12.6.1 Human Health

In relation to ‘human’ health – which typically dominates discussions of health in colonial spaces – it has long been established that Western biomedical approaches normalise deficit discourses upon Indigenous peoples and racism, resulting in health inequalities for Indigenous peoples.Footnote ³⁷ Calls for changes to the health system to both indigenise and decolonise primary care have led to a wide range of initiatives, including the ongoing leadership and advocacy of organisations such as the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Gayaa Dhuwi (Proud Spirit) Australia;Footnote ³⁸ research and programs stemming from the Poche Centres for Indigenous Health across the country and other research efforts such as the National Health and Medical Research Council (NHMRC) funded Decolonising Practice in Aboriginal and Torres Strait Islander Primary Health Care Project (2018–2023);Footnote ³⁹ the development of culturally valid clinical testing and best practice;Footnote ⁴⁰ and the establishment of Indigenous-led ‘best practice’ organisations such as the Lowitja Institute and the Balit Durn Durn Centre which prioritises culturally valid research,Footnote ⁴¹ knowledge exchange, and coordination and expansion of Social and Emotional Wellbeing Services to both non-Indigenous and ACCOs. While these examples represent a fraction of the initiatives that have been led by Indigenous peoples for decades, they are emblematic of the foundation pillars that drive the efforts of Indigenous peoples, communities, and organisations: a holistic conceptualisation of health and the criticality of self-determination.

12.6.2 Animal Health

Understanding of Indigenous Knowledges and the intersections between ‘animal’ health and ‘human’ health in a One Health context across Aboriginal and Torres Strait Islander communities has been evolving in recent years, led by Wiradjuri scholar Tamara Riley. Riley highlights that, while One Health aligns with Aboriginal and Torres Strait Islander Peoples’ holistic view of health, Australia’s current health systems do not ‘adequately account for the impact of animal and environmental factors that contribute to human health outcomes’.Footnote ⁴² Riley emphasises the importance of collaborative approaches at the ‘animal-human-environment interface’,Footnote ⁴³ stating that Indigenous governance and leadership is limited and argues in favour of an integrated national health system where Indigenous leadership and engagement is embedded through the development of strong networks and governance structures.Footnote ⁴⁴ Such an approach, which would create space for Indigenous communities to decide what to prioritise and what steps to take, aligns with the United Nations Declaration on the Rights of Indigenous Peoples.Footnote ⁴⁵

12.6.3 Environmental Health

Environmental systems across Australia create fertile ground for both indigenisation and decolonisation of systems, structures, and ways of doing. The need for such approaches has never been greater; since colonisation, Australia has lost 40 per cent of its forests and nineteen ecosystems are showing signs of collapse (or near collapse).Footnote ⁴⁶

The ‘2021 State of the Environment Report’ highlights that partnerships between Indigenous and Western approaches to biodiversity management show promise. The introduction and expansion of the Indigenous ranger programs and Protected Area programs – which combine traditional techniques with modern science approaches to protect ecosystems – create space for Indigenous communities to be directly involved and create ‘locally driven, country-specific approaches into biodiversity actions’.Footnote ⁴⁷ The Report noted, however, that despite their success, these ‘programs and opportunities to work on Country are limited’.Footnote ⁴⁸ There are many such examples where Indigenous Knowledges play a critical role in manifesting the outcomes that One Health is seeking to achieve, spanning across a wide range of fields including wildlife management,Footnote ⁴⁹ fire management,Footnote ⁵⁰ and so on, all of which suffer from similar resourcing constraints and practice and policy limitations.

13.2.1 In Medias Res

It was near the end of his opening remarks during a virtual press conference on 11 March 2020 that Dr Ghebreyesus lamented that a single word had managed to seize the world’s attention.Footnote ¹⁷ As Director-General of the WHO, Ghebreyesus had just briefed the media on the concerning rise in COVID-19 clusters.Footnote ¹⁸ Outside China, cases had increased thirteen-fold.Footnote ¹⁹ The number of affected states had tripled to well over a hundred.Footnote ²⁰ Globally, more than 100,000 infections had been documented, with some 4,000 lives already lost.Footnote ²¹ It was against this meteoric rise in epidemics that Ghebreyesus disclosed the WHO’s official position that COVID-19 had crossed a conceptual threshold to become a ‘pandemic’,Footnote ²² the one word he feared would dictate how the narrative would unfold from that moment on.

While the pronouncement was characterised by some media outlets as largely symbolic,Footnote ²³ Ghebreyesus stressed it was one the WHO did not issue lightly given the gravity of its impact. Speaking to this concern, Ghebreyesus observed how the term had the power to not only incite fear but also instil a sense of resignation, if not defeatism.Footnote ²⁴ Although Ghebreyesus did not expand upon the remark, its subtext was clear. In expressing concern that the WHO’s position might incline the public to consider the ‘fight [to be] over’, the Director-General laid bare the distinction, at least with regard to perception, between epidemics and pandemics,Footnote ²⁵ with the etymological root of the latter, pan demos, literally translating to all people.Footnote ²⁶ To employ a topical metaphor in light of Ghebreyesus’s repeated appeals to keep fighting,Footnote ²⁷ the distinction between epidemics and pandemics might be conceived as one between localised battles and a world war. While the former may be beyond one’s direct experience, the latter offers no retreat or safe harbour. But of course, the reality of pandemics proves far more bleak. Indeed, neither pacts of non-aggression nor declarations of neutrality can prevent a widespread disease from invading a nation’s borders. Unlike epidemics, then, pandemics affect all people. And insofar as they may be considered wars, they are ones that cannot be avoided – only survived. In addition to the WHO’s admission that the world had never witnessed a pandemic that could be controlled,Footnote ²⁸ further complicating efforts to contain the disease was the unprecedented nature of the outbreak itself. Not only did SARS-CoV-2 constitute a novel pathogen, but the world, Ghebreyesus stressed, had also never been forced to confront a coronavirus-based pandemic.Footnote ²⁹

While the rise in both cases and number of nations affected attested to the practical difficulties that lay ahead, what Ghebreyesus nevertheless underscored was that numbers alone failed to ‘tell the full story’.Footnote ³⁰ In stating that the WHO could not say ‘loudly enough, or clearly enough, or often enough [that] all countries [could] still change the course of [the] pandemic’,Footnote ³¹ what Ghebreyesus sought to impress upon the public was how the story of the pandemic – that is, of all people – was still in the process of being written and that their leaders had the power – both the literal and figurative authority – to shape how that story would end. But just as the Director-General was calling upon leaders to take steps to mitigate the spread of COVID-19, forces were already working to plot the conflict back to its origins in order to shape the dominant narrative, assign the roles of its pro- and an-tagonists, and construct the moral of the story writ large.Footnote ³²

13.2.2 Plotting the Backstory of the Pandemic

As fraught with consequences for public sentiment as it may have been to declare that the world was in the midst of a pandemic, the promotion of competing narratives to explain the origins of the novel virus proved concerning as well. Several accounts – some of them pure fiction – had been heavily promoted to become the dominant narrative in certain circles. One such theory asserted that SARS-CoV-2 had been leaked from the Wuhan Institute of Virology, a belief that still finds purchase given the facility’s close proximity to where the first cases were catalogued, as well as the facility’s multiple failures to follow through on biosecurity protocols.Footnote ³³ Another widely disputed theory contended that the coronavirus had been engineered as a bioweapon by the People’s Liberation Army of China.Footnote ³⁴ Yet another asserted that it had imported into China via frozen food products,Footnote ³⁵ the implication being that while China may have witnessed the first outbreaks, it was neither the source of, nor responsible for, the coronavirus’s emergence. While a definitive answer as to the origins of the pandemic may never be established, much less agreed upon in light of the political interests involved,Footnote ³⁶ the great weight of evidence continues to point to Wuhan’s Huanan Wholesale Seafood Market as the epicentre of the outbreak, or where the novel virus spilled over from animals into humans.Footnote ³⁷

Serendipitously carried out between May of 2017 and November of 2019, a pre-outbreak study tracing the source of a tick-borne disease to one of Wuhan’s live animal markets offered a compelling dataset for scientists to pore through.Footnote ³⁸ Substantiated by data gleaned from monthly visits to each of Wuhan’s four live animal markets, where wild animals were known to be sold as food or exotic pets, what the report illuminated was that roughly a third of the animals bore tell-tale signs of having been poached, such as leg-trap and gunshot wounds, with others likely having been bred in captivity.Footnote ³⁹ What the overall picture revealed was that the live animal markets were host to a diverse array of species, many of which were known hosts of disease-bearing parasites and zoonoses.Footnote ⁴⁰ All the more concerning was that practically all of the captive animals were stacked in cages and in poor condition, with the Huanan market featuring seven such wildlife shops.Footnote ⁴¹

Post-outbreak reports also pointed to the Huanan Wholesale Seafood Market as the most likely source of the outbreak. For example, a joint WHO-China review of COVID-19 cases associated 55 of the earliest 168 documented COVID-19 cases with the site.Footnote ⁴² In addition, the most comprehensive study to date found two lineages of the pathogen there,Footnote ⁴³ a detail that suggests the virus had jumped not once but twice from animals into humans and undercuts the view that the market was merely a super-spreader site.Footnote ⁴⁴ Furthermore, a spatial analysis conducted within the market returned numerous positive samples of the pathogen, with at least one stall returning multiple positive results and a metal cage in a back room also featuring traces.Footnote ⁴⁵ Notably, the stalls in this section of the market were associated with the sale of wildlife,Footnote ⁴⁶ with many of the animals, such as raccoon dogs, known to be highly susceptible to SARS-CoV-2.Footnote ⁴⁷ While the authors of the report could not definitively rule out the possibility that the virus had come from another source, the cluster of cases put the odds at 1 in 10,000,000.Footnote ⁴⁸ Although every outbreak proves unique, the trope that the COVID-19 outbreak fell into, however, was common; so much so that it might be described as merely a variation on a theme.

13.2.3 Variations on a Common Theme

In determining the Huanan Wholesale Seafood market to be the epicentre of the COVID-19 outbreak, the authors of the report buttressed their conclusion by observing how the trade and sale of captive wildlife in such markets have proven to be a ‘common theme’ in spillover events.Footnote ⁴⁹ Indeed, it was a variation on this theme that gave rise to the first documented case of Severe Acute Respiratory Syndrome (SARS) years before.Footnote ⁵⁰ Claiming roughly 1,000 lives across 29 countries,Footnote ⁵¹ the 2002 SARS epidemic was likewise caused by a coronavirus infection, with the pathogen traced to masked palm civets sold at a live market.Footnote ⁵² Such markets have proved hotbeds for zoonotic disease spillovers not just because they feature wildlife but also because the animals are often held in cramped, unsanitary, stress-inducing conditions. Indeed, wild animals in these settings have been documented suffering from numerous ailments, such as dehydration, open wounds, missing limbs, and so on.Footnote ⁵³ With a diverse array of species kept in close proximity, if not stacked one on top of the other, leading to an exchange of air, faeces, and urine, the stress induced by these unhygienic conditions further compromises their immune systems, increasing chances of the spread, mutation, and emergence of novel viruses and other pathogens.Footnote ⁵⁴ This concerning mistreatment has seen live animal markets characterised as ‘cauldron[s] of contagion’.Footnote ⁵⁵

