ONE-HEALTH / ECO-HEALTH: INTEGRATED APPROACH

How to develop integrated knowledge on one-health / eco-health 

Published in 2016

Excerpts from: Biodiversity OneHealth EcoHealth workshop organised by the Belgian Biodiversity Platform

Full report available at: Biodiversity OneHealth EcoHealth workshop 

During our workshop held in Brussels on 6-7 October 2016, five key integration challenges were identified:
1. Data integration
2. Interdisciplinary & cross-sectorial collaboration
3. Developing soft skills
4. Recognition of One Health actions and research 
5. How can interdisciplinary/transdisciplinary research get published. 

The participants of the workshop were divided in subgroups of about ten participants. For each of these five areas, the subgroups discussed potential solutions as well as potential “success indicators” to assess and monitor the improvements of the integrated approach:

 

1. data integration

Key discussion questions proposed here were:

  • How to setup linked databases dealing with heterogeneous data?
  • What are the alternatives to standardisation of data?
  • How to keep the necessary level of complexity, diversity and heterogeneity in data while modelling complex socio-ecosystems? 

Participants brought up underlying questions of why data should be shared and pointed out that data sharing should not just be done for the sake of sharing data, but that it should be beneficial for all involved. They remarked that it is often difficult to decide which data should be shared, i.e. project specific or rather general data. In the discussions, three main theme crystallised; namely data access challenges, data quality and linking of databases.

  • With regards the data access challenges, participants pointed out that data ownership is often not clear-cut in interdisciplinary collaboration and that this may lead to tensions, as data ownership can be a competitive advantage. It was agreed that data exchange between well-collaborating scientists /consortia is usually not a problem, but relies on good working relationships and clear agreements which clearly define access and use so that the competitive advantage can be protected. It was recommended that some form of guidance on how to solve this in consortia would be beneficial. Because it takes time to set up these good working relationships, people should therefore – as a first step on the way to data sharing – establish relevant collaborations. Some people criticised the role of big organisations like the WHO that are gathering data centrally, but can sometimes be reluctant to share these data, even though these data are perceived to be public goods. They pointed out that these “big” organisations need to be reminded of their role and should be lobbied to make cleaned datasets publicly available and secure quality control. 

 

  • With regards data quality, participants remarked that this is always an issue, as there are no perfect data and quality of data can be highly variable. They recommended that any user always must bear this in mind and adhere to established professional data quality standards. It was agreed that having good meta-data is key to understanding the data and making a judgment on quality and consequently an informed decision on their use.  This was perceived to be a general data use/sharing challenge, a not necessarily a One Health challenge, even though there may be an additional level of difficulty due to differing professional standards. Users are advised to follow best practice when accessing such data and be prudent in use. Participants further observed that the accuracy of data can be more or less important depending on the purpose. Consequently, users are encouraged to ask themselves what exactly they want to know, e.g. answer big picture questions or detailed questions? 

 

  • When talking about linking databases, it was agreed that an important pre-requisite is to first harmonise data by sector and that sectors should spend time and effort into harmonisation and standardisation (“sectors need to do their homework”). Ideally, sectors would talk to each other to avoid duplicating databases. When using or linking raw data (not summarised or interpreted data), users should make sure to link those that have a similar structure to avoid linking apples with pears (e.g. OIE WAHID  and GBIF). Participants also emphasised that the use of online databases can be very efficient and easy if they are set up in the right way and fit for purpose. Hence, it was recommended to promote access to web-based platforms and facilitate their use. 

 

2. interdisciplinary and cross-sectorial collaboration

Key discussion questions proposed here were:

  • How to overcome the potential conflicts and gaps in knowledge across disciplines?
  • How to involve disciplinary institutions?
  • How to promote cross-sectorial collaborations among Environmental/natural resources management, public health, agriculture, rural development, land management sectors?
  • How to involve various types of stakeholders, intervening at different levels from local to transnational?
  • How to promote participatory processes? How to better articulate collective action and public actions? 

