One Sustainable Health for All: How to Go from Cascading Crises to an Integrated Policy Response

DOI: https://doi.org/10.25453/plabs.32788503

Published on June 25th, 2026

In May 2026, the One Health Summit, organised in Lyon by the French Presidency in the context of the One Planet Summits and the G7, brought together actors from the Global North and South to address the planetary health challenges collectively. WHO's subsequent announcement of a global network of One Health Institutions, anchored in part by the WHO Academy in Lyon as a training hub for practitioners and policymakers alike, confirms that the architecture is being built.  

Here we explain the why and how of this much-needed initiative. 

The diagnosis: fractured governance compounds crises 

The health of people, animals, plants and ecosystems is deeply interconnected — yet the institutions responsible for governing these domains remain stubbornly siloed. This structural misalignment is now a primary obstacle to effective action, and the current political context is making it worse. 

Multilateral and national institutions that historically served as custodians of global health common goods — from the Quadripartite to national public health agencies — are being undermined and budgets are under threat, resulting in a significant reduction in available resources and capital, creating challenges for future planning and operation. Data, once a shared scientific asset, is increasingly weaponised in areas where it was never previously weaponised, such as health. This is the result of a transactional logic that prioritises national advantage over collective benefit. The “most favoured nation” concept, designed to share benefits in trade, is being usurped to designate predatory monopolisation of information and data flows in ways that fracture the cooperative infrastructure on which One Health depends. 

Meanwhile, the scientific evidence is unambiguous. Climate change is accelerating the spread of both non-communicable and infectious diseases, including those that are vector-borne, while also degrading the ecological buffers that limit pathogen spillover to susceptible species. Biodiversity loss weakens ecosystem resilience. Environmental pollution compounds chronic disease burdens. Antimicrobial resistance — driven simultaneously by overuse in human and veterinary medicine, livestock production, aquaculture, and agriculture — threatens to render routine infections untreatable worldwide. Food systems, accounting for a major share of global greenhouse gas emissions and freshwater use, remain misaligned with both nutritional equity and ecological sustainability [1-5]. 

Critically, the knowledge needed to act largely exists. What is blocking progress is not lack of understanding of the problem, but institutional inertia: sectoral Pavlovian reactions (i.e., the tendency to revert to familiar routines even when better alternatives exist), parochial silo thinking, misaligned incentive structures, an unwillingness to change business models, and a reluctance to shift from crisis management towards more investment in prevention and preparedness [6]. This reluctance towards prevention leads to crises — a bias that imposes its heaviest costs on low- and middle-income countries [3] and undermines sustainability worldwide. 

The policy imperative: from “more data” to “decision-grade” integrated knowledge 

Translating the One Health agenda into policy requires more than evidence — it requires decision-grade evidence: data and knowledge systems explicitly designed and structured to support cross-sectoral policy and action [7]. Demonstrated correlation must lead to action — or to a justified political decision to refrain from action. It is precisely this accountability that makes well-used data so powerful: a force capable of driving change and challenging entrenched historical models. 

Inspiration can be drawn from data-sharing frameworks that transformed other sectors — Open Banking in Europe, India's Unified Payments Interface data empowerment and protection architecture, and Brazil's Open Finance system. Each pairs secure interoperability, consent management and regulatory oversight to build trust-based information ecosystems. Open Banking transformed financial services by mandated standardised APIs and equitable access rules enabling data portability, innovation and transparency without compromising privacy. The health sector can adopt the same logic: an "Open One Health Data" model exemplified by Data Africa would democratise access to development data while advancing interoperability, transparency, and data sovereignty, permitting authorised institutions, researchers, and communities to access and contribute to interoperable datasets under shared governance principles — balancing data protection with utility, empowering citizens over their own information, and catalysing the cross-sector integration One Sustainable Health requires. 

Emerging African experiences reinforce the point. Kenya's national digital health strategy and health information exchange framework are laying foundations for secure interoperability; Rwanda's investments in digital public infrastructure and integrated health information systems show how cross-institutional data sharing improves service delivery and public health decisions, and at the continental level, the Africa CDC's regional surveillance platforms and data-sharing mechanisms affirm that health security depends on trusted, cross-border data ecosystems — concrete building blocks for a future African "Open One Health Data" architecture. 

Advances in environmental monitoring — including satellite technologies, remote sensing, epidemiological surveillance, and data integration — offer new opportunities to detect risks earlier and guide adaptive policy. Strengthening these knowledge systems is essential for managing climate impacts, monitoring pollution and protecting biodiversity and ecosystem services [1, 9]. 

Seven criteria, at a minimum,must be respected: 

1. Data and analysis must be supportive of explicit policy decisions — antimicrobial use stewardship, food safety regulations, vaccination strategies, land-use controls and urban planning. Policymakers shape questions and use cases, not scientific conclusions, thus preserving academic freedom. 

2. Quality is non-negotiable: provenance, reproducibility, uncertainty bounds and auditability must be defined and maintained; 

3. Time series, not snapshots, are essential to detect trends, thresholds and intervention effects;  

4. Data must be structured, standardised and interoperable — common vocabularies, metadata and linkable geographies enabling human, animal, plant and environmental datasets to be joined and feedback loops established;  

5. Critically, equity must be embedded from the outset. Data systems must be governed not only by FAIR principles (Findable, Accessible, Interoperable, Reusable), but also by CARE principles (Collective Benefit, Authority to Control, Responsibility, Ethics) — ensuring that low- and middle-income countries both contribute to and benefit from shared knowledge infrastructures [3];  

6. Outputs must be machine-actionable for AI-guided analysis;  

7. Data systems must also be institutionally anchored through sustained financing and stewardship roles that survive electoral cycles. 

