Hope Ferdowsian

CABI One Health (2023)

https://doi.org/10.1079/cabionehealth.2023.0005
One Health

COMMENTARY

A silent call for a socially and ecologically

just One Health approach
Hope Ferdowsian1,2

Abstract
In 1962, the world began reading biologist Rachel Carson’s warnings of a silent spring, which challenged the claim that humans
are separate from nature. Carson wrote of a hidden danger—a synthetic insecticide known as DDT—threatening human and
nonhuman lives. She warned of how birdless skies and fishless waterways foreshadowed what could happen to humans—
ultimately ushering in an environmental movement and a transformation in national and international policy.

One Health Impact Statement

This article is an invited commentary that illustrates the need for a socially and ecologically just One Health approach and how the author
arrived at this evidence-based view throughout her own medical and public health career.

Introduction that the field could advance a more socially and ecologically just
view of health, as Carson maintained. Over the next two decades,
In 1962, the world began reading biologist Rachel Carson’s warnings I would work with others on these issues, though primarily in the
of a silent spring, which challenged the claim that humans are distinct silos of medicine, public health, ethics, human rights, and
separate from nature (Langston, 2012). Carson wrote of a hidden animal protection. In books and essays, I would begin to express
danger—a synthetic insecticide known as DDT—threatening how the visible and invisible violence that other-than-human
human and nonhuman lives (Carson, 1962). She warned of how animals experience in homes, communities, and industries creeps
birdless skies and fishless waterways foreshadowed what could into human society—from cages and family separation to barren
happen to humans—ultimately ushering in an environmental environments that injure the literal and figurative hearts of humans
movement and a transformation in national and international policy and animals alike (Ferdowsian, 2018).
(Bekoff and Nystrom, 2004; Dunn, 2012).
Meanwhile, a growing legion of physicians, scientists, and
I bought a used copy of Silent Spring during one of my clinical public health specialists were beginning to acknowledge the
years in medical school. By my third year, I had considered connections that Carson wrote about. This time, the culprit was not
dropping out. Despite a genuine curiosity about the lives of Dichlorodiphenyltrichloroethane (DDT) but a never-before-seen virus.
patients and the diseases that ailed them, reductionist remedies
seemed incomplete. More deeply, stories about how society had
failed patients persisted. A virus with a crown
By that point in my life, I could also better articulate what I In 2003, scientists discovered a threat that could spread through
understood as a child—that the sheep, chickens, bees, and cows the air like the flu—a novel virus with a crown (a coronavirus) called
living and dying around me were as caught up in society’s failures SARS-CoV, the pathogen that causes SARS. Although there are
as humans are. As Carson suggested, the crop dusting of the field many endemic zoonoses, SARS was considered the first life-
across from our home in rural Oklahoma affected them, too, and threatening, easily transmissible, animal-borne disease to emerge
the ways they were treated mattered. in humans in the twenty-first century (Mackenzie and Jeggo, 2019).
When I bought my first copy of Silent Spring, I had no idea that SARS-CoV is believed to have originated in cave-dwelling bats and
it would be as impactful as my first stethoscope. The worn, dog- to have spilled over to civet cats and then to humans. Soon after
eared text bought over twenty years ago still sits on my bookshelf its discovery, scientists, health professionals, and conservationists
next to newer copies of Carson’s earlier books about the wonders began using the term One Health more regularly to describe the
of the sea. Instead of abandoning my medical studies, I realized interconnected health and well-being of humans, other animals,