Insofar as such spillover events represent a ‘common theme’ in a recurring narrative, one might be tempted to describe COVID-19 pandemic as having gone according to script, which, in many ways, it did. With its plot concerning the spread and response to a pandemic in an increasingly globalised world, the 2011 film Contagion prophetically – one might be tempted to say if such outbreaks were not so routine – dramatised almost this exact scenario: the transmission of a novel virus from bats to animals raised for food and ultimately into humans via live animal market-type conditions.Footnote ⁵⁶ Although MEV-1, the fictional pathogen in Contagion, was not a coronavirus, it was based on two real-life viruses, Hendra and Nipah, which affect equines and pigs, respectively, and are likewise transmitted by bats.Footnote ⁵⁷ Although the film saw its novel virus mutate in a pig as opposed to captive wildlife, the encroachment of humans into animals’ habitat, whether to clear land to farm domesticated animals or otherwise, has led to numerous viral spillovers events and remains a leading theory as to how SARS-CoV-2 emerged as well. Speaking to the conditions that led to the COVID-19 outbreak, the film’s director, Steven Soderbergh, stated, ‘Everybody we talked to when we were preparing that film, every expert, when we asked them how will the next one start, to a person, they said, wet market, Asia, there’s probably going to be a bat involved. Literally all of them.’Footnote ⁵⁸ Echoing this sentiment, Scott Burns, the film’s screenwriter, agreed that no crystal ball was necessary.Footnote ⁵⁹ In consulting with epidemiologists as to whether the prospect of a pandemic as contemplated by their script was within the realm of possibility, their answer was that the question of a pandemic was not one of if but when.Footnote ⁶⁰

While the purpose of the film was to capture, as a sociological study, how individuals and states would respond to such a crisis,Footnote ⁶¹ what Burns did not anticipate was how real life would fail to reflect the art they had intended to reflect real life. Put differently, what proved inconceivable was just how misguided, and even dangerous, responses by governments would be.Footnote ⁶² Of course, Contagion necessitated the conditions for a pandemic in order to dramatise its impact on society. Calling attention to the ability of states to prevent such outbreaks altogether, America’s top infectious disease expert, Dr Anthony Fauci, expressed incredulity as to how such markets could continue operating, stating, ‘It boggles my mind how[,] when we have so many diseases that emanate out of that unusual human-animal interface, that we don’t just shut it down’,Footnote ⁶³ which, notably, China ended up doing,Footnote ⁶⁴ although history suggests that the ban may only be temporary.Footnote ⁶⁵

While Dr Fauci’s recommendation proves sound given the recurring if dominant theme of animal markets giving rise to novel pathogens, the world would be remiss to ignore the emergence of infectious diseases arising out of other human–animal interfaces and in other parts of the world. Indeed, multiple zoonotic disease outbreaks have been documented both in the midst, or ‘shadow’, of the COVID-19 pandemic,Footnote ⁶⁶ as well as in its wake. In 2021, for example, the Indian state of Kerala witnessed an outbreak of Nipah virus, which features a 75 per cent mortality rate and is known to spread from fruit bats, its primary host, to pigs, as intermediate hosts, before infecting humans.Footnote ⁶⁷ In 2021, severe Salmonella cases rose in the United States due to the keeping of wildlife as pets.Footnote ⁶⁸ From its initial outbreak in May of 2022 to September 2022, over 60,000 cases of monkeypox, another deadly zoonotic disease, had been documented in 104 countries worldwide.Footnote ⁶⁹ In that same year, the United States reported an outbreak of swine flu resulting from a child’s attendance at an agricultural fair.Footnote ⁷⁰ Even after the WHO’s declaration that COVID-19 no longer constituted a global health emergency in May of 2023,Footnote ⁷¹ numerous outbreaks have continued to emerge. In November of that same year, Zambia reported an outbreak of anthrax, a bacterial disease that spills into humans via contact with ruminants, such as cows, goats, and sheep.Footnote ⁷² Yet another is an outbreak of psittacosis in late 2023 across Europe, with those who come into contact with birds, such as poultry workers, proving susceptible to contracting the deadly respiratory disease.Footnote ⁷³ Regardless of whether these outbreaks occurred before, during, or after the COVID-19 pandemic, many continue to linger. For example, with the outbreak of a highly pathogenetic avian influenza in the United States in February of 2022, more than 1,000 flocks in 48 states have been affected, leading to the deaths of over 82 million birds and counting.Footnote ⁷⁴ Having mutated to infect dairy cattle, the virus has spun off other variants and already spilled over into humans.Footnote ⁷⁵

Although they have not become widespread enough to constitute pandemics, these localised epidemics nevertheless form the substance of a collective narrative, one that offers universal lessons if world leaders wish to turn the page on a recurring story. Notably, it was a year after uttering the lone word he feared would diminish the world’s resolve that Ghebreyesus echoed a dire warning in calling for a new chapter to be authored: the question of the next pandemic, he said, was not one of if but when.Footnote ⁷⁶

13.3.1 A Clarion Call for Change

Adding his voice to those of over two dozen heads of state, Ghebreyesus, the first signatory in their joint letter, issued a clarion call for the negotiation of a pandemic treaty on 30 March 2021.Footnote ⁷⁷ At the time, COVID-19’s death toll was nearing 3 million,Footnote ⁷⁸ with roughly 130 million people having already been infected.Footnote ⁷⁹ As tragic as the loss of life proved in and of itself, the pandemic had also given rise to global human rights concerns, ranging from the imprisonment of journalists and healthcare workers seeking to combat misinformation to the implementation of intrusive surveillance practices,Footnote ⁸⁰ with marginalised groups bearing the brunt of harms.Footnote ⁸¹ As the joint letter attested, no one was spared. Indeed, the pandemic proved a difficult if much-needed reminder ‘that nobody is safe until everyone is safe’.Footnote ⁸² Calling out the fractures among states that COVID-19 had laid bare, the letter framed the pandemic as the greatest challenge the world had faced since the 1940s,Footnote ⁸³ an allusion to the devastation wrought by World War II. In observing how states at the time embraced multilateralism as a means to meet the moment, the letter articulated how state cooperation was needed yet again if global health and security, among other shared aims, were to be realised.Footnote ⁸⁴

Citing the need to protect future generations, the joint letter braided the continuing ‘fight’ against COVID-19 with a call for a ‘more robust international health architecture’, one grounded in the WHO with the purpose of serving to better ‘predict, prevent, detect, assess and effectively respond to pandemics’.Footnote ⁸⁵ To this end, the letter underscored that the proposed agreement would recognise the One Health model, which, in affirming the interconnectedness of human, animal, and planetary health, would guide the treaty’s principle of ‘health for all’,Footnote ⁸⁶ an echo of the signatories’ acknowledgement that none could be safe until all were safe. Although the letter made explicit mention of the need to contemplate the health of animals, nothing in the non-exhaustive list of provisions that a prospective accord might feature includes considerations for them.Footnote ⁸⁷ This lack of detail as to what measures might buttress the sphere of animal health has created significant uncertainty as to the effectiveness of such a treaty in light of the proposition – one informed by the One Health concept – that none can be safe until all, including animals, are safe.

13.3.2 The Draft Agreement

It was in December of 2021 that prospects for a WHO Pandemic Agreement began to emerge.Footnote ⁸⁸ It was during the second-ever special session of the World Health Assembly, comprised of all 194 WHO member states,Footnote ⁸⁹ that the Intergovernmental Negotiating Body (INB) was formed.Footnote ⁹⁰ With the Constitution of the WHO empowering the Assembly to adopt international agreements on matters within the WHO’s sphere of competence,Footnote ⁹¹ the INB was charged with constructing an agreement on ‘pandemic prevention, preparedness, and response’.Footnote ⁹² With the INB beginning its work in February of 2022, the prospect of an accord was heralded as a ‘once-in-a-generation opportunity to strengthen the global health architecture to protect and promote the well-being of all people’,Footnote ⁹³ an allusion to the etymological roots of the term ‘pandemic’. To date, the INB has produced multiple drafts of the proposed treaty instrument,Footnote ⁹⁴ whose text was slated to be finalised by May 2024.Footnote ⁹⁵ As noted above, however, the language of the proposed treaty has yet to be agreed upon by states. That said, some have expressed optimism that the instrument will eventually be agreed upon and concluded.Footnote ⁹⁶

Although all aspects of the instrument are subject to change until that time,Footnote ⁹⁷ certain provisions have already witnessed consensus.Footnote ⁹⁸ For example, the preamble as currently drafted acknowledges the danger of antimicrobial resistance.Footnote ⁹⁹ The instrument defines the One Health concept as an approach that seeks to ‘sustainably balance and optimise the health of people, animals and ecosystems’ and affirms ‘that the health of humans, domestic and wild animals, plants and the wider environment (including ecosystems) is closely linked and interdependent’.Footnote ¹⁰⁰ To be sure, the definition of the One Health model as currently constructed appears to devote appropriate attention to the health of animals, whose interests are intertwined with that of humankind. Yet the actual measures to safeguard those interests prove ambiguous at best.

Again, with many of the provisions of the current draft not yet agreed upon, with regard to One Health-related obligations, Article 5 would require parties to develop a coherent and integrated strategy into national law.Footnote ¹⁰¹ In addition to calling for collaboration,Footnote ¹⁰² the treaty would obligate parties to identify and address pandemic drivers, including the emergence and re-emergence of diseases at the human–animal–environmental interface, and to intervene to prevent, prepare for, and respond to zoonotic outbreaks.Footnote ¹⁰³ Article 4 would require parties to, subject to their individual capacities, take measures to prevent the spread of infectious diseases between humans and animals and to combat antimicrobial resistance.Footnote ¹⁰⁴ The actions a party would be required to take to meet these obligations is not identified in the present draft. Although the text does feature language that would commit parties to lay out the ‘operational’ among other dimensions of what the One Health approach would require at a later date, the provision itself is contested and its integration into the final treaty, if one is concluded, is uncertain.Footnote ¹⁰⁵

Assuming the WHO Pandemic Agreement is concluded and meets the requisite threshold to enter into force,Footnote ¹⁰⁶ the qualifying language in many of the substantive provisions regarding the capabilities of parties to fulfil their obligations, in addition to the lack of specific obligations, may yield few if any gains for the interests of animals. That said, assuming that the Agreement is concluded and enters into force, its provisions may be complemented by the Convention on Animal Protection for Public Health, Animal Well-Being, and the Environment, which was designed to fill this void.

13.4.1 Overview and History

The origins of the CAP trace back to the early stages of the COVID-19 outbreak, specifically to the efforts of international animal law scholars, attorneys, and advocates working within the International Animal Law Committee of the American Bar Association (ABA).Footnote ¹⁰⁷ Notably, it was just before a long-planned Committee meeting to discuss the International Convention for the Protection of Animals, which was drafted in 1988 and represents the first proposed treaty to contemplate the interests of animals as individuals, that COVID-19 was reported as having struck the United States.Footnote ¹⁰⁸ Given the likely animal origins of the novel coronavirus and several of the Committee members’ acute awareness of how the health and well-being of animals is inextricably tied to that of humans and the environment, the question that emerged was whether world leaders might, in light of the health crisis that was unfolding, finally prove receptive to the need for global standards regarding the protection of animals.