Real-world examples of decision-grade designs for policy and action exist. The Copernicus Atmosphere Monitoring Service demonstrates how heterogeneous data on air pollution and health, solar energy, greenhouse gases and climate forcing can be converted into decision-relevant operational forecasts through structured science-policy interaction — without politicising science.  

Rift Valley fever early warning systems demonstrate what becomes possible when environmental, animal and human data are synthesised: rainfall anomalies, livestock outbreak dynamics and human exposure data combined to generate risk forecasts that trigger targeted vaccination, vector control and risk communication before outbreaks escalate [5]. Similar initiatives with One Health–relevant coordination have been implemented e.g. in Brazil (ArboAlvo Dengue Surveillance System) and India (National One Health Mission), or global efforts such as the Lancet Countdown that tracks health metrics and climate indicators and the Pathfinder Initiative’s Evidence Bank which aims to provide implementable solutions for better policies through data.

Digital twin frameworks for pandemic monitoring further demonstrate that real-time, cross-border data integration can power adaptive, prevention-oriented decisions — but only if international agreements on equitable data sharing are in place [11]. 

These closed-loop models, connecting surveillance to policy to action and back, are the governance architecture One Sustainable Health demands. Financing must follow the same logic: traceable blended public-private mechanisms, aligned with the UN 2030 SDG framework [12], must structurally reward prevention over response — making resilience investable and distributing benefits equitably. 

Translating this agenda into practice requires institutional infrastructure that bridges silos at several levels without replacing them — working across mandates, accountable, multi-stakeholder, and designed to embed integration into practice rather than merely advocate for it. This endeavor requires action at the national, regional, and global level, ensuring that the most effective experiences are documented, shared and scaled for the benefit of all. 

The One Sustainable Health for All Foundation (OSH4A)and its associated initiatives, including OSH Forum, the resulting OSH Declaration, Conference reports, OSH Factory and the emerging “interactome” platform currently being developed with the Virchow Foundation, are designed precisely as this kind of test bench. Bringing together governments, academics, the private sector and civil society — including youth — the Forum operationalises interdisciplinary working groups that co-design decision-grade knowledge products and translate them into implementable policy recommendations aligned with the UN 2030 Agenda [12].¹

In a political moment defined by the erosion of multilateral trust and the weaponisation of data, the Forum's mission lies not only in convening expertise, but in demonstrating — through accountable, institutionally anchored practice — that science-grounded, equitable, multi-stakeholder action on interconnected health threats remains both possible and necessary. 

¹ The forum’s structural contribution is threefold: fostering the cross-sector relationships and shared analytical frameworks that integrated policy requires; piloting governance arrangements — mandates, accountability mechanisms, data infrastructures — that can be evaluated and scaled; and nurturing the next generation of leaders capable of navigating cross-domain complexity [7, 10].

References

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2. Destoumieux-Garzón D, Mavingui P, Boetsch G, et al. (2018). The One Health concept: 10 years old and a long road ahead. Frontiers in Veterinary Science, 5, 14. 

3. Winkler A et al. (2025). The Lancet One Health Commission: harnessing our interconnectedness for equitable, sustainable, and healthy socioecological systems. The Lancet 406, 501–570. DOI: 10.1016/S0140-6736(25)00627-0 

4. HLPE (2020). Food security and nutrition: building a global narrative towards 2030. High Level Panel of Experts on Food Security and Nutrition, Committee on World Food Security, Rome. 

5. Mariner, J.C., Raizman, E., Pittiglio, C., Bebay, C., Kivaria, F., Lubroth, J., Makonnen, Y. (2022). Rift Valley fever action framework. FAO. https://doi.org/10.4060/cb8653en 

6. Ottersen OP, et al. (2014) The political origins of health inequity: prospects for change. Lancet. 383:630-667. doi: 10.1016/S0140-6736(13)62407-1. Epub 2014 Feb 11.  

7. Cvitanovic C, McDonald J, and Hobday AJ (2016). From science to action: principles for undertaking environmental research that enables knowledge exchange and evidence-based decision-making. Journal of Environmental Management, 183, 864–874. 

8. World Bank. 2022. Technical Note on Open Banking: Comparative Study on Regulatory Approaches. © World Bank. http://hdl.handle.net/10986/37483. 

9. Landrigan PJ, Fuller R, Acosta N, et al. (2018). The Lancet Commission on pollution and health. The Lancet, 391, 462–512. 

10. Science Advice Mechanism (2025). One Health Governance in the European Union. https://scientificadvice.eu/advice/one-health-governance-in-the-european-union/ 

11. Ekström AM and Ottersen OP (2023). Digital twin for pandemic monitoring and prevention: Urgent need for agreements for global data sharing. Proc. Natl. Acad. Sci. U.S.A. 120(40): e2311969120. https://doi.org/10.1073/pnas.2311969120 

12. United Nations (2015). Transforming our world: the 2030 Agenda for Sustainable Development (A/RES/70/1). https://sdgs.un.org/2030agenda 

Acknowledgement: The authors wish to thank Liv A. Watson, Data Foundation, for insights into the Open Banking Framework. 

Disclosure: Portions of the above text underwent structural revision, drafting, and editing with the assistance of AI-based language tools (GPT 5.3, Microsoft Copilot and Claude (Anthropic, claude.ai; Sonnet 4.6, 2025)). The authors reviewed and take full responsibility for the final content.  

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