Correspondence: 1Phoenix Zones Initiative, 13170-B Central Avenue SE, PMB 385, Albuquerque, NM, 87123, USA; 2Department of Internal
Medicine, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA
Corresponding author: Hope Ferdowsian. Email: [email protected]
Submitted: 15 December 2022. Accepted: 07 February 2023. Published: 15 March 2023
© The Author 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in
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Hope Ferdowsian CABI One Health (2023) https://doi.org/10.1079/cabionehealth.2023.0005  2

plants, and the broader environment, and the need for collaboration to captive and free-living animals, workers, and communities
within human and animal medicine, public health, and the social disproportionately comprised of immigrants and people of color,
and biological sciences (Mackenzie and Jeggo, 2019; Osofsky and the environments upon which these individuals depend
et al., 2003). The term emerged throughout various institutional (MacDonald, 2021). Until recently, more attention has centered
contexts, including veterinarian Calvin Schwabe’s use of the term on mitigating the risk of emerging infectious diseases in these
“One Medicine” to argue for a more interdisciplinary approach to industrial systems of exploitation than on eliminating their root
medicine (Cassidy, 2017). causes through just transitions away from these industries
(Bruun, 2021; MacDonald, 2021). Intergovernmental operational
It would take more time to realize that the SARS outbreak was a
frameworks and finance mechanisms linked to One Health have
missed opportunity to challenge long-standing assumptions about
yet to incorporate the latter approach (The World Bank, 2018; FAO
our relationships with each other, other animals, and our shared
et al., 2022).
environments. Perhaps the threat did not seem as acute then as
it does now. Fewer than 800 people died of SARS, and within six One Health approaches that ignore the primary drivers of
months of its identification, the World Health Organization (WHO) interlinked threats to humans, animals, and the environment are
declared the global outbreak of SARS over (WHO, n.d.). But, as incomplete as the reductionist patient model that I learned in
by late 2019, another virus with a crown emerged. It was soon medical school. Fortunately, this patient model has since been
identified as SARS-CoV-2, the coronavirus that causes Covid- augmented by an emphasis on the connections between health
19. Although the precise origins of SARS-CoV-2 are uncertain, and justice (McKenzie et al., 2020). Within medicine and public
most experts believe it emerged through another spillover event health, there is now broad consensus that physical and mental
involving a bat and one or more animals at a live market (Hu et al., health outcomes are determined by whether one’s rights are
2017; Maxmen, 2022; Worobey et al., 2022). recognized—through social, economic, environmental, legal, and
political frameworks (Mann et al., 1994; Farmer, 1996; Gostin
The natural world has many barriers to prevent pathogen
et al., 2019; Dawes et al., 2022).
transmission between humans and other animals. Space and
time, normal weather and migration patterns, biodiversity, and It is now also clear that nonhuman animals need access to basic
healthy social and ecological relationships all provide natural rights to be healthy (Cavalieri, 2001; Garner, 2002; Wise, 2002;
barriers to disease emergence. Destroying these natural barriers— Sunstein, 2003; Ferdowsian, 2018; Ferdowsian, 2021; Sellars
through changes in ecosystems and land use, intensive farming, et al., 2021). To meet the needs of nonhuman animals, the law
and trade—can lead to spillover events and more diseases. and treatment of animals will need to change. Currently, humans
More deeply, the commodification of animals in food and clothing are viewed as subjects of law, whereas other animals are viewed
production, research, entertainment, and other areas of society has as instrumental objects for human use (Wettlaufer et al., 2021).
disrupted normal barriers that protect humans and other animals. Although there have been some advancements in animal welfare
For nonhuman animals, the risks of commodification extend beyond laws nationally and internationally, nonhuman animals still do
