY FINDINGS:
- The One Health has consolidated itself as a cross-cutting operational framework that integrates human, animal, plant, and environmental health
- Major health challenges cannot be addressed from isolated disciplines.
- Understanding the economic value of One Health is crucial for making decisions on One Health investments.
Content
The problem and the context.
In the last two centuries human developments have advanced global health markedly. In fact, average life expectancy at birth for people was kept at about 30 years for most of human history. However, during the past 200 years, global life expectancy has more than doubled, now reaching more than 72 years according to the World Bank. According to Maddison’s calculations, the average global income per person per year stood stable during this time period. Again, the advent of the Industrial Revolution in the late 18th century changed everything. In 2008, the last year in Maddison’s final estimates, the real standard of living rose by more than tenfold between 1800 and 2008. That increase was largely a consequence of better nutrition and improvements of public health measures, such as filtered water and sewers and control of infectious diseases.
However, this progress has been taken place at the expense of many interlinked threats, for instance the impact of infectious diseases, non-communicable diseases, and antimicrobial resistance (AMR) is increasing, climate change is accelerating, biodiversity is declining, and crises of food insecurity and freshwater scarcity are frequent (Winkler et al., 2025).
“The Limits to Growth” was published 50 years ago. Ordered by the Club of Rome, the study was a milestone in the analysis of the economic, demographic, technical and ecological effects of the existing economic system. In industrialised Western countries in particular, the critical examination of the development model of continuous economic growth led to a broad discussion about the far-reaching implications of a global economy focusing on growth, on a planet with finite natural resources.
Five major challenges and global threats have been classically identified in the context of One Health: 1) The growth of the global population, expected to reach 10 billion people by 2100; 2) The resulting increase in demand for animal and plant foods; 3) The climate emergency and environmental overexploitation; 4) The loss of biodiversity associated with the rise of zoonoses; and 5) The increase in global trade, which multiplies the mobility of vectors and pathogens. As a key evolution of the One Health approach, the centrality of the environment and the interconnections with the triple planetary crisis of climate change, pollution, and biodiversity loss, and the impacts in sustainability and health are now part of the central discussion on this subject.
The One Health perspective and approach to global health threats.
One Health is thought to be an ancient concept. A milestone was Rudolf Virchow’s definition of the term zoonosis and pointing out that: «there is no scientific barrier, nor should there be, between veterinary medicine and human medicine; the experience of one must be used for the development of the other.» A milestone was Rudolf Virchow’s definition of the term zoonosis and pointing out that: «there is no scientific barrier, nor should there be, between veterinary medicine and human medicine; the experience of one must be used for the development of the other.» The term zoonosis designates those diseases naturally shared between vertebrate animals, domestic or wild, and the human species. It is estimated that 60% of existing human infectious diseases are zoonotic. At least 75% of the emerging human infectious diseases have an animal origin such as Ebola HIV or avian influenza. Five new human diseases appear every year and some biological agents with potential bioterrorist use are zoonotic. Another fundamental advance was the proposal of the term “One Medicine” by Calvin Schwabe in recognition that the interdependence between animals, humans and their ecosystem extend beyond medical intervention for clinical disease. Most recently, One Health integrates eco-health and supports the concept that the health and well-being of animals, humans and the environment are interdependent (Zinsstag et al., 2018). Specifically, it has been in the last two decades; with a growing momentum after the COVID-19 pandemic, that the One Health concept has consolidated itself as a cross-cutting operational framework that integrates human, animal, plant, and environmental health and their relationship with ecosystems, emphasizing that major health challenges cannot be addressed from isolated disciplines. Additionally, it suggests the necessary collaboration between professionals from different sectors, especially in complex and global contexts. Key elements in this approach include the so-called «4Cs»: (I) communication across sectors and levels; (II) institutional coordination; (III) multidisciplinary collaboration; and (IV) capacity building.
The present framework is based on the One Health Joint Plan of Action (JPA), launched by the One Health Quadripartite (WHO, FAO, OMSA and the UN Environment Programme), and the definition of principles, and theory of change put forth by the One Health High-Level Expert Panel (Winkler et al., 2025). Health JPA is built around six interdependent action tracks that collectively contribute to achieving sustainable health and food systems, reduced global health threats and improved ecosystem management and provide a framework for prioritising One Health action that requires investment.
One Health Economics: actions needed.