 

Several concrete suggestions for enhancing collaboration were developed during this discussion group:

  • Overcoming professional protectivity, in the human health sector in particular, by showing the mutual benefits of collaboration
  • Pool your data & cooperate (analysis and publication)
  • Education programmes across disciplines & early life education (children), education of other stakeholders (patients)
  • Participation of all actors, overcoming change “hierarchy”
  • Resources spent on integration
  • Proper management
  • Start with a specific problem with actors with a common goal
  • Bottom-up is the driver
  • Behavioural change - consumers ->  industries
  • Steering through democratic governance public-private partnerships towards fair, sustainable One Health/ Eco Health
  • Interdisciplinarity of publications, references, contributions & citations
  • Win-win situation based on clear service-level agreements
  • Policy makers (EU-national-international-…) impose some decisions regarding One Health/ Eco Health.

In terms of capacity building (opportunities and threats), the need for build-up of more structural support capacity needed for typical complex OneHealth/EcoHealth issues was raised. Indeed, if one waits with organising such capacity until a crisis occurs for which such capacity is needed, is often ineffective and too late. A solution may be considered in creating a new, broader, more encompassing institution which incorporates the relevant disciplinary and sectorial elements. The disadvantage may nevertheless be that by creating such, one creates new boundaries for outsiders, and again limits involvement of and collaboration with groups that for whatever reason are not included at first instance. This then becomes a new barrier in such collaboration, which, even if unintentional, could be counterproductive. More flexible, open formats, such as e.g. a community of practice, but with structural support to being able to function properly, could be a better way forward. Regional expert clusters/networks close to policy makers and activity of people in a cluster were also proposed. Networks can benefit from or form a basis for data sharing. Joint projects are good examples.

In terms of indicators for interdisciplinary and cross-sectorial collaboration, it was discussed that indicators could be the number of participants from different disciplines involved in the work. An interesting proposal for an indicator would be not so much on the outcomes side, but on the support side: how much resources, e.g. funding, are made available for such work/aims?

 

3. developing soft skills

Key discussion questions proposed here were:

  • How to promote behavior and attitudes enabling an interdisciplinary framework?
  • How to smooth interest conflicts and power relationships among heterogeneous stakeholders?
  • How to manage conflicting points of view about complex One Health issues?
  • How to promote interdisciplinary leadership?

From this brainstorming group exercise, the skills related to communication were considered to be important. Learning the jargon (scientific language) of disciplines you attend to collaborate with, but also interpersonal communication and science and political communication to be able to communicate well with policy makers.

 

The skills related more to the management of the collaboration were also often mentioned such as listening abilities, leadership skills, adaptability competences, team management (team building), inclusiveness, problem-based learning and finally, psychological skills.

But what was perceived to be at stake in order to promote behavior and attitudes enabling interdisciplinary was to build first of all common goals and also common One Health/ Eco Health language (terminologies, concepts,…). It was indeed essential to make use of an innate biophilia in One Health/ Eco Health (having a positive attitude regarding One Health/ Eco Health approach), but also to recognise your own limitations, be reflexive and therefore acknowledge cultural sensitivity (e.g. by adopting nonverbal communication skills). Responsiveness, media literacy, management of information and argumentative skills were also part of the One Health/ Eco Health competencies set identified to be necessary to manage conflicting points of view about complex One Health/ Eco Healthissues. Thinking out of the boxes and be creative were both very important skills to develop among the One Health/ Eco Health community.

Specific attitudes to include into One Health/ Eco Health competencies were flagged such as patience, flexibility, empathy, openness, tolerance, passion and ethics.
Finally, in term of knowledge, knowing the values and principles of others disciplines and their epistemology were something unavoidable to work together (e.g. develop the ability to understand financial aspects when you are an anthropologist).

Several remarks were raised by the participants during this group discussion. First of all these skills mentioned above are not only necessary for One Health but for any collaborative work and secondly they all referred to learning skills but what about teaching skills? In that sense, participants raised the need for more creativity, more applied courses and the use of new tools (e-learning, animation…) but also that actions are really needed in addition of education to create more meaning and challenging these new capacities learned in real life. One Health/ Eco Health soft skills should also be trained before being involved in our work/research, although it would be too late to change. As a final remark, a change of paradigm would be imperative to address One Health/ Eco Health learning challenges: Health (humans-animals-environment)/well-being oriented instead of diseases oriented.