the toll of novel viruses to include the fear, pain, and suffering that not have legally recognized rights. And there is still no worldwide
come with captivity, invasive procedures, and being killed. international treaty governing the treatment of animals (Georgetown
Law Library, n.d.; Global Animal Law Association, n.d.), which
Unfortunately, many scientists believe that Covid-19 is not the
impedes their ability to achieve social, physical, and psychological
“big one” (Davey, 2020). Today, the threat of a silent spring looms
health and well-being (Ferdowsian, 2018; Ferdowsian, 2021;
even larger than it did when Carson’s words first highlighted our
Sellars et al., 2021).
interdependence with other animals, plants, and the rest of the
natural world. Likewise, although there have been advancements in human
rights law—and a recent resolution recognizing the human right
to a clean, healthy, and sustainable environment (Human Rights
Justice as a prerequisite for health Council, 2021)—nations including the United States have yet to
ratify key international human rights treaties (Abaya et al., 2022;
The notion of One Health traces back in time to ancient civilizations
OHCHR, n.d.). Enforcement of international law remains an issue
and Indigenous Traditional Knowledge (Evans and Leighton, 2014;
in multiple areas of the world where women, children, and racial,
Jack et al., 2020), and the concept made its way to medicine
ethnic, and other minorities are deprived of their rights. Integration
by the nineteenth century when physician-pathologist Rudolph
of these concerns in One Health approaches lags, though
Virchow noted that there is no clear dividing line between the
frameworks that emphasize Indigenous Traditional Knowledge,
basis for human and animal medicine (Lindenmayer and Kaufman,
gender equity, and rights-based action plans have been proposed
2021). Now adopted by intergovernmental organizations and
(Garnier et al., 2020).
international financial institutions, One Health is increasingly used
in international agreements, funding decisions, research, and A One Health view could help to address many of our problems,
development programs. Unfortunately, these approaches often but only if it places rights and justice—within our species and with
remain trapped in the myopic paradigm of human invasion and other species—at the center of global and local policy, research,
dominance that Carson warned of. and practice. Needed now are international, national and local
social, economic, and legal frameworks that move beyond
As other authors have noted, modern One Health approaches
anthropocentrism, commodification, and simple disease measures
encompassing agriculture, public health, disease control, and
to incorporate the rights, health, and well-being of humans, other
conservation measures are commonly rooted in colonial
animals, and the rest of the natural world. Human-centered
engagement and ignorant of local human knowledge and
frameworks are insufficient to tackle interconnected problems
nonhuman knowledge (Laine and Morand, 2020). Too often,
that pose an existential threat to human and nonhuman beings
conventional One Health approaches reinforce ongoing human,
(Ferdowsian, 2021).
animal, and environmental commodification in food production,
research, international trade, and other areas of society—fueling As a human rights and public health physician, I have seen what
inequality, violence, and the triple planetary crisis of climate is possible. In the eastern part of the Democratic Republic of the
change, air and water pollution, and biodiversity loss (Ferdowsian, Congo (DRC), one can plainly see how the invasion of human
2018; Ferdowsian, 2021; Sellars et al., 2021; UNFCCC, n.d.). and animal communities by foreign mining companies has fueled
For example, over the last several decades, the model of food war and human-animal conflict, sexual violence against the most
production embedded in industrialized countries—and bolstered vulnerable women and children, and air and water pollution
by international finance institutions—has spread across the (Mukwege and Nangini, 2009; Beyers et al., 2011). Physical scars
world. Intensive animal farming has increased entangled threats from machetes and posttraumatic stress after rape or combat can
Hope Ferdowsian CABI One Health (2023) https://doi.org/10.1079/cabionehealth.2023.0005 3

