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Implementing One Health as an integrated approach to health in Rwanda
  1. Thierry Nyatanyi1,2,
  2. Michael Wilkes3,4,5,
  3. Haley McDermott3,6,
  4. Serge Nzietchueng2,7,
  5. Isidore Gafarasi8,
  6. Antoine Mudakikwa9,
  7. Jean Felix Kinani9,
  8. Joseph Rukelibuga10,
  9. Jared Omolo10,
  10. Denise Mupfasoni10,
  11. Adeline Kabeja11,
  12. Jose Nyamusore11,
  13. Julius Nziza4,
  14. Jean Leonard Hakizimana11,
  15. Julius Kamugisha11,
  16. Richard Nkunda11,
  17. Robert Kibuuka4,
  18. Etienne Rugigana4,
  19. Paul Farmer5,6,12,
  20. Philip Cotton4,
  21. Agnes Binagwaho5,12
  1. 1Ministry of Health, Kigali, Rwanda
  2. 2University of Minnesota, Minneapolis, Minnesota, USA
  3. 3University of California Davis, Davis, California, USA
  4. 4University of Rwanda, Butare, Rwanda
  5. 5Harvard Medical School, Boston, Massachusetts, USA
  6. 6Partners in Health, Rwanda
  7. 7USAID Preparedness and Response Project
  8. 8Rwanda Agricultural Board, Kigali, Rwanda
  9. 9Rwanda Development Board, Kigali, Rwanda
  10. 10Centers for Disease Control and Prevention (CDC), Kigali, Rwanda
  11. 11Rwanda Biomedical Center, Kigali, Rwanda
  12. 12University of Global Health Equity
  1. Correspondence to Dr Michael Wilkes; mswilkes{at}ucdavis.edu

Abstract

It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, non-governmental and educational agencies. ‘One Health’ refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation. As in most countries, the health of Rwanda's people and economy are highly dependent on the health of the environment. Recently, Rwanda has developed a One Health strategic plan to meet its human, animal and environmental health challenges. This approach drives innovations that are important to solve both acute and chronic health problems and offers synergy across systems, resulting in improved communication, evidence-based solutions, development of a new generation of systems-thinkers, improved surveillance, decreased lag time in response, and improved health and economic savings. Several factors have enabled the One Health movement in Rwanda including an elaborate network of community health workers, existing rapid response teams, international academic partnerships willing to look more broadly than at a single disease or population, and relative equity between female and male health professionals. Barriers to implementing this strategy include competition over budget, poor communication, and the need for improved technology. Given the interconnectedness of our global community, it may be time for countries and their neighbours to follow Rwanda's lead and consider incorporating One Health principles into their national strategic health plans.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Handling editor Seye Abimbola.

  • Twitter Follow Jean Felix Kinani @ohac_gorilla, jfkinani, gorillahealth

  • Contributors The following are members of the One Health Strategic Planning Task Force, Ministry of Health, Rwanda: TN, SN, IG, AM, JFK, JR, JO, DM, AK, JNy, JNz, JLH, JK, RN, RK, ER, PF and AB provided guidance on this project. TN and MW were the primary authors. TN is the guarantor of the article. TN, MW, SN and HM drafted and revised the paper based on comments from all members of the One Health strategic planning task force. All members of the strategic planning committee developed the plan for the paper. PC provided review and comments on drafts of the paper. PF and AB reviewed the final draft of the paper and provided comments.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Transparency declaration TN, the manuscript's guarantor, affirms that the manuscript is an honest, accurate and transparent account of the study being reported, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.