One Health cannot fulfill its promise without health promotion

One Health has become a defining framework for addressing health challenges that transcend the boundaries of human, animal, and environmental health. Its growing prominence has strengthened global efforts in zoonotic disease control, antimicrobial resistance, food safety, and pandemic preparedness.^[1] However, in some settings, One Health policy and practice have tended to emphasize surveillance, early detection, and emergency response. Although these functions are indispensable, they have also contributed to a predominantly reactive approach that responds to health threats after they emerge rather than preventing the conditions that allow them to arise.

This emphasis on response risks overlooking one of the most important lessons in public health: sustainable health begins with prevention. Health promotion has long recognized that improving health requires more than treating disease. It requires addressing the social and environmental determinants of health.^[2-4] These principles closely reflect the philosophy of One Health, yet they remain insufficiently integrated into its implementation.

The disconnect is increasingly evident in the growing challenges of climate change, biodiversity loss, environmental degradation, and changing patterns of land use. These interconnected pressures not only threaten ecosystems but also create favorable conditions for emerging infectious diseases, food insecurity, and antimicrobial resistance.^[1,5] Although surveillance systems can identify these threats at an earlier stage, they cannot always address the upstream drivers responsible for their emergence. A preventive approach that promotes healthy ecosystems, sustainable livelihoods, and informed communities is therefore essential for reducing future health risks.

Health promotion provides this preventive perspective by shifting attention from disease control to health creation. Community engagement, health literacy, behavioral change, and intersectoral collaboration are fundamental strategies for building resilient societies. When communities are empowered to participate in decisions about their health and environment, interventions become more acceptable, sustainable, and equitable.^[3,4] Likewise, policies that promote environmental protection, sustainable agriculture, clean water, and healthy living conditions generate benefits for people, animals, and ecosystems alike.

Another overlooked opportunity lies in the Health in All Policies approach. This recognizes that decisions made outside the health sector profoundly influence population health.^[6] Agriculture, urban planning, education, environmental management, transport, and economic development all shape the conditions in which health is created or undermined. Integrating this perspective into One Health would encourage stronger collaboration across sectors, helping to move the framework beyond institutional silos towards shared responsibility for health.

Integrating health promotion into One Health does not diminish the importance of surveillance or emergency preparedness; instead, it complements these efforts by addressing the root causes of health threats before they escalate into crises. Investing in healthier environments, stronger communities, climate resilience, responsible antimicrobial use, and sustainable food systems offers greater long-term benefits than relying solely on increasingly sophisticated surveillance and response mechanisms.^[5]

This shift is particularly relevant in the context of the Sustainable Development Goals, where health, environmental sustainability, food systems, climate action, and social equity are closely interconnected.^[7,8] A One Health approach grounded in health promotion is better positioned to support these shared objectives because it prioritizes prevention, participation, and long-term resilience over short-term crisis management.

Repositioning health promotion at the center of One Health would transform the framework from a predominantly disease response model into one that places greater emphasis on prevention. This transformation would help create healthier people, healthier animals, and healthier ecosystems. Such a transition is essential if One Health is to fulfill its promise of achieving sustainable and equitable health for present and future generations.^[8,9]

The future of One Health should be defined not only by its ability to respond to emerging health threats but also by its capacity to prevent them. Achieving this vision requires embedding health promotion at the core of One Health policy, practice, education, and research.^[1,2]

Governments should strengthen cross-sector collaboration by bringing together public health, veterinary, environmental, agricultural, and educational sectors under a shared preventive agenda. Equal emphasis should be placed on creating supportive environments, improving health literacy, empowering communities, and developing healthy public policies that address the social, environmental, and behavioral determinants of health.^[2,6] Community participation should also be a cornerstone of One Health implementation, ensuring that interventions are locally relevant, culturally appropriate, and sustainable.

Future investments should extend beyond surveillance and outbreak preparedness to include preventive strategies that promote environmental stewardship, climate resilience, sustainable food systems, responsible antimicrobial use, and biodiversity conservation. At the same time, academic institutions should strengthen interdisciplinary education and training to prepare a workforce capable of translating One Health principles into coordinated action across sectors.^[5,8]

Integrating health promotion into One Health is not about replacing existing priorities but about strengthening the framework through prevention. A One Health approach that invests in healthier people, healthier animals, and healthier ecosystems before crises emerge will be better equipped to address the complex health challenges of the future.

Ultimately, the success of One Health should be measured not only by how effectively it responds to outbreaks but also by how successfully it prevents them and promotes long-term health resilience.

One Health has transformed how we understand the interconnected health of people, animals, and the environment. Yet its long-term success depends not only on responding to emerging threats but also on preventing them. Integrating health promotion into One Health shifts the focus from responding to health crises to preventing them by addressing the root causes of disease and creating healthier communities and ecosystems. Ultimately, One Health cannot fulfill its promise without health promotion.