As a first step toward this goal, core members of the International Animal Law Committee authored a Resolution and Report for the ABA as a whole to consider taking a formal position on this issue.Footnote ¹⁰⁹ To that end, the language of the Resolution, which was approved, read that the ABA ‘urges all nations to negotiate an international convention for the protection of animals that establishes standards for the proper care and treatment of all animals to protect public health, the environment, and animal wellbeing’ and that it likewise encouraged the US State Department to initiate and assume a leadership role with respect to its negotiation.Footnote ¹¹⁰ Given the ABA’s general anthropocentric focus, what this development attested to was the need to embrace animal health and well-being as a means to safeguard the interests of humankind. Coming off this development, the core working group that authored the ABA Resolution and Report founded the International Coalition for Animal Protection (ICFAP), a nonprofit organisation through which they developed two drafts of the CAP treaty.Footnote ¹¹¹

13.4.2 The Draft Convention

Notably, both drafts of the CAP employ the One Health model to advance the interests of animals yet differ widely with regard to approaches taken. Whereas the protections advanced by the first specifically arise out of the disease prevention context,Footnote ¹¹² those in the second are informed by the intrinsic interests of animals, with the prevention of disease, among other benefits, necessarily flowing from those safeguards. Put differently, while the second draft of the CAP is still informed by anthropocentric interests, these interests feature less prominently than the inherent interests of animals themselves. This shift is reflected by the change made to the title in the second draft of the Convention, with the term ‘Welfare’, which primarily focuses on reducing pain and suffering, replaced by the arguably more holistic term ‘Well-Being’,Footnote ¹¹³ which contemplates the need to consider, if not provide for, animals’ positive affective states.Footnote ¹¹⁴ Although other noteworthy distinctions between the drafts exist, going forward, this chapter will focus on the second and, at present, final draft of the Convention.

13.4.3 Preamble and Fundamental Principles

Informed by the One Health concept, the CAP foregrounds the interconnectedness of anthro-, eco-, and zoo-centric concerns in its preamble while also emphasising the intrinsic value of animals and the need to safeguard their interests for their own sake. To this end, the first preambular statement observes how protecting animals and the ecosystems that support them promotes public health, biodiversity, and economic development, among other benefits.Footnote ¹¹⁵ From here, the second attests to the need to secure the interests of animals outside of the species context,Footnote ¹¹⁶ which many international agreements concerning animals fail to go beyond.Footnote ¹¹⁷ By stressing that animals, as sentient beings, have intrinsic value, the CAP indicates that their individual well-being merits consideration.Footnote ¹¹⁸ In addition, the preamble attests to how failing to do so poses a critical risk factor with regard to the spread of infectious diseases and how an integrated approach to global health, as contemplated by the One Health approach, can mitigate such risks.Footnote ¹¹⁹ In a similar vein, the CAP addresses the ecosystem functions that animals provide by mitigating the effects of anthropogenic climate change, which they also suffer from.Footnote ¹²⁰ It is in light of the interconnectedness of human, animal, and environmental interests, as well as the fact that animals cross geopolitical borders, that the preamble stresses the need for cooperation among states if their interests are to be secured.Footnote ¹²¹ Appreciating that doing so represents a complex, multifaceted endeavour, the CAP distinguishes itself in desiring to realise benefits to public health, the environment, and the well-being of animals through the development of binding obligations for contracting parties to it.Footnote ¹²²

In terms of the rationales that guide the provisions of the Convention, Article 1 of the CAP establishes five fundamental principles.Footnote ¹²³ The first attests to humankind’s evolutionary heritage and coexistence with animals within interdependent ecosystems; in doing so, it articulates how the health and well-being of animals at the group level, both species-specific and as to local populations, and individual level buttress the health of shared ecosystems, thereby supporting public health, environmental protection, and conservation efforts.Footnote ¹²⁴ Beyond extrinsic value, the second affirms that animals, as sentient beings, have intrinsic value, one that creates a moral imperative to ‘act responsibly’ toward them.Footnote ¹²⁵ Far from prescribing animal abolitionism, what the principle advances is the view that animals should not be subjected to cruelty and ‘unnecessary suffering’,Footnote ¹²⁶ with this language mirroring many states’ existing animal cruelty frameworks.Footnote ¹²⁷ While this provision arguably creates a general, if ambiguous, floor with respect to limitations as to how animals should be treated, the CAP’s third fundamental principle states that positive duties exist in the context of animals under human control.Footnote ¹²⁸ In this regard, the CAP requires their well-being to be provided through an ‘adequate, species-specific environment and care appropriate for their particular needs’.Footnote ¹²⁹ In doing so, the CAP contemplates the interests of animals at both the species and individual level. In observing how psychological, physical, and environmental stressors compromise their well-being and increase their likelihood of becoming vectors of disease, the last two principles observe the need to employ a precautionary approach in regulating human interaction with animals.Footnote ¹³⁰

13.4.4 Substantive Provisions

While the CAP’s preamble and fundamental principles do not in and of themselves establish specific obligations, they nevertheless inform the anthro-, eco-, and zoo-centric arguments for why the substantive provisions of the Convention prove critically important. Recognising that any specific obligations that arise must be attentive to differences in states’ use of and interaction with animals, the CAP first creates a baseline of protections applicable to animals generally, then advances provisions specific to free-roaming wild animals and to those animals, whether domestic or wild, under human control.Footnote ¹³¹ While numerous other categorisations could certainly be conceived, the CAP appreciates that different obligations may, and arguably should, flow to animals based upon humans’ use of and interaction with them. With regard to these duties, contracting parties are required to designate a competent authority to carry out all matters relating to their obligations under the CAP.Footnote ¹³²

With respect to protections applicable to all animals, the Convention requires contracting parties to, as far as is possible, take legislative, administrative, and other policy measures to construct a minimum baseline.Footnote ¹³³ Captured in Article 3, these measures include ensuring animals are not subjected to cruel acts or conditions and that, if killed, the methods employed inflict the least amount of pain and suffering possible.Footnote ¹³⁴ In addition to the killing of animals for food, clothing, and other commercial purposes, this provision would also apply to non-commercial activities, such as hunting and the eradication of non-native species. Furthermore, the CAP also requires contracting parties to consider the well-being of animals across all sectors, programs, and policies in order to provide for a whole-of-government approach to promoting their interests.Footnote ¹³⁵ As part of this mandate, contracting parties would be required to identify the actual or likely impact of their activities upon their well-being and develop measures to mitigate such harms.Footnote ¹³⁶ In addition, contracting parties must ensure that these measures are not weakened so as to undermine existing protections.Footnote ¹³⁷

Subject to their capability, contracting parties are required go further in providing for the well-being of animals under human control. As articulated in Article 4, such measures take into account differences in requirements among species and require contracting parties to ensure that animals are provided: sufficient and suitable food and water; shelter from the environment; opportunities for exercise, movement, socialisation; an environment that allows them to engage in natural behaviours; veterinary care that contemplates not just their physical health but also their well-being and the sanitary conditions of their surroundings.Footnote ¹³⁸ In addition to echoing the prohibition against cruelty and unnecessary suffering, Article 4 prohibits the overworking and abandonment of animals,Footnote ¹³⁹ with the latter being attentive to the reality that animals, whether domestic or captive wildlife, may not be able to survive on their own after having been dependent upon human care. For animals in transport, contracting parties must establish maximum times for their transport and confinement, as well as develop species-specific requirements for rest, food, water, and ventilation and protections against adverse environmental conditions.Footnote ¹⁴⁰

With regard to wild animals not under human control, contracting parties are obligated to take measures, insofar as possible, to secure their interests as captured in Article 5. First, contracting parties must establish and maintain a system of protected areas for the express purpose of conserving and protecting them.Footnote ¹⁴¹ They, too, must promote non-lethal management practices, ones that result in the least suffering of both targeted and non-targeted animals.Footnote ¹⁴² Furthermore, contracting parties must develop measures to protect wild animals in their assessments of infrastructure and development projects. In addition to monitoring the impact of such projects on wild animals and their habitats, contracting parties are also required to monitor the impact of climate change and other anthropogenic stressors.Footnote ¹⁴³

As discussed in Section 13.2, the failure to provide for the interests of animals and protect their habitat has driven the emergence and reemergence of new and known pathogens. Taken together, then, Articles 3, 4, and 5 of the CAP inherently serve to mitigate the risk of such outbreaks, both zoonotic and non-zoonotic, by obligating states to secure the physical and psychological health and well-being of animals both within and beyond the direct human–animal interface.

That said, Article 6 of the CAP features provisions focused specifically on combating the emergence and spread of pathogens, as well as antimicrobial resistance.Footnote ¹⁴⁴ To this end, the CAP requires contracting parties to develop veterinary services tailored to locally relevant pathogenic risks, to create facilities to monitor and prevent their emergence, and to detect and manage high-risk practices with respect to the wild animal, human, and animal-under-human-control interface.Footnote ¹⁴⁵ With respect to what has been termed the ‘silent pandemic’, or the emergence of antibiotic-resistant bacteria through their overuse in animal-based agriculture,Footnote ¹⁴⁶ the CAP goes beyond what is prescribed by the present draft of the WHO Pandemic Agreement by prohibiting the prophylactic use of antibiotics for purposes of promoting growth or increasing yield outside of exceptional cases.Footnote ¹⁴⁷ Notably, this prohibition would echo what the EU requires for its domestic producers and for imported products.Footnote ¹⁴⁸ In addition, the CAP proves attentive to the need to monitor animal-use facilities and transport chains and requires that animals be properly contained and separated by species, with due regard needing to be paid to health and sanitation conditions.Footnote ¹⁴⁹ The CAP also obligates contracting parties to promote alternative practices to reduce the risk of the emergence and spread of pathogens.Footnote ¹⁵⁰ With Article 6 requiring that contracting parties exchange information regarding the link between animal well-being and the emergence and spread of disease, it inherently complements the substantive provisions from Articles 3, 4, and 5. Finally, in recognising that the emergence of pathogens cannot be eliminated outright, Article 6 obligates contracting parties to prioritise the use of non-lethal management methods so as to consider the well-being of animals, whose suffering should be minimised.Footnote ¹⁵¹

Taken together, the provisions advanced through Articles 3–6 of the CAP establish a global floor for animal protection, yet the CAP also provides for the development of protocols to further elevate the interests of animals beyond it.Footnote ¹⁵² As such, the CAP holds the promise of housing critical gains for animals over time. With states being able to enter into a protocol only if a contracting party to the Convention,Footnote ¹⁵³ states are further incentivised to ratify the CAP in order to help shape future animal protections, which may seek to strengthen or expand upon those already contemplated by the CAP or else result in wholly new requirements, such as prohibitions against the use of animals for cosmetic testing purposes or bans on whaling, both of which have already gained traction globally.Footnote ¹⁵⁴

13.4.5 Promoting Protections through Trade

To be sure, one of the most criticised aspects of treaties concerns their enforcement. While this issue is arguably exacerbated by the CAP’s limiting language that obligates contracting parties to carry out measures ‘as far as possible’, the Convention contemplates the use of trade and trade agreements as a means to encourage both contracting parties and non-contracting party states to meet the thresholds envisioned by the CAP. Articulated in Article 8, contracting parties engaged in the trade of live animals or their products are expected to encourage non-contracting party states to adopt animal well-being standards that either meet or exceed those prescribed by the CAP.Footnote ¹⁵⁵ Furthermore, when developing trade agreements concerning live animals or their products, contracting parties are required to include provisions to see that the well-being of the animals involved meets or exceeds those contemplated by the Convention.Footnote ¹⁵⁶ Together, these provisions help to ensure that contracting parties do not suffer economic disadvantages by virtue of having advanced animal protections. In a similar vein, the CAP also prevents contracting parties from weakening their domestic animal protections for the purpose of inducing trade.Footnote ¹⁵⁷

Given the immensity of the trade in animals and their products globally, these provisions serve to encourage non-contracting party states to ratify the CAP, as contracting parties would be incentivised, whether for economic, health, or moral reasons, to restrict engaging in trade with them. Critically, the CAP’s framework would not provide for new forms of economic protectionism than those that already exist today. Rather, it could help formalise, if not ground, the existing use of trade barriers to prohibit the import of lower welfare and higher disease risk animal products.