 

4. Recognition of One Health actions and research

Key discussion questions proposed here were:

  • How to acknowledge the legitimacy of interdisciplinary/ cross-sectorial profiles and postures?
  • How to recognise the relevance of the process of building interdisciplinary/ cross-sector approach?
  • How to acknowledge that building an integrated framework is a research topic/ an intervention in itself? 

Several indicators were brought forward:

  • Funding available for interdisciplinary research
  • More actors joining the One Health/ Eco Health community
  • Research data are made known to more stakeholder groups, e.g. through open data.
  • Several steps forward were proposed:
  • Avoid misuses of One Health concept which harms recognition
  • Bridge the gap between policy makers and scientists
  • Focus scientific work on practical problems in real life and then involve scientists to help solving the problems with research
  • If more people use One Health/ Eco Health terminology and labels, then there is more recognition
  • If policy makers think in One Health/ Eco Health frameworks
  • Create case studies with tangible benefits and impacts of One Health/ Eco Health approach –sometimes unexpected synergies an be shown; comparative case research
  • Getting dis-aggregated data of social groups when doing assessments. In Bolivia, working with women especially helps because they are in charge of many health-related family activities
  • Policy committees having members from One Health/ Eco Health sectors: animal, human, environment
  • Clarify interrelations and then build linkages with scientific disciplines
  • Get Board members who have a One Health concept in mind when they take decisions
  • Green light from hierarchy to work on One Health/ Eco Health, even if it may take more time to show impact
  • When One Health/ Eco Health concept is part of veterinary, medicine and environmental education systems. Need to build transdisciplinary One Health/ Eco Health curricula that also give accreditations.

 

5. How can interdisciplinary/transdisciplinary research get published

Key discussion questions proposed here were: 

  • How to promote scientific excellence while elaborating interdisciplinary research at individual and collective (institutional) level?
  • Interdisciplinary/transdisciplinary research has great difficulties in getting published in scientific journals
  • Especially in the most well-known and most prestigious journals. 

The main problems that are faced while entering in the process of publishing One Health/ Eco Health research is that authors tend to always target the same audience with dedicated journals. Indeed, they face disciplines frontiers, that are shaping the editorial board and lead to rejection of the manuscripts. The group stated the same issue regarding projects funding, evaluation of proposals, as it seems  not  easy to set-up efficient interdisciplinary committees (several domains with their own protocols).

 

Throughout the discussions, the group proposed some solutions to overcome these issues:

  • Taking leadership on editorial process (books, new journal etc.)
  • Influencing editorial boards, setting-up lobbying strategies involving new types of actors from media, political side, civil society
  • Identifying “Champion researchers” who should take responsibility in trying to influence editorial boards, and promoting interdisciplinary journals through increasing citations, research networks, invitation to conferences (as not only Impact factors but also citations can have an impact)
  • Promoting social sciences research on transdisciplinarity as a research question in itself and a process to be documented 
  • Changing the target: not only high Impact Factors (IF) journals, because practitioners do not read that type of publications but sometimes other journals, with lower academic impact get a lot of citations. 
  • High IF publications matter notably when authors want to gain legitimacy regarding donors. Some IF publications are then still needed.
  • Focusing also on the social impact of the research, developing a culture of impact assessment, valorising in the research system the impact of One Health/ Eco Health actions on policies etc.

 

Regarding the specific question of interdisciplinarity promotion, the participants raised the fact that it can be addressed in different ways regarding the institutions and also cultural area (better acknowledgment and recognition of interdisciplinarity in Anglo-Saxon countries?). Interdisciplinarity can be promoted by involving persons from different disciplines in the committees for selection of researchers to be recruited or evaluation or of scientific papers. 

As a conclusion, taking ownership of interdisciplinary work is a long process and calls for some innovations in team work and scientific career management.