Although One Health is progressing towards interdisciplinarity, transdisciplinarity, and systems thinking, a need remains to integrate the social sciences and humanities more extensively, including economics (Lapinski et al., 2015; Leandri & Dalmas, 2024). In addition, minimal acknowledgment of ecosystem health and an absence of engagement of private sector organizations in One Health initiatives have been emphasized; for instance, the financial sector and policymakers have long underestimated the economic significance of ecosystem services, many of which are neither traded in markets nor directly assigned a monetary value (Ceglar et al., 2024). Recent reviews have indicated a paucity of standardised methods and metrics for the economic evaluation of One Health (Auplish et al., 2024). Some of the main challenges in conducting One Health economic evaluations are summarized below:
- Limitations in data availability and quality.
- Time horizon: analysing long-term benefits.
- Metrics used in economic analysis.
- Perspective of economic analysis.
- Valuation of wider costs and benefits (e.g., less tangible and non-monetary costs and benefits).
- Unequal distribution of costs and benefits between sectors and involved stakeholders.
However, understanding the economic value of One Health is crucial for making decisions on One Health investments. The World Health Organization’s Choosing Interventions that are Cost-Effective (CHOICE) programme has been a global leader in the field of economic evaluation, specifically cost-effectiveness analysis (Bertram et al., 2021). New academic developments have tried to conceptualize economic evaluations of One Health and delve into the costs and benefits associated with One Health interventions, covering tangible and intangible costs, market prices of resources, and the evaluation of benefits over time (Canali et al., 2025). Standardisation of appropriate evaluation frameworks and decision-making tools are therefore urgently needed (Ceglar et al., 2024; Dobson et al., 2020, Winkler et al., 2025).
Conclusion and proposals
- At present, the impact of infectious diseases, non-communicable diseases, and antimicrobial resistance is increasing, and crises of food insecurity and freshwater scarcity are frequent associated with the triple planetary crisis.
- The One Health initiative has consolidated as an operational framework that integrates human, animal, plant, and environmental health.
- Although One Health is progressing towards interdisciplinarity, transdisciplinarity, and systems thinking, a need remains to integrate the social sciences and humanities more extensively, including economics.
- Understanding the economic value of One Health is crucial for making decisions on future investments. Standardisation of appropriate evaluation frameworks and decision-making tools are therefore urgently needed.
Links to recommended readings or specific bibliography on the content of the panel.
- Auplish A, et al. Current evidence of the economic value of One Health initiatives: A systematic literature review. One Health. 2024 May 9;18:100755. doi: 10.1016/j.onehlt.2024.100755.
- Canali M, et al. The economic evaluation of One Health interventions. In: Principles of One Health for a better planet, pp: 300-331 (eds B. Häsler, A. Tvarijonaviciute and S. Savić), CAB International 2025. doi: 10.1079/9781800623002.0014.
- Ceglar A, et al. Economic and financial impacts of nature degradation and biodiversity loss. ECB Economic Bulletin, Issue 6/2024.
- Dobson AP, et al. Ecology and economics for pandemic prevention. Science. 2020 Jul 24;369(6502):379-381. doi: 10.1126/science.abc3189.
- Lapinski MK, et al. Recommendations for the role of social science research in One Health. Soc Sci Med. 2015 Mar;129:51-60. doi: 10.1016/j.socscimed.2014.09.048.
- Leandri M, & Dalmas L. One Health Economics: why and how economics should take on the interdisciplinary challenges of a promising public health paradigm. Front Public Health. 2024 May 30;12:1379176. doi: 10.3389/fpubh.2024.1379176.
- Winkler AS, et al. The Lancet One Health Commission: harnessing our interconnectedness for equitable, sustainable, and healthy socioecological systems. Lancet. 2025 Aug 2;406(10502):501-570. doi: 10.1016/S0140-6736(25)00627-0.
- Zinsstag J, et al. Climate change and One Health. FEMS Microbiol Lett. 2018 Jun 1;365(11):fny085. doi: 10.1093/femsle/fny085.
Authors
- Emma Huertas, Ph.D. in Marine Sciences. Scientific Researcher at the CSIC (Spanish Research Council). Deputy Director of the ICMAN-CSIC. Coordinator of the Interdisciplinary Thematic Platform OCEANS+: Sustainable Oceans.
- Luis Miguel Ortega-Mora, Professor of Animal Health at the Complutense University of Madrid, director of the SALUVET group and promoter of ETCU-UCM SALUVET-Innova S.L.
Furthermore, this document is signed in a personal capacity and does not represent the official position of the institutions or entities to which the author may belong.
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