be traced to social and ecological destruction. Publicly available Davey, M. (2020) WHO warns Covid-19 pandemic is ‘not necessarily
data have indicated that regions affected by “rape with extreme the big one.’ The Guardian. Available at: https://www.theguardian.com/
violence” are rich in mineral resources and under the control of world/2020/dec/29/who-warns-covid-19-pandemic-is-not-necessarily-the-
big-one (accessed 14 December 2022).
armed forces (Mukwege and Nangini, 2009).
Dawes, D.E., Amador, C.M. and Dunlap, N.J. (2022) The political
But in the same area of DRC, a sustainable alliance led by determinants of health: A global panacea for health inequities. Global
local leaders and communities also serves to reduce conflict Public Health. DOI: 10.1093/acrefore/9780190632366.013.466.
and violence, protect human and animal lives, and fuel the
empowerment of women and girls. For example, female rangers Dunn, R. (2012) In retrospect: Silent Spring. Nature 485, 578–579.
in Virunga National Park have broken away from headlines Evans, B.R. and Leighton, F.A. (2014) A history of One Health. Revue
about violence to protect animals and plant life living in the park scientifique et technique 33(2), 413–420.
(Nieddu, 2016). In surrounding areas of the park, Virunga Alliance
Farmer, P. (1996) On suffering and structural violence: A view from below.
has brought together public authorities, civil society, and other Dædalus 125(1), 261–283.
stakeholders to address poverty, sustainability, and stability—
despite ongoing challenges posed by exploitative industries (Parc Ferdowsian, H. (2018) Phoenix Zones: Where Strength is Born and
Resilience Lives. University of Chicago Press, Chicago, IL.
National des Virunga, n.d.). Two nations away, colleagues have
shared how local diversified plant-based agriculture and renewable Ferdowsian, H. (2021) Ecological justice and the right to health. Health
energy projects can help to lift a rural Ethiopian community out of and Human Rights Journal 23(2), 1–5.
poverty, reduce malnutrition and disease, and improve the chances Food and Agriculture Organization of the United Nations (FAO), United
that a child can learn and survive. These stories are manifestations Nations Environment Programme (UNEP), World Health Organization
of a socially and ecologically just One Health approach that Carson (WHO), and World Organisation for Animal Health (WOA) (2022) One
described using different words. Health Joint Plan of Action (2022–2026): Working Together for the
Health of Humans, Animals, Plants, and the Environment. FAO, UNEP,
Interventions that Carson inspired—collective action and WHO, and WOA, Rome. Available at: https://wedocs.unep.org/bitstream/
thoughtful innovation, guided by humility and empathy—are as handle/20.500.11822/40843/one_health.pdf?sequence=1&isAllowed=y
relevant today as they were when she penned Silent Spring. (accessed 20 January 2023).
Within the fields of human and veterinary medicine, public health,
Garner, R. (2002) Political ideology and the legal status of animals. Animal
and other professions touched by One Health, students and Law Review 8, 77–91.
practitioners can take note. Leaders can ensure that educational
competencies, professional expectations, research standards, and Garnier, J. et al. (2020) Helping to heal nature and ourselves through
policy initiatives reflect a socially and ecologically just One Health human-rights-based and gender-responsive One Health. One Health
Outlook 2, 22. DOI: 10.1186/s42522-020-00029-0.
approach. Academic, national, and international institutions can
also exhibit leadership through their own policies, projects, and Georgetown Law Library (n.d.) International and Foreign Animal
partnerships. After all, embedded throughout Carson’s writing is Law Research Guide. Available at: https://guides.ll.georgetown.edu/
the view that each of us has the power to alter current and future InternationalAnimalLaw/treaties (accessed 20 January 2023).
lives—for better or worse. Global Animal Law Association (n.d.) Legislation Database. Available
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CONFLICT OF INTEREST February 2023).

The author has no conflicts of interest to declare. Gostin, L. et al. (2019) The legal determinants of health: Harnessing the
power of law for global health and sustainable development. The Lancet
393(10183), 1857–1910.
ETHICS STATEMENT
The author confirms that the research meets any required ethical Hu, B. et al. (2017) Discovery of a rich gene pool of bat SARS-related
coronaviruses provides new insights into the origin of SARS coronavirus.
guidelines, including adherence to the legal requirements of the PLoS Pathogens. DOI: 10.1371/journal.ppat.1006698.
study country.
Human Rights Council (2021) The Human Right to a Safe, Clean,
Healthy and Sustainable Environment, UN Doc. A/HRC/48/L.23/
FUNDING STATEMENT Rev.1.
The author has no funders to declare.
Jack J.C., Gonet, J., Mease, A. and Nowak, K. (2020) Traditional
Knowledge underlies One Health. Science 369(6511), 1576.
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