Indeed, while the world’s foremost regulatory trade body, the World Trade Organization (WTO),Footnote ¹⁵⁸ is fundamentally concerned with removing obstacles to trade among states, several of its regulatory frameworks permit states to construct trade barriers for ‘justifiable’ reasons,Footnote ¹⁵⁹ reasons that include safeguarding animals and their interests. For example, one such exception to the rule that prohibits discriminating against foreign products under the WTO’s General Agreement on Tariffs and Trade (GATT) permits states to create barriers if deemed ‘necessary to protect human, animal, or plant life or health’.Footnote ¹⁶⁰ Another WTO framework that permits the construction of trade barriers is the Sanitary and Phytosanitary (SPS) Agreement.Footnote ¹⁶¹ Negotiated between the WTO and the World Organisation for Animal Health (WOAH), the SPS Agreement permits states to develop trade barriers based not just upon WOAH’s animal health standards, which conceivably operate as a global floor, but also their own national regulations, thereby providing flexibility to secure the health of their citizens, as well as that of animals by extension.Footnote ¹⁶² Citing the SPS Agreement, the EU has entered into trade agreements that prohibit the import of meat products if the well-being of animals was not taken into account during stunning and slaughter.Footnote ¹⁶³ In a similar vein, the EU has also prohibited prophylactics for the purpose of stimulating the growth and yield of farmed animals, an issue that, while focused on preventing antimicrobial resistance, implicates the well-being of farmed animals.Footnote ¹⁶⁴ By banning the import of animal products developed using the prophylactic use of antibiotics, the EU measure has considerable extraterritorial reach, one that the CAP’s provisions on trade would not just allow for but also encourage.

On top of this, the WTO framework also permits states to prohibit or otherwise construct welfare labelling around the import of animals and animal products based upon the moral views of its citizens. In one such case, the EU moved to ban the import of seal products for commercial purposes.Footnote ¹⁶⁵ Referred to as the EU Seal Regime, the ban was founded upon the EU public’s moral distaste for the killing of seals.Footnote ¹⁶⁶ Although the WTO’s Appellate Body found that the EU Seal Regime violated the GATT because its exception for seal products from Inuit and Indigenous community hunts provided favourable market access to Greenland’s Indigenous communities compared to those of Canada, among other reasons, it nevertheless affirmed that public moral sentiment around the ethical treatment of animals could justifiably be used to restrict market access.Footnote ¹⁶⁷ In light of this pronouncement, the WTO has effectively provided that states may leverage the strength of their domestic animal protection laws to encourage other states to follow suit if they wish to gain access to markets with higher animal welfare standards,Footnote ¹⁶⁸ an argument that is already gaining traction in some states, like New Zealand.Footnote ¹⁶⁹ By encouraging contracting parties to adopt such barriers, the CAP promotes the protection of animals for their own sake, to prevent the emergence and spread of pathogens, and to gain certain economic and market advantages.Footnote ¹⁷⁰

13.4.6 Entry into Force, Compliance Measures, and Enforcement

Requiring at least ten states to ratify the Convention before going into force,Footnote ¹⁷¹ the CAP is open indefinitely to accession.Footnote ¹⁷² Upon joining, contracting parties must furnish the Secretariat with all domestic laws, policies, and regulations related to their obligations,Footnote ¹⁷³ with biennial reports regarding how they continue to fulfil them submitted every two years.Footnote ¹⁷⁴ Similar to other conventions, the CAP features a Conference of the Parties (COP), which would meet every two years after the initial COP.Footnote ¹⁷⁵ In addition to contracting parties adopting financial and administrative rules and procedures and contemplating the creation of new committees to carry out functions,Footnote ¹⁷⁶ each COP would be charged with reviewing the implementation of the Convention by contracting parties and scientific data and recommendations concerning the well-being of animals and the emergence and spread of pathogens and potentially act upon recommendations and adopt resolutions, amendments, and protocols.Footnote ¹⁷⁷ Notably, it is also at each COP that a Standing Committee comprised of representatives from contracting parties would be elected to investigate issues, consider and offer recommendations, and suggest new protocols and amendments, among other powers.Footnote ¹⁷⁸ Notably, a Standing Committee would have the power to interrogate the legislation and enforcement efforts of contracting parties.Footnote ¹⁷⁹ Although only contracting parties are afforded a vote at a COP, non-contracting party states, international organisations, and non-governmental organisations that work in the realm of animal protection, environmental protection and conservation, or disease would have an opportunity to attend and participate.Footnote ¹⁸⁰

Of course, as with any international agreement, a critical question concerns how to ensure that parties are fulfilling their obligations and how disputes between and among them will be handled. As to the former, the CAP empowers contracting parties to develop procedures and mechanisms to determine when a contracting party is in non-compliance and what measures may be taken, including: the provision of advice and assistance; an official notice of non-compliance; a suspension of rights under the Convention itself; and, in cases of repeated non-compliance, other measures as deemed appropriate by the Standing Committee.Footnote ¹⁸¹

As it concerns disputes among contracting parties related to the interpretation, application, performance, or implementation of their obligations, the Convention provides three options, including: negotiations between the contracting parties involved; submission by mutual consent to the Permanent Court of Arbitration at The Hague for a binding decision; and conciliation through the creation of a commission, whose resolution is not binding yet is expected to be considered in good faith.Footnote ¹⁸² Of course, while contracting parties may withdraw from the CAP,Footnote ¹⁸³ the ability of contracting parties to employ trade measures to encourage non-contracting party states to meet or exceed the provisions of the CAP offers a compelling opportunity to ensure that the interests of animals are centred on the global stage – whether for their health and well-being or for humankind’s, as contemplated by the One Health concept.

14.2.1 Finding Entry Points

The National Biodiversity Strategies and Action Plans (NBSAPs) are the main implementation mechanism under the CBD. In line with the Kunming-Montreal Global Biodiversity Framework (GBF), parties have been requested to revise their NBSAPs to reflect the GBF’s four goals and 23 targets. Like the preceding Aichi Biodiversity Targets, the GBF has several points of relevance for One Health – in particular Targets 5, 7, 11, and 14 – and mentions ‘One Health and other integrated approaches’ in its introductory text. A clear One Health scope is reflected in GBF Target 5 through the focus on reducing disease risks associated with wildlife trade, calling on parties to ‘Ensure that the use, harvesting and trade of wild species is sustainable, safe and legal, preventing overexploitation, minimising impacts on non-target species and ecosystems, and reducing the risk of pathogen spill-over, applying the ecosystem approach, while respecting and protecting customary sustainable use by Indigenous peoples and local communities.’Footnote ⁵ Target 7 examines the risks and impacts of pollution on biodiversity, opening the door for legislation on the human and wild animal health effects of chemical exposures, including ‘cumulative effects’.Footnote ⁶ Target 11 acknowledges the value of ecosystem services,Footnote ⁷ many directly or indirectly contributing to health, to ‘Restore, maintain and enhance nature’s contributions to people, including ecosystem functions and services, such as regulation of air, water, and climate, soil health, pollination and reduction of disease risk, as well as protection from natural hazards and disasters, through nature-based solutions and/or ecosystem-based approaches for the benefit of all people and nature.’ Finally, Target 14 refers to a suite of broad tools at the national level through which biodiversity can be mainstreamed, to

Each of these targets offers entry points for implementation under a One Health approach, including for infectious and non-infectious disease risks and outcomes. For example, under a One Health frame, environmental impact assessments – a routine and typically legally required tool used in countries’ project and development proposal review and permitting processes – could in theory consider outcomes for human, animal, and environmental health.Footnote ⁸ Multi-sectoral participation in the development of NBSAPs and monitoring of their implementation progress may also help to encourage legal action from other sectors to support environmental protection (for example, tackling the illegal trafficking of wildlife based on public health endangerment and invasive species risks in addition to conservation status, in line with GBF Target 5).

Interactions with biodiversity by local communities are based on several different cultural, spiritual, nutritional, and economic factors. Hence, a multisectoral and multi-dimensional approach to the NBSAP revision and implementation can also affect options for law and policy development or changes. For example, in Liberia, partners have requested inclusion of One Health provisions in the amended and restated wildlife law to address zoonotic disease risks related to wildlife trafficking and increase access to information appertaining to threats to local residents based on interactions with wildlife. A similar call is made to provide varying sets of legal treatment for cases involving illegal wildlife capture by local residents, where the intended use relates to the local’s livelihood (for wildlife used as protein sources) compared to individuals illegally collecting wildlife for commercial benefit; however, a public health risk may be present in both situations.

14.2.2 Identifying Gaps

National legislation is a key channel for translating international agreements and mandates into action. Until an international agreement is ratified nationally, it does not carry the same weight as a national legislation.Footnote ⁹ However, even where there is a substantial body of legislation at a national level, the scope may not necessarily cover all contexts needed under a One Health lens. For example, a legislative review of 38 jurisdictions (in Africa, Asia, Australia, North America, and South America) found that despite existing global and legal responses around the management of zoonotic disease risks, legislation did not fully address risks presented by the wildlife trade.Footnote ¹⁰ The lack of harmonisation among laws, as well as the variation in risk contexts, leaves gaps among different sectors, settings, and jurisdictions. To overcome this, One Health coordination is needed in the review of proposed and existing policies to ensure coherence and coverage. In Liberia, for example, with several national outbreaks of zoonotic diseases, the One Health Coordinating platform was instrumental in recommending the restatement and amendment of the Public Health Law to include all aspects of One Health and enhanced provisions for mitigating the risk of zoonosis.Footnote ¹¹

Mapping the coverage of laws and policies through a One Health lens can also reveal gap areas, including where formal authority, legislation, or implementation mechanisms are lacking. For example, responsibility for environmental health is often fragmented, and a designated authority for the full scope of wildlife health and wildlife disease has been lacking at the global level and within countries.Footnote ¹² Overburdening national institutions/agencies with a plethora of functions or responsibilities beyond their individual capacities tends to limit the focus on environmental and wildlife health. A case in point is the Liberian Forestry Development Authority, which has operated as an entity with extreme focus on commercial timber harvest. Lately, it veered into conservation practice, initially with no or limited focus on wildlife health.Footnote ¹³ Its wildlife program is skewed towards illegal trade rather than wildlife health and risk of zoonosis. For instance, the national forest policy and implementation strategy, the overarching policy for forest conservation and terrestrial wildlife in Liberia, does not mention any activity related to wildlife health. It focuses on the ban on bushmeat hunting,Footnote ¹⁴ collecting biodiversity information for the establishment of protected areas and promoting community participation in area-based conservation.Footnote ¹⁵ Disentangling and specialising the focus of these agencies to account for One Health application will require legal and policy in addition to implementation efforts being championed by the National Focal Point for Wildlife. A former USAID project, Conservation Works, supported The Forestry Development Authority is finalising the National Conservation Strategy that incorporates issues of wildlife health and the general concept of One Health.

