Towards One Health impact assessment

One Health Impact Assessment (OHIA) is an extension from classical Health Impact Assessment (HIA), placing particular emphasis on interlinks between human, animal and ecosystem health, as well as animal health per se (Quigley et al. 2006; Winkler et al. 2013).

From an ecosystem health perspective, this should also extend to the social-ecological system as a whole. Thus, OHIA promotes a very broad consideration of potential health impacts linked to the development of projects, programmes or policies.

For example, the construction of a new road should not only be planned in a way to prevent road accidents and human safety, but also consider reducing the killing of wildlife and preventing livestock from accessing the road. Modern road construction addresses this extension already, but impact assessment could extend its indicators to the risks for humans and animals and express the impact in terms of human and animal mortality.

Similarly, the construction of a new dam in Africa potentially results in higher exposure to schistosomiasis for humans as well as livestock. In addition, livestock is likely to be exposed to liver flukes (eg Fasciola spp.). Such an integrated approach has been tested for humans and livestock on the shores of Lake Chad (Greter et al. 2015).

A further extension of OHIA is the economic evaluation of health impacts, including the expected cost to human and animal health. Considering the Sustainable Development Goals (Flückiger and Seth 2016), the One Health economic impact can be extended to include the social and ecological consequences of any large infrastructure developments. In particular, mining projects have far-reaching consequences which affect human and animal health. In Mongolia, for example, herders and their animals were displaced, losing both pasture resources and access to safe drinking water.

In complement to the impact assessment at the planning stage of a project, OHIA should monitor impact on human and animal health over the entire project cycle. This means impacts on human and animal health are monitored during the construction, operation and closure phases of a project such as a mining operation, a hydropower project or any other large development project. Even hospitals may also represent an environmental hazard if biological, chemical and radioactive waste is not properly handled.

Moreover, health impacts may not only be of concern in the early phases of a project development but potentially also in the long run and towards its devolution. For example, the closing of a nuclear power plant requires very careful and costly measures to avoid human and animal exposure to infrastructural and waste components. Nuclear energy is a prime example in this respect, demonstrating that the full societal and ecological cost is exorbitant, and thus it is in the long term not competitive against less efficient, but cleaner, energy systems.

We are not yet there, and many countries, in particular transition countries, will have huge needs for HIA and OHIA, aiming at disease prevention and health promotion in the agriculture, industry, energy and transport sectors in the future.

References

Quigley, R., L. den Broeder, P. Furu, A.Bond, B. Cave and R. Bos (2006). Health Impact Assessment International Best Practice Principles. Special Publication Series No. 5. Fargo, USA: International Association for Impact Assessment.

Winkler, M.S. et al. (2013). Untapped Potential of Health Impact Assessment, in: Bulletin of the World Health Organization 91, 298-305.

Greter, H. et al. (2015). Human and Animal Trematode Infections at Lake Chad. A One Health Approach to Schistosomiasis and Fascioliasis in Mobile Pastoralists and their Livestock, Tropical Medicine & International Health 20, 156 pp.

Flückiger, Y. and Seth, N. (2016). Sustainable Development Goals. SDG Indicators Need Crowdsourcing, in: Nature 531(7595), 448 pp.