This article is part of a series in which OECD experts and thought leaders — from around the world and all parts of society — address the COVID-19 crisis, discussing and developing solutions now and for the future. Aiming to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge, opinions expressed do not necessarily represent the views of the OECD.
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Pandemics are unique and transformational events, shaking our lives by exposing the vulnerability of Homo sapiens to previously unknown pathogens that will ultimately infect most human beings on the planet. But COVID-19 has done much more than this. It has exposed us to another type of vulnerability: that of the systems we operate in, including healthcare. It has also opened our eyes to the harsh reality that we live in a closed system, in which we are entirely interconnected and interdependent with other inhabitants and resources on planet earth. This awareness has paved the way to acknowledge that as a society we should embrace the One Health approach, which recognises the links between the health of humans, animals and the environment.
COVID-19 is the most measured event in history and it is showing us that such a health crisis has multiple social, economic and digital drivers, with many unexpected ramifications on the way pandemic unraveled. Pandemics, however, are not the only driver of our health or of the health of the planet.
We believe that it is time to approach health in a more inclusive manner through a new Circular Health model encompassing the intricate and novel links between our health and the health of this closed system.
We must acknowledge that since the turn of the millennium we have been experiencing several other challenges that concern our closed system and affect our health, for instance the climate and food crises. For example, we are aware of the devastating effect of rising temperatures on the health of our oceans, on the loss of biodiversity and on the migration of humans and animals. We are also well aware that the planet’s demographics will require more food to feed a world population expected to reach 9.7 billion by 2050, and at the same time we have committed to diminishing greenhouse gas emissions to reduce pollution and our CO2 footprint.
Following the conceptual blueprints of Circular Economy and Circular Agriculture, we believe that it is time to approach health in a more inclusive manner through a new Circular Health model encompassing the intricate and novel links between our health and the health of this closed system. With this in mind, the One Health approach could become the core of a greater interdisciplinary effort that is more inclusive and contemporary. This circular approach could be implemented by using the Sustainable Development Goals (SDGs) roadmap as an accelerator of convergence for health. All of the 17 goals have ties to the health of humans, animals, plants, and the environment, and it would seem reasonable to prioritise certain activities and capitalise on existing guidelines and commitments.
Linking health advances to the SDGs as an interdisciplinary effort has been suggested in the past by ad hoc committees and NGOs such as GAVI. We were inspired by a study and its graphic representation provided by GAVI, which pointed out how every SDG except 12, 14, and 15 can be facilitated if vaccination becomes more widespread (Fig1). In addition, the power of vaccination unveiled by the COVID crisis is now in the public domain and is widely considered a unique tool to control infectious diseases and preserve health.
Figure 1 - Circular health model applied to vaccination (adapted from GAVI)
As another real-life case study, we applied the Circular Health approach to the ongoing “silent pandemic”, Anti-Microbial Resistance (AMR), considered one of the greatest public health threats with a projected 10 million deaths per year by 2050. In Fig 2, we elaborate on the results and recommendations of the O’Neill Review to identify possible win-win relationships while both combating AMR and achieving multiple SDGs. Through this work, it appears that reducing the use of antibiotics intersects several SDGs (2, 14,and 15); at the same time, implementing actions within SDGs 4, 5, and 12 will facilitate increasing awareness and stewardship of AMR efforts. Moreover, dovetailing with SDG8, they would each promote the development of the human capital needed to contrast AMR. Empowered human capital will operate at both the general population level and the expert level. On one hand, reducing infections through higher vaccination rates (SDG3) and better hygiene practices (SDGs 6 and 11) will reduce the need to use anti-microbials. On the other hand, technological developments (SDG9) and local and global institutions (SDGs 16 and 17) are necessary to promote investment in novel antibiotics, effective surveillance mechanisms, and rapid diagnostics tools. In all these cases, increased access to resources, especially healthcare and electricity (SDGs 10 and 7), are fundamental to obtain long-lasting and widespread results.
Figure 2 - Circular health model applied to AMR (adapted from O’Neill Review)
The novelty of the Circular Health approach is to use the renewed post-COVID-19 health priorities as leading threads, or zipper concepts, promoting convergence of health related actions through the Sustainable Development Goals framework. Only by treating health as an essential resource within a closed system will be possible to advance it sustainably and address its complexity for the future.