The local, national, and transboundary threats to wildlife health from infectious and non-infectious disease and anthropogenic change reinforce the need for law and policy action and coordination on wildlife health. In light of this, in 2022 WOAH adopted a Wildlife Health Framework that formally brings biodiversity and wildlife health into their scope;Footnote ¹⁶ however, as WOAH is an international organisation with voluntary membership, this Framework, like all WOAH frameworks and policy documents, has not been paired with legally binding requirements. At the global level, WOAH’s reporting obligations only extend to diseases of concern for international trade (WOAH listed diseases), which in general primarily affect domestic animals. Outside of the listed diseases, reporting is voluntary for disease in wild animals, and subsequently, limited. Member countries could potentially use national legislation to require reporting of wildlife diseases (as well as pathogens and toxins) based on conservation, public health, or other reasons. A natural extension of this is a mechanism for the reporting of findings to government from research, as demonstrated by Indonesia’s reporting framework mandate on wildlife and human disease surveillance studies.Footnote ¹⁷

14.2.3 Ensuring Policy Is Evidence-Based and Considers Possible Trade-Offs

Another dimension of One Health, the translation of evidence-based recommendations into practice, can also be supported by legal and policy action. For example, the Food and Agriculture Organization (FAO) Convention on the Conservation of Migratory Species of Wild Animals (CMS) Task Force on Avian Influenza and Wild Birds has repeatedly identified opportunities to reduce disease risk, including for the protection of wild animals.Footnote ¹⁸ Some of these opportunities include national-level implementation considering regulating livestock production activities around migratory areas in land planning decisions (e.g. restricting poultry production around wetlands and associated risks of highly pathogenic avian influenza). To ensure effectiveness, a suite of laws, policies, or regulations would need to be issued and adequately enforced. In Malaysia, several disease risk reduction requirements were enacted following the Nipah virus epidemic in 1999, such as distancing between orchard trees and livestock, enhanced biosecurity, and the designation of farming areas safe for pig production areas (with alterative livelihoods encouraged outside of those areas).Footnote ¹⁹

14.2.4 Promoting Coordination and Harmonisation

Without sufficient coordination and harmonisation, there may also be unintended consequences of environment regulations on health. For example, Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) listings have inadvertently affected the timely movement of emergency diagnostic specimens through restrictions on international movement.Footnote ²⁰ While simplified procedures have been enacted under CITES in response, they do not provide automatic exceptions for Appendix I species, which are often among the most threatened with extinction, and thus would logically be considered priorities for rapid disease investigation.Footnote ²¹ In another example, decisions to manage health in some sectors could have consequences for others; the need for a One Health approach to the licensing of veterinary pharmaceuticals was highlighted after a mass decline in Gyps vulture populations in South Asia from chemical poisoning linked to the ingestion of cattle carcasses that had been treated with diclofenac for pain relief.Footnote ²² The loss of vultures has wide-ranging implications for ecosystem health given their unique and valuable role as scavengers.Footnote ²³ Negative impacts to wildlife and ecosystems can also be generated from ill-informed responses to infectious disease threats; for example, the vilification and culling of bats overlooks their important ecosystem services and may actually increase zoonotic disease risk.Footnote ²⁴ These misguided responses reinforce the importance of multi-sectoral coordination to proactively minimise trade-offs and maximise co-benefits.

14.2.5 Enabling Equitable Prioritisation and Access to Capacity Strengthening

In addition to the scope of international environmental agreements and their associated national legislation, implementation support may similarly influence priorities and progress. The overwhelming voluntary nature of funding of capacity building and technology transfer (CBTT) to support international environmental protection agreements results in uneven availability and access by countries and stakeholders;Footnote ²⁵ it is also foreseeable how this could subject CBTT to potential conflicts of interest with economic investment priorities at odds with environmental protection. For example, a demand for investment and expansion of the Liberian government rent-seeking agenda from large-scale iron ore mining is potentially undermining the original intention to convert the Wologisi Proposed Protected Area into a National Park, thereby increasing the risk of environmental degradation, exacerbating climate change impact, and potentially generating health consequences from mining chemicals.Footnote ²⁶ While the reporting of human and animal diseases is often associated with One Health initiatives, the reporting of environmental damages, environmental crime enforcement and deterrent capacity strengthening, and remediation measures should also be considered a priority to promote the same transparency prioritised by human and animal health sectors.

14.3.1 National and Subnational

The establishment of multi-sectoral coordination mechanisms, such as national One Health coordination platforms, is a major focus for advancing One Health implementation at the government level.Footnote ²⁷ Different models have been used for governance structures, with varying form and funding mobilisation mechanisms (e.g. a lead agency, coordinator role, pooled resources).Footnote ²⁸ These models have also been established at regional levels.Footnote ²⁹ These mechanisms provide a foundation for the coordination and mapping of roles and responsibilities; in doing so, the clarification of mandates can reveal gaps needing attention. In most cases, the roles and responsibilities of government ministries and agencies overlap and/or are absent on the issue of wildlife health. When coordinated through the One Health platforms, the need to delineate the specific functions of wildlife health becomes apparent, from wildlife protection, public or domestic animal health protection, protected area management and environmental protection. These functions, in some cases, could be housed in a single ministry or department but the clarity, through law or policy, on the responsibility to ensure adequate protection must be stated. Additionally, in general, responsibility is fragmented for managing risks and impacts (e.g. certain agencies are responsible for watershed management and agricultural runoff, whereas water, sanitation, and hygiene (WASH) services and treatment for waterborne diseases are handled in other domains). This division and resulting dis-incentives for collaboration (and lack of jurisdiction) can hinder coherent policy decisions; the need to engage beyond the health sector is recognised in the sentiment of ‘health in all policies’.Footnote ³⁰

A mix of assessment, planning, information sharing, and risk communication tools have been used to operationalise collaboration under national (and in some cases subnational) One Health platforms. The ongoing development of One Health Strategic Plans, intended as a national-level translation of the global One Health Joint Plan of Action developed by the Quadripartite,Footnote ³¹ offers an opportunity to contextualise a One Health approach to each country’s unique context, including risks and policy instruments.Footnote ³² To inform decision making, a One Health economics approach has the potential to support more robust evaluation of investments, in particular to assess and weigh trade-offs and co-benefits.Footnote ³³ While the value of ‘societal’ (versus single-sector) perspectives in economic analysis has been emphasised, the increasing integration of environmental and health economic methods provides an exciting opportunity for the field of economics.Footnote ³⁴ Economic and other evaluations can also be informed by the findings from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES), in particular in terms of an increasing evidence base on the interlinkages between biodiversity and health.

14.3.2 Community

Community governance can play a key role in managing natural resources, including in decision making on use of proposed protected and conserved areas. These rightsholders (whether formally or informally established) often include Indigenous Peoples, who make up approximately 6 per cent of the world’s human population but govern a quarter of terrestrial areas, including 39 per cent of the planet’s most ecologically intact landscapes, many of which are threatened by industrial development.Footnote ³⁵ One important element of governance centres on land tenure, including those with formal ownership as well as those with informal rights and dependence on ecosystems (e.g. for cultural, religious, economic, or other reasons). The lack of clarity on land tenure or the absence of specific rights to land by local communities can undermine conservation efforts, lead to uncontrolled and unsafe interactions with wildlife, and destruction of key habitats with the risk of increasing the probability of zoonotic disease spillover and vulnerability of these communities.

The principle of Free, Prior, and Informed Consent (FPIC) is recognised (and increasingly enforced) as a minimum standard for decisions on land tenure in/around proposed protected areas. Defined as ‘a specific right granted to Indigenous Peoples recognised in the UN Declaration on the Rights of Indigenous Peoples (UNDRIP), which aligns with their universal right to self-determination’, ‘FPIC allows Indigenous Peoples to provide or withhold/ withdraw consent, at any point, regarding projects impacting their territories. FPIC allows Indigenous Peoples to engage in negotiations to shape the design, implementation, monitoring, and evaluation of projects’.Footnote ³⁶ Factors such as influence, awareness, and different value systems should be considered throughout community land formalisation processes to ensure FPIC is respected. Importantly, the lack of recognition of certain rights of communities to land and natural resources in local policy and legislation can undermine the principles of FPIC and increase the likelihood of conflict, unstainable harvest of natural resources and unsafe exposure to wildlife. In Liberia, for example, the Land Rights Act 2018,Footnote ³⁷ has vested in the community unequivocal and unconditional right to customary land and the resources thereon. This has improved bargaining power of the community to negotiate, using the FPIC principles, for sustainable utilisation of their land. In addition, the national guidelines for establishing protected areas, as a legal instrument, require land tenure clarification as condition precedent to the creation of conservation or protected areas on land.Footnote ³⁸

One Health understanding is particularly relevant for the ‘informed’ component of FPIC, given how direct and indirect impacts may affect the health and wellbeing of communities in diverse and potentially complex ways. For example, a timber logging concession in a primary forest area may generate jobs, revenue, and potentially improved access to health and other services, at least in the short term; whereas longer-term environmental consequences could lead to persistent pollution of waterways, change in species ecology, and other effects that may be at odds with other principles (e.g. intergenerational and multi-species rights and equity). Even formalising or increasing the protection status of a conserved area can potentially have adverse consequences for communities and rightsholders, such as loss of access to sacred sites. The use of a One Health lens in cost-benefit or cost-effectiveness analyses can explore trade-off and co-benefits and consider the distributions of monetary and non-monetary costs and benefits (e.g. to government, private industry, and local communities).Footnote ³⁹ An extended time horizon, in some cases longer than a development project lifespan, may be needed to reflect long-term impacts on the environment and health, societal, and economic impacts (whether positive or negative) to a community.

14.3.3 Protected and Conserved Areas

Protected and conserved areas (PCAs) and Other Effective Area-Based Conservation Measures (OECMs) can involve a range of governance and management strategies. The IUCN has broadly defined these relevant for protected areas as governance by government, shared governance, private governance, and governance by Indigenous Peoples and local communities, with a set of management categories generally based on use purpose and restrictions.Footnote ⁴⁰ In practice, PCAs often face multiple demands (some competing) from conservation management (including external management models), large-scale tourism and revenue generation (e.g. private lodging concessions, mining, and logging), as well as small-scale livelihood and cultural and space considerations (e.g. poaching, transhumance, access to medicinal plants). Activities at the periphery may also affect conditions within a protected area, such as through livestock grazing or wastewater generated via mining. As conditions are often dynamic, monitoring and decision-making processes can benefit from a One Health lens to identify and manage risks and impacts to human, animal (domestic and wild), and environmental health, requiring coordination between communities, industries, environmental scientists, the human and animal health sectors, and park managers.

International standards also provide guidance and benchmarks for the effective management of PCAs. For example, the IUCN Green List Standard for protected areas provides a voluntary certification on the basis of sites demonstrating certain criteria: ‘Respect: for the local community through fair and meaningful engagement of rights-holders and stakeholders; Design: planning that identifies the needs to secure the important values of the area; Effective management: monitoring of the status of these important values; Successful conservation results: for nature and for people; clear contribution: to climate change responses, health and well-being and other challenges’. The integration of a One Health approach in the Green List Standard has been recognised, with the planned integration of disease management indicators into the revised Green List Standard,Footnote ⁴¹ and the formation of multi-sectoral Expert Assessment Groups (including veterinary expertise, for example) for the Green List at the country level.

14.3.4 Industry

There is precedent for voluntary sustainable industry standards, potentially to pre-empt environmental regulations, respond to public demand, and meet corporate social responsibility obligations. For example, the Forest Stewardship Council (FSC) has developed a system for voluntary accreditation to certify companies as providing services and goods in line with ‘environmentally appropriate, socially beneficial and economically viable forest management’.Footnote ⁴² The existing FSC standard includes indicators around worker health and ecosystem services and could potentially be interpreted under a One Health lens. Parallel mechanisms could be explored for other industries; for example, an audit checklist was developed to assess emerging infectious disease risks in the extractive industries.Footnote ⁴³ Implementation of such tools and standards in line with a One Health approach will likely require a broader scope of expertise (e.g. disease ecology and wildlife health) than commonly included in biodiversity and community health impact assessment and monitoring.

14.4.1 National One Health Coordinating Platform

Liberia has been a leader in operationalising One Health, including through the establishment of a National One Health Coordination Platform in 2016.Footnote ⁴⁶ A formal governance structure set expectations and designated roles for participation, including for its Steering Committee, Technical Committee, and Technical Working Groups.Footnote ⁴⁷ The Steering Committee is chaired by the Vice President; the Technical Committee is chaired by the Director General of the National Public Health Institute of Liberia; and the six Technical Working Groups have a rotational chairing format. This leadership structure is supported by a One Health Secretariat with a coordinator and officers from seven target agencies (Ministry of Health, Ministry of Agriculture, Forestry Development Authority, Environmental Protection Agency, National Disaster Management Agency, National Public Health Institute of Liberia, and Ministry of Defense). Terms of Reference have been developed in the Platform’s Governance Manual to clearly define roles and responsibilities for each component of the governance structure. A standalone website managed by the One Health Platform Secretariat has been developed to provide a central place to access information, including laws and policies.Footnote ⁴⁸ The development of county-level platforms is now translating this model to the subnational level to promote more localised dialogue across ministries and support information flow to and from national authorities.

14.4.2 Revision of the National Biodiversity Strategy and Action Plan (NBSAP)

The National Biodiversity Strategy and Action Plan (NBSAP), in theory, presents a turnkey solution for the sustainable management of biodiversity and creating a conditionality whereby humans, ecosystems, and wildlife can thrive harmoniously. NBSAPs are ‘central for mainstreaming biodiversity by translating global ambition into national policies’.Footnote ⁴⁹ They are also useful ways of integrating the One Health concepts and practices into national planning and decisions for managing wildlife. The first NBSAP for Liberia was designed in 2004 in an effort by the national government to centralise decisions and incorporate issues affecting biodiversity into national policies and plans. Upon the signing of the Nagoya Protocol and Aichi Targets, Liberia, again, realised the need to adjust its NBSAP to mirror and align with the international agreement.

Despite the attending value attached to sustainably managing biodiversity, certain underlying conditions, if not addressed, can lead to a complete failure of the NBSAP. ‘Conflicting interests, weak financial support, and poorly integrated institutional and regulatory structures can affect implementation of NBSAP’. Thus, coordination across sectors is vital.Footnote ⁵⁰

In March 2017, a new revised NBSAP, encapsulating five goals and twenty targets, was endorsed by the Liberian Government spanning the period 2017–2025. Positioned as the overarching national strategy for managing biodiversity, neither the 2004 nor the 2017 described the concept or mentioned the word One Health. Understandably, this may be as a result of the limited exposure and understanding of One Health in the country. More so, the international community was still piecing together the inextricable link between wildlife health, environmental change, and disease spillover vis-à-vis the need to imbed these considerations into national planning for environmental decision making.

The twin devastating outbreaks of Ebola and COVID-19 impetuously shattered health systems, livelihoods, and human wellbeing. Incontrovertibly, the Ebola outbreak was a wake-up call for Liberians that highlighted the unavoidable need to integrate One Health into national policies and laws. This notion was furthered re-echoed following the global pandemic of COVID-19. In time past, global biodiversity instruments did not reference or strategically consider the importance of this concept. Notwithstanding, following the devastating impact of the Coronavirus, the Kunming-Montreal Global Biodiversity Framework moved significantly towards integrating One Health. With the vision to align its national strategy with the GBF, Liberia embarked on the revision of its NBSAP, as a standard practice and based on a request from the Convention on Biological Diversity (CBD). Interestingly, the initial call from the government was to integrate the interfaces between wildlife health, environmental changes, and human health. After a few national consultations and engagements with key national experts, the government took a bold step towards establishing a new target in the revised NBSAP relating to One Health. Submitted to the CBD Secretariat and awaiting finalization of the implementation plan and monitoring and evaluation framework, Target 1.5 of the 2024 revised NBSAP provides that it will ‘by 2030, integrate the One Health approach into the assessment and management of biodiversity and establish and implement a comprehensive national program to monitor, control, and reduce the risk of chemical hazards and pathogen spillover presenting risks to human and animal health’.Footnote ⁵¹ To this target, six indicators were correspondingly developed for monitoring and evaluation purposes. When finalised and officially endorsed, this will not only highlight the importance of improving policy and legislations for One Health but will increase awareness on the subject, attract international and national support, and subsequently reduce the risk of zoonosis.

14.4.3 Integrating One Health in Environmental and Social Impact Assessment (ESIA)

Environmental Impact Assessments (EIA) are a tool typically used to assess the effects of a proposed project on the environment.Footnote ⁵² In Liberia, EIA is the primary mechanism for assessment of potential development projects, covering a wide scope ranging from commercial and artisanal extractive activities to agricultural and transportation development to protected area establishment and ecotourism. Projects classified in Annex I of the Liberia Environmental Protection and Management Law of Liberia (EPML) must undergo the EIA process prior to receiving approval by the government. Health impacts are potentially included in the scope of the EIA procedures, but there has historically been limited awareness of health aspects by the country’s impact assessment workforce. The system, processes, and regulations for EIA significantly improved over time due, principally, to the evolution of different impacts associated with major capital projects that were not originally embedded in the EIA framework. For instance, after many years of evaluating project impacts via the EIA process, many issues still existed within these locations including those affecting residents, expropriation of land, and health-related impacts not necessarily attributed to environmental pollution. Hence, the Government of Liberia, through the Environmental Protection Agency of Liberia (EPA), published the first legal instrument, in the form of regulations in 2016 calling for the adjustment to the list of project categories that are covered under the EIA process as well as the inclusion of social impacts.Footnote ⁵³ Essentially, this resulted in the designation from EIA to ESIA, with the ‘S’ representing social impacts.

Despite this seemingly progressive intervention, the evaluation of health impacts from these projects under the ESIA process did not meet the required threshold. Project proponents or developers were required to assess only the occupational health risks and hazards of their interventions and not a full health impact assessment with consideration of direct and indirect impact to wildlife, environment, or people as a result of the project. A One Health approach was proposed as an anchor for evaluating health impacts, mainly those associated with the project and directly affecting wildlife or indirectly leading to a zoonotic spillover. In 2022, the EPA launched a call for inputs to be made to the ESIA regulations. With support from national and international experts, a set of recommendations were proffered as an improvement to evaluating health impacts with emphasis on integrating the One Health concepts in the revised regulations. Unfortunately, by the time the recommendations were received, EPA had already published the new revised ESIA Regulations, 2022. Notwithstanding, the government received the draft of recommended changes and committed to integrating specific language during the next iteration of the regulations in 2026. More importantly, the new requirement for assessing health impacts under the 2022 revised regulations incorporates wildlife health impacts associated with projects earmarked for an ESIA study. This progress is not the anticipated result but it is a watershed movement for highlighting, in a legal instrument, the importance of integrating One Health as well as the immense contribution this can have on wildlife and ecosystem health with a cascading effect on human health. At the request of the EPA, to support capacity for implementation, in 2023 training on One Health in ESIA was conducted for members of the Union of Certified Environmental Professionals of Liberia.Footnote ⁵⁴ The training highlighted how a One Health approach can more comprehensively assess the impacts of toxicology and infectious disease risks across a project lifespan, including direct impact at a site as well as from biodiversity offsets.

15.2.1 Expanding One Health

One Health is a policy framework that recognises that human, animal, and environmental health are linked. Accordingly, the One Health framework requires a ‘collaborative, multisectoral, and transdisciplinary approach – working at the local, regional, national, and global levels’.Footnote ² The UN Food and Agricultural Organization describes One Health as an ‘integrated approach’ with implications for ‘food security, sustainable agriculture, food safety, antimicrobial resistance’ and more.Footnote ³ Given these links between human, animal, and environmental health, governments can improve outcomes for human health and well-being in many contexts by improving outcomes for animal and environmental health as well.

To see why One Health is valuable, consider how humans interact with captive animals, particularly farmed animals. Humans breed, raise, and kill more than 100 billion vertebrates and more than one trillion invertebrates for food each year.Footnote ⁴ These practices not only harm and kill many animals, but also contribute to the spread of infectious diseases (particularly bird and pig farming) and to land-use and climate change (particularly cow farming).Footnote ⁵ By thinking about human, animal, and environmental health holistically, we can build future food systems that treat humans, animals, and the environment better at the same time.

Similarly, consider how humans interact with wild animals. Humans breed or capture tens of millions of wild land animals and hundreds of millions of wild aquatic animals for a variety of purposes each year.Footnote ⁶ But as with animal farming, many forms of the wildlife trade are bad for humans, animals, and the environment. They harm and kill many animals, contribute to the spread of infectious diseases (according to one study, animal farming and the wildlife trade are the two main causes of disease spread among wild animals),Footnote ⁷ and contribute to biodiversity loss and ecosystem collapse (particularly industrial fishing).Footnote ⁸ Once again, by thinking about these issues holistically, we can seek alternatives to the wildlife trade that are better for all.

However, while the One Health framework is valuable, current applications have important limitations.Footnote ⁹ One limitation is that current applications focus on benefiting humans, rather than on benefiting human and non-human animals alike.Footnote ¹⁰ One Health recognises that human, animal, and environmental health are linked, but responds to these links by treating animal health as a resource to protect for the sake of human health.Footnote ¹¹ However, many non-human animals are living, conscious beings with sentience and agency; their health matters not only to us but also, and primarily, to them. By taking an instrumentalising approach to animal protection, we miss opportunities to improve animal health for the sake of the animals themselves.

Another limitation is that current applications of One Health focus on health in particular rather than on health and welfare in general. Of course, this focus on health makes sense, because health impacts are easier to measure than welfare impacts, and because health is a ‘primary good’ that makes possible the pursuit of all other goods. But for human and non-human animals alike, health is not an end in itself and protecting our health is not always sufficient for supporting our flourishing in life. By focusing narrowly on our health rather than widely on what brings meaning and value to our lives, we miss opportunities to improve not only human and animal health but also human and animal lives and societies.Footnote ¹²

To see how these limitations can lead us astray, return to our treatment of captive animals. Many humans assume, rightly, that proper regard for animal and environmental health requires making changes to animal farming. However, when we assess our options without considering animals as stakeholders, and without considering animal welfare at all, we end up causing and allowing unnecessary harm to vulnerable animals. For example, many experts are proposing further intensification of animal farming to reduce the amount of land used per animal, despite the fact that further intensification risks increasing animal suffering.Footnote ¹³ Many experts are proposing a shift from cow to chicken farming for the same reason, despite the same trade-off.Footnote ¹⁴

Similarly, many humans assume, rightly, that proper regard for animal and environmental health requires making changes to the wildlife trade. But once again, when we assess our options without considering animals as stakeholders, and without considering animal welfare at all, we end up causing and allowing unnecessary harm. For example, we tend to set limits on the wildlife trade when we see animals as vectors for disease (for instance, bans of live markets during COVID-19), or when we see particular practices as ecologically harmful (for instance, bans of ‘unsustainable fisheries’). But as long as we see the exploitation and extermination of other animals as compatible with human health, we tend to permit them.Footnote ¹⁵

Of course, there may be cases where human and non-human interests conflict. At least at present, many humans rely on animal use industries for food, income, and other vital needs. Additionally, many animals do pose threats to humans, and nonviolent resolutions to these conflicts are not always available. However, to say that we should consider human and non-human health and welfare is not necessarily to say that we should always avoid practices that harm animals in cases where these practices are deemed necessary. Instead, it is merely to say that we should consider the impacts of policies on all relevant stakeholders, and we should seek ways of improving human and animal lives together where possible.

15.2.2 Assessing Wild Animal Welfare

Unfortunately, political will is not the only obstacle that stands in the way of legal and political consideration of wild animal welfare. A more fundamental obstacle is that we currently lack the ability to predict and control the net effects of our actions and policies on wild animal welfare. This is partly due to our limited knowledge about wild animal welfare and is partly due to our limited capacity to act on the knowledge that we have. Before we can find a way forward, we need to identify where we are and where we need to go. So, in this section, we briefly survey several basic questions about animal welfare that we need to answer before we can responsibly estimate the net effects of our actions and policies on wild animal welfare.

To the extent that animal welfare is currently measured in policy contexts (which, to be clear, is a limited extent), it is typically measured for alignment with the ‘five freedoms’. These were developed in the early 1990s and were the first metrics to capture, or attempt to capture, the subjective experience of animals in addition to their health and behaviours.Footnote ¹⁶ They include: (1) freedom from hunger or thirst; (2) freedom from discomfort; (3) freedom from pain, injury, or disease; (4) freedom to express normal behaviour; and (5) freedom from fear and distress. Each freedom has corresponding provisions that are recommended; for example, to ensure that an animal has freedom from hunger or thirst, the standard recommendation is to provide the animal with access to fresh water and a healthy diet.

While the five freedoms represent an important step towards the inclusion of animal welfare in public policy, they are incomplete measures of animal welfare. One of their limitations is that they are open to interpretation, which means that a range of environments could arguably meet their criteria.Footnote ¹⁷ Another limitation is that they represent what humans believe is important for animal welfare. They are not backed by animal welfare science as the five most important freedoms to animals. A third limitation is that they focus only on freedom from negative states, when positive animal welfare should be considered a benefit in policy making.Footnote ¹⁸ A more complete metric of animal welfare might track positive experiences as well as negative ones and represent the balance between them.

To develop a better framework, however, we need to answer several basic questions about animal welfare. First: Which animals are welfare subjects? That is, which animals are capable of experiencing morally significant benefits and harms? Does this capacity require sentience (the ability to suffer), agency (the ability to pursue goals), or only life (the ability to survive or procreate)? And if it requires sentience or agency, which animals have these features? The empirical evidence supports at least a non-negligible chance that all vertebrates and some invertebrates have these features.Footnote ¹⁹ But to the degree that we remain uncertain about particular animals (say, insects), how, if at all, should they factor into welfare assessments?

Second: How do our actions and policies affect these animals? When we attempt to help wild animals, our interventions can easily reverberate across vast ecological webs. Thus, if we want to assess the net effect of our actions and policies on wild animal welfare, then we need to consider not only the direct and intended effects on some animals, but also the indirect and unintended effects on all animals. That requires improving our understanding of natural systems in general, so that we can find order in what currently appears to be chaos. This project is already difficult when we restrict welfare assessments to, say, mammals and birds. It will be much harder when we expand these assessments to include all animals who merit consideration.

Third: Which effects are good and bad for particular animals? Many humans assume that we benefit animals when we extend their lives and expand their populations, and that we harm them when we shorten their lives and contract their populations. However, if an individual animal experiences more suffering than happiness, then extending their life may not be good for them. Similarly, if a group of animals experience more suffering than happiness overall, then expanding this population may not be good for its members overall. Thus, even if we knew how our actions and policies would affect wild animals, we still might not know which actions and policies are good or bad unless we know which effects are beneficial or harmful.

Fourth: How can we compare welfare impacts across species? Suppose we agree about which impacts are good and bad for particular animals. In this case, we still need to ask how good and bad these impacts are for these animals. Do an elephant, a mouse, and an ant all have equally strong interests, such that we should give them all equal weight in our welfare assessments? Or is the strength of their interests a function of, say, their cognitive complexity and longevity, such that we should give more weight to the elephant than to the mouse, and more weight to the mouse than to the ant? Because smaller animals tend to have larger populations, how much weight we give these animals will end up mattering a lot.

Finally: How should we factor welfare assessments into our decisions? Ethics, law, and policy are about more than promoting welfare, at least in practice. They are also about respecting rights, honouring relationships, and working within our epistemic and practical limitations. When we consider all relevant factors, we might find that even if animals have a lot at stake in our decisions, there is a limit to how much we can, and should, support them. However, our claim in this chapter is merely that, for all we know now, we might be able to improve our treatment of animals at least somewhat. And insofar as we can improve our treatment of animals in a responsible, achievable, sustainable way, we owe it to them to try.

15.2.3 Improving Animal Welfare, One Step at a Time

Given the complexity of these issues, one might think that we should wait for more information before we attempt to improve our treatment of animal populations, particularly wild animal populations. After all, until we know more about which animals are welfare subjects, how our policies will affect them, which effects are good or bad for them, how to compare welfare across species, and how to factor welfare assessments into our policy decisions, our attempts to improve animal welfare can easily be ineffective or counterproductive. In the meantime, vulnerable human populations still need support too. Perhaps we should prioritise improving human lives while we wait for more information about how to improve non-human lives.

However, it would be a mistake to delay consideration of non-human animals for these reasons. First, these issues are urgent, and there are risks in both directions. Again, humans kill more than 100 billion captive vertebrates, more than a trillion captive invertebrates, more than a trillion wild vertebrates, and quadrillions of wild invertebrates every year. In the future, human-caused environmental changes will amplify our effects on non-human populations considerably. Thus, there is no risk-free option in this context. While considering animal welfare might lead us to mistakenly cause new harms, continuing to neglect animal welfare will lead us to amplify – and potentially lock in – current patterns of harm, exploitation, and extermination.

Second, we may never be able to completely answer these questions, and bad assessments can still be better than nothing at all. Determining how to treat wild animals requires addressing fundamental issues in ethics and science, including questions about the nature of other minds and the value of other lives. We will likely not be certain about these issues anytime soon. At the same time, we are not completely in the dark about these issues either, and we have sophisticated tools for making policy decisions about important and difficult issues under risk and uncertainty, such as precautionary principles and expected value principles.Footnote ²⁰ We should do the best we can with what we have as we continue to research these issues over time.

Third, bad assessments can pave the way for better assessments. Part of how we can learn how to improve our treatment of animals is by attempting to improve our treatment of animals and then studying the effects. Of course, this is not to say that we should experiment with risky, costly, harmful, large-scale interventions simply to study the effects; it would be bad to destroy the environment simply to confirm that destroying the environment is bad! Instead, the idea is that experimenting with reasonably safe, low-cost, small-scale interventions can have both practical and epistemic benefits. Practically, it can help at least some animals in the short term, and epistemically, it can teach us how to help more animals in the long run.

Fourth, knowledge is not the only bottleneck; capacity and motivation are as well. We already know how to improve our treatment of animals in many ways, but we lack the ability and political will necessary to act on this knowledge. Thus, it would be naive for us to simply spend 100 years developing knowledge about animal welfare and then expect the world to be ready to act. We instead need to develop relevant knowledge, capacity, and motivation simultaneously. Experimenting with reasonably safe, low-cost, small-scale interventions can help in all these ways, as it can contribute not only to the development of animal welfare research, but also to the development of legal and political institutions for considering animal welfare.

Fifth, many changes can be co-beneficial for humans, (many) animals, and the environment. The One Health policy framework is a reminder that improving our treatment of animals and the environment can have positive effects for us as well. Of course, this is not to deny the reality of trade-offs both within and across species. Few if any policies will benefit everyone. Still, if we at least consider everyone when making decisions, then we might find that we can improve our treatment of humans and non-humans at the same time; or, at least, that we can improve our treatment of non-humans without worsening our treatment of humans. Experimenting with these kinds of seemingly co-beneficial options is a good place to start.

Finally, many decisions can involve path dependence and even a ‘lock in’ effect, particularly decisions regarding the built environment. In particular, governments are or, at least, will soon be spending vast amounts of money to build more resilient and sustainable infrastructure in the face of climate change. If we at least consider animal welfare when we build this infrastructure, then we might be able to identify relatively safe, low-cost, small-scale changes that appear to benefit humans, animals, and the environment. And of course, it would be cheaper and faster to change our infrastructure once, with both human and non-human interests in mind, than to change it once for humans and then all over again for everyone else.

In our view, these reflections support the following theory of change for wild animal welfare. As we research basic ethical and scientific issues regarding wild animal welfare, we should also experiment with relatively safe, low-cost, small-scale interventions that appear co-beneficial for humans, (many) animals, and the environment in the short term, and that will help us to build the knowledge, capacity, and motivation necessary to pursue better interventions over time. And in order to produce these further effects, we should focus on infrastructural and institutional changes that can involve path dependence, and to develop partnerships between researchers and policymakers so that we can study the effects of policy experiments.

15.3.1 Building Local Government Capacity to Advance Wild Animal Welfare

Cities can begin to incorporate wild animal welfare into local plans, monitoring, institutions, and policies.Footnote ²⁶ Through these cross-cutting actions, cities can build their capacity for promoting wild animal welfare consistently across local policy areas.Footnote ²⁷

15.3.2 Sample Local Policy Recommendations

Cities can also implement specific policies that support not only wild animal welfare, but also human health and climate change mitigation or adaptation. They can begin with relatively safe, low-cost, small-scale interventions that appear to be co-beneficial for humans, (many) animals, and the environment, reflecting a One Health approach to local policy making. Such policies have low risks and many benefits. Over time, they will help us to build the knowledge, capacity, and motivation necessary to pursue more effective and widespread interventions in the future. There are a range of local policies on land use and the built environment that reflect a One Health approach, but this chapter focuses on a few illustrative examples that have the potential to benefit humans, animals, and the climate with relatively few welfare trade-offs.Footnote ⁴² The following examples can be implemented on private lands via local ordinance and on city-owned lands.

15.3.3 Green Infrastructure Design

Cities should consider how their green infrastructure (GI) can better support the welfare of wild animals. GI – including green roofs, rain gardens, bioswales, retention basins, and green spaces – can help cities and their residents adapt to the impacts of climate change. Many cities have begun to implement GI to address storm water run-off and flooding, combat air pollution, and reduce the urban heat island effect.Footnote ⁵⁵ In addition to the climate and human health benefits, GI can take into account wild animals in GI planning, design, and implementation. GI can provide habitat, shelter, and food sources for wild animals and mitigate extreme heat which can harm wild animals.Footnote ⁵⁶

Cities can start by including wild animals in their GI planning. For example, Harford County, MD has a green infrastructure plan that lists providing high-quality wildlife habitat and wildlife corridors as an explicit goal in the GI network.Footnote ⁵⁷ Beyond planning, cities can require consideration of wild animals in GI design and siting and issue technical guidance and GI design manuals that include consideration of wild animals. Guidance and design manuals can require plant selection for GI to provide habitat, shelter, and food sources to wild animals that could enhance their welfare. In Lancaster, PA, the city’s GI design manual requires that GI plants are selected in part based on ‘wildlife value’, including habitat, food, and shelter for wild animals.Footnote ⁵⁸

15.3.4 Lawn Maintenance Practices

Cities should consider supporting lawn maintenance practices that benefit humans, wild animals, and the environment such as prohibiting gas lawn equipment and allowing naturalised lawns. Gas lawn equipment may harm human and wild animal welfare through exposure to high-decibel noise (especially for gas leaf blowers), increased air pollution, and exposure to carcinogenic chemicals and other pollutants.Footnote ⁵⁹ Gas lawn equipment may further disrupt leaf litter habitat and cover for insects and reptiles, decrease their food availability, and reduce bird nesting material availability.Footnote ⁶⁰ Over 100 cities in the United States have prohibited the use of gas leaf blowers, including Washington, DC and Maplewood, NJ.Footnote ⁶¹ Some cities have implemented electric municipal lawn care equipment or provided rebates to private individuals for switching from gas to electric lawn equipment.Footnote ⁶² Overall, cities should consider prohibiting or phasing out all gas lawn equipment.

Naturalised lawns may also provide benefits to humans, animals, and the environment. Naturalised lawns typically include a range of native plants of different types and heights, rather than monoculture or turf lawn.Footnote ⁶³ Naturalised lawns can promote climate change mitigation and adaptation by reducing water use in drought conditions, greenhouse gas emissions from lawn fertiliser, and the use of gas lawn equipment.Footnote ⁶⁴ The benefits of naturalised lawns for wild animal welfare are not well established, but naturalised lawns may promote habitat connectivity and provide wild animals (such as insects) with habitat and food sources.Footnote ⁶⁵ This is an example where a city could partner with a research institution or otherwise study the effects of naturalised lawn policies on wild animal welfare. To start, cities can at least amend existing local laws to remove height limits for plants in lawns or exempt naturalised lawns from laws limiting plant height. As scientific understanding of wild animal welfare benefits of naturalised lawns develops, cities could go further to provide incentives for naturalised lawns on private lands (including turf grass replacement programs) and install naturalised lawns on non-functional city lawns. A number of cities have already removed plant height limits and implemented incentive programs for naturalised lawns.Footnote ⁶⁶

16.2.1 One Health

The One Health Initiative, working at the local, regional, national, and global levels,Footnote ¹⁹ has the goal of achieving optimal global health outcomes through recognising the interconnection between people, animals, plants, and their shared environment.Footnote ²⁰ However, the environment is certainly the most neglected pillar of the One Health triad, including in addressing the AMR challenge.Footnote ²¹ Misuse and overuse of antibiotics in humans and animal production globally needs to be understood in the context of the physical, biological, and societal drivers as pathways for AMR to find its way into the environment and subsequently to humans and animals.Footnote ²² There is growing support in the literature raising the alarm for a more integrated and holistic approach for any global One Health action plan to be effective and complete.Footnote ²³ There is a need to generate innovative ideas and put them into action to ensure a more sustainable global ecosystem in the years to come, including production methods and systems with high animal welfare and health and less climate and environmental impact as ways to ensure human health. Research and innovation alone are not sufficient to achieve societal transformation. They need to be supported by policy and practice to foster inclusive participation by stakeholders (i.e. government, industry, society, academia, scientists, and special interest groups) to ensure effective societal uptake of the resulting solutions.Footnote ²⁴ For example, because AMR surveillance requires access to data, legal questions associated with privacy, data protection, and intellectual property, as well as data security concerns relating to transparency, accountability, and responsibility can manifest as barriers.Footnote ²⁵ By better understanding the interests and concerns of each of the relevant stakeholders, there is an informed basis to design, develop, and implement initiatives and solutions that are responsive to stakeholders’ needs. This in turn will foster greater trust and accountability, along with a change in perception to reduce societal opposition to innovative solutions.

16.2.2 Value-Based Health and Care (VBHC)

Globally, the cost of delivering health and care has increasingly become unsustainable, with the aging world population placing significant pressure and demand on health systems.Footnote ²⁶ Without an integrated and holistic value-based approach to achieving a balance between human, animal, and environmental health, there is a real risk that the global health ecosystem will become unsustainable. The concept of ‘one medicine’ has been explored in the literature to emphasise the dangers of siloed approaches to human health without considering the social-ecological or human-environmental context.Footnote ²⁷ The inextricable interconnectedness and interdependence between human, animals, and the environment requires an alignment in practice and framework structures to deliver comprehensive health and care solutions that do not negatively impact the planet. Sustainability of the entire health and care ecosystem therefore needs to be assured to continue to meet the current and future needs of the people and the planet through a value-based strategy that optimises human, animal, and environmental health.Footnote ²⁸

The core principle of VBHC is to achieve the best possible health outcomes within the resources available.Footnote ²⁹ VBHC is currently defined by the National Health Services as ‘[t]he equitable, sustainable and transparent use of the available resources to achieve better outcomes and experiences for every person’.Footnote ³⁰ In view of growing demand and limited resources, it comes as no surprise that VBHC is gaining acceptance as a model to address increasing health and care demands by including patients, public authorities, industry, and healthcare providers in a coordinated effort to collectively achieve improved outcomes for all.Footnote ³¹ In principle, the adoption of VBHC approaches will lead to long-term social and economic benefits from optimising the use of available resources to support a health and care system that delivers a productive and healthy population. Society as a whole stands to benefit from lower costs and improved public health by sharing risks and rewards through a system of mutual accountability. However, to achieve value, the stakeholders that make up the health and care ecosystem need to come together in a coordinated effort to collectively define what constitutes value from a One Health perspective. Most of the literature on the concept of value in VBHC focuses mainly on the relationship between value and financial cost with the aim of lowering costs without sacrificing human health outcomes.Footnote ³² There appears to be a disconnect between the concept of value as understood in the literature compared to the proposed practices aimed at implementing and achieving VBHC outcomes, which seem to focus predominantly on devising funding models and strategies to optimise effective resource management by lowering cost without One Health objectives in mind.Footnote ³³

One of the key challenges to successfully develop and implement VBHC practices is the lack of a common definition or shared understanding of the concept of ‘value’. For example, what may be the best solution for the treatment of a particular disease from a clinician’s or scientist’s perspective may not be viable to industry because the value proposition from a commercial standpoint does not justify the time and costs required to bring the product on the market. Alternatively, what may be an affordable treatment from a hospital or public authority’s perspective may not be the best solution for the intended user because of undesirable side effects that interfere with the patient’s ability to take part in everyday life. The flip side of that example is the long-term personal health and societal benefit of expensive, potentially curative solutions that will enable patients to contribute more to society over a longer period of time as a healthy individual. Furthermore, curative solutions will also enable family members of patients to be more productive if they are relieved of care responsibilities. Similarly, the healthcare system will also be relieved of the long-term financial investment to treat patients over the course of their lifetime.

Understandably, efforts focused on cost reduction are pragmatic given the public scrutiny and accountability for the use of limited public resources to meet health and care needs. There is evidence in the literature of overuse and underuse of healthcare services and technologies, both of which contribute to waste of resources in addition to causing potential harm to patients and the planet.Footnote ³⁴ However, if the concept of value focuses (or is even perceived to focus) too heavily on reducing expenditure without sufficient and inclusive consultation with different stakeholders and impact on environmental and ecological sustainability, there may be very little support and uptake of practices aimed at achieving VBHC outcomes due to lack of transparency and trust and insufficient consideration to achieve broader One Health goals.Footnote ³⁵ In addition to health gains to humans, the environmental footprint and impact on animal health also need to be measured and considered as a concrete value.

Without a framework that is upheld by legally supported governance structures and informed by policy objectives such as One Health, SDGs, the principles of RRI, and the Health System Governance strategy,Footnote ³⁶ effective implementation of VBHC practices to address global health will continue to remain elusive and challenging. Decisions driven mainly by cost containment or reduction efforts without considering the impact on environmental and animal health will likely obscure innovative opportunities to improve outcomes and lower the true cost to the system.Footnote ³⁷ The value proposition of incentivising the development of new innovations from a VBHC perspective requires a mindset of prioritising patient-centred outcomes as well as environmental and animal health considerations.

Even if there is a sufficient level of societal readiness from patients to adopt a solution, the innovation may not be commercially viable to industry to justify the time and costs required to translate and develop the solution into a market-ready product because the value proposition does not justify the resources required. Alternatively, a patient-preferred and scientifically supported treatment may not be sustainable from an environmental and global common good perspective. Bioprospecting under the banner of sustainable drug discovery may lead to conservation, biopiracy, and cultural appropriation concerns if not governed properly. For example, natural compounds derived from bioresources such as plants are considered more sustainable than creating chemical compounds in drug discovery and development,Footnote ³⁸ but have also attracted criticism when the resources and knowledge of Indigenous communities are exploited and appropriated through commercial activity without any benefit sharing.Footnote ³⁹ As such, value in terms of efficacy of treatment, value in terms of financial costs, value in terms of profitability, value in terms of societal acceptance, and value in terms of patient welfare are all ‘valued’ differently from the perspective of different stakeholders. Despite a shared intent, because stakeholders define and perceive value very differently, there may be very divergent opinions and approaches to achieving the same goal of improving health outcomes through a One Health approach. For example, when making decisions on the allocation and use of healthcare resources from a VBHC perspective, understanding value based on a short-term assessment of efficiency at the expense of considering investments in the long-term One Health outcomes may be short-sighted and give rise to health inequities, especially for those suffering from rare or neglected diseases. Advanced therapy medical products (ATMPs) are an example of a very expensive personalised medicine treatment that has the ability to cure rare diseases compared to lower cost solutions that are currently being offered to treat the same diseases. Despite the high upfront cost of ATMPs, this investment needs to be considered in light of the financial, environmental, and well-being cost of resources required for the care and treatment of the disease over the course of the patient’s lifetime, which may far exceed the cost of the curative potential of ATMPs. The long-term environmental impact, healthcare, and social outcomes of more expensive solutions do not seem to fit well with the current economic models of, and approaches to, VBHC despite recognition on a policy level of the importance of equity, One Health considerations, and value judgments.Footnote ⁴⁰

The literature therefore supports the argument that a value-based approach to capturing and incentivising the social value as well as technological value of innovations may be a viable solution to encourage the development of health- and care-related innovations. By focusing on the blended value of private and social return on investment and rewarding innovations with high social benefits by translating social value into economic value, a responsible, sustainable, and value-based innovation framework emerges to reinvigorate the innovation pipeline.Footnote ⁴¹ However, without an appropriate legal framework that takes into consideration and balances the social, political, financial, and administrative pressures associated with innovation development and procurement, there will always likely be implementation challenges and frustrations. As will be described in greater detail below, the procurement of innovative technologies is well suited to value-based procurement as a way to encourage and incentivise the development of innovations that are socially, economically, and environmentally sustainable.

For new models or framework designs to have legitimacy in the eyes of those who will implement and operationalise VBHC, as well as those that VBHC intends to benefit, there needs to be meaningful engagement to align stakeholder interests and needs through responsive dialogue to include One Health perspectives. This is where the law and the principles of RRI can play a key role in providing the necessary legal and policy framework to give credibility and accountability to ensure that stakeholder interests and concerns are reflected and taken into to account as part of the process of implementing and adopting VBHC initiatives.Footnote ⁴² A more nuanced and holistic approach to global health requires exploring how the principle RRI can help achieve the objectives of VBHC in a more balanced, inclusive, and equitable manner in line with a One Health approach. Existing legal tools can also be leveraged to operationalise RRI to practically align societal needs with the economic realities of healthcare systems to achieve One Health objectives and VBHC outcomes.

Through the inclusive engagement envisioned and described under RRI, a foundation for collaborative partnerships based on a system of mutual accountability and understanding of the underlying interests can be formed. Legitimacy, trust, and accountability are essential to ensure that the development of VBHC solutions that include a One Health approach is sustainable in terms of effective societal uptake.

16.2.3 Responsible Research and Innovation (RRI)

Research and innovation have been identified as key pillars of the EU’s strategy to create sustainable growth and prosperity.Footnote ⁴³ RRI was therefore adopted as an approach to govern research and innovation in a manner that is interactive, transparent, and responsive to public concerns to reduce the risk of societal opposition to new innovations arising from research efforts.Footnote ⁴⁴ One of the main objectives of RRI is to align research with societal values through inclusive engagement to make science more responsive to societal needs and to ensure effective uptake of the resulting innovations.Footnote ⁴⁵ Broadly speaking, RRI refers to efforts aimed at enhancing the accountability of research through societal engagement and societal inclusion.Footnote ⁴⁶ The premise is that research done responsibly will help form the foundation for the sustainable development of resulting innovations.

There has been an increasing policy focus on meaningfully engaging different stakeholders in the process of research and innovation to ensure that research and development takes social considerations, values, and interests into account so that the outcomes of research meet societal needs.Footnote ⁴⁷ While there is an ongoing demand for greater reflection of responsibility, particularly on emerging science and technologies,Footnote ⁴⁸ interests in responsibility need to be considered along with real-world dynamics such as economic complexities and accountability to public interests,Footnote ⁴⁹ particularly in the field of healthcare.Footnote ⁵⁰ Because of the uniquely high costs and sector-specific dynamics associated with innovating health-related technologