Surveillance is a tool for creating information for decision-making. The activities and information created by health surveillance are therefore limited by the decisions it supports. Since most One Health programs target single diseases and aim to benefit only humans, OHS is currently limited to a small number of activities that produce a limited amount of information. If the decisions in One Health remain univariate in nature (have one outcome), there will be little or no need for change in the type of surveillance information produced. However, considering the impact of humanity on all species on this planet (and vice versa), it is imperative that health decision-makers begin to think about policy that aims to concurrently benefit people, non-human species, and the environment. This will require broadening of the scope of their responsibility and jurisdiction to include the health of many species. Changing health legislation and organizational structures is not an easy process. It will likely require a shift in societal values to the point where all species, ecosystems, and the environment are highly valued.
One Health practice, on the other hand, aims to implement solutions to health- related problems that provide multiple species benefits. It should be collaborative in nature, engaging a w'ide range of stakeholders, including those affected by the health problem in question, and those affected by proposed solutions. Solutions developed in this manner are more likely to be effective and sustainable than top-down approaches where health ministries develop policies with little or no engagement with stakeholders or affected communities. Because of the complex, multi-stakeholder nature of One Health practice, decision-making is likely to require more information and knowledge than is needed for single disease- species approaches.
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