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January 23, 2020

Ruston et al 2011 [Economic benefits or drivers of a ‘One Health’ approach: Why should anyone invest?”]
-Why is One Health not main stream? Where are extra resource needed and who has control of the resources?
-If One Health is important, how can the case for a major paradigm shift be more persuasively 
presented? Realize the dynamics of human population growth include expansion of livestock product and resurgence of transboundary zoonotic disease such that we recognize costs of disease in terms of losses in production of livestock, , the costs of controlling the disease , the human health impact costs. We need to look at avoidable costs by establishing efficient disease programs.
“In common with all the disease groups there is the need for an understanding of the role of human behavior in terms bringing host and pathogen together“.

Between animal and human medicine there are no dividing lines—nor should there be. 
-Rudolf Virchow, 1856 
Häsler et al 2012 [The Economic Value of One Health in Relation to the Mitigation of Zoonotic Disease Risks]
The limitations of an economic approach are due to the necessary resources are not instantly available. The time investments and costs for training and to develop human, institutional, and infrastructure capabilities exceed initial fixed capital investment. There increasing demands on disease surveillance with new emerging and reemerging pathogens particularly with the aforementioned increased demand for livestock-derived food products, production intensity, and changes in geographic range of trade volumes. All these increase the risk of disease transmission. To emphasize that, look at the new coronavirus that arose from an unknown food source in a wetmarket in Wuhan, China as well as the use of bushmeat globally. 
Economic assessments in three stages: 1) Strategic planning and outcome prediction; 2)Provide an interim assessment of the probability of a successful outcome and redirect funds towards that goal, and 3) Final analysis of the factors relevant to the success or failure and its economic value.
Narrod et al 2012. [A One Health Framework for Estimating the Economic Costs of Zoonotic Diseases on Society]
A stepwise approach is utilized:
1. Estimate the extent of the disease and potential spread; The impact and burden of disease (DALYs: years of life lost+years of life with a disability)
2. Estimate the cost of zoonotic disease on livelihoods outcomes (income, health, and trade), including environmental impacts; using cross-sectional data and compare cost of disease before and after interventions
3. Assess the cost-effectiveness of risk management strategies currently employed for reduction of human and animal zoonotic disease exposure risk; Direct costs and cost-effectiveness analysis
4. Identify factors affecting adoption of zoonotic risk reduction strategies in poor households, the commercial sector and government bodies. The KAPs: Knowledge; Attitude, and Perception Analysis; Willingness to Pay Analysis

Making One Health Operational (World Bank):
“What am I responsible for? (Classical approach)” or should it be, “What needs to be done? (Integrated Approach)” 

Häsler et al 2014 [A review of the metrics for One Health benefits ]
Benefits include
– protection of the environment and healthier ecosystems – enhanced social and cultural values 
– improvements in human and animal health and well- being, and animal welfare 
– better/improved/more effective/more rapid disease control and/or biosecurity measures 
– a higher quality or quantity of information and data; more knowledge and better skills. 

Baum et al 2016 [Evaluating one health: Are We demonstrating effectiveness?]
“The absence of a standardized framework to capture metrics across disciplines, even in a generic format, may hinder the more widespread adoption of One Health among stakeholders.”

Machalaba et al 2017 [One Health Economics to confront disease threats]
Key recommendations include: 1. systems thinking to identify risks and mitigation options for decision-making under uncertainty (hazard-specific); 2. multisectoral economic impact assessment to identify wider relevance and possible resource-sharing (opportunity costs of resources, financial consequence of zoonotic disease, post-analysis of benefits of prevention) and 3. consistent integration of environmental considerations (valuing ecosystem regulation of disease risk, the impact of mitigation measures on ecosystem
services, and the role of pathogens in regulating other ecosystem processes and services)

Smith et al 2019 [Infectious disease and economics: The case for considering multi-sectoral impacts]
These involve the Health sector (e.g, Zika epidemic estimate costs $7-18 billion dollars), agricultural sector (50% livestock losses are from zoonotic disease); tourism and travel (SARS lost 41% international travel; H1N1 epidemic cost Mexico $2.8 billion dollars in pro and travel), trade and retail (SARS global economic loss=$40 billion dollars; Nipah virus $582 million dollars) 

This is why we need ONE HEALTH.


One Health Awareness Month Day 23: Economic Benefits of One Health: A Chronology of Thought from 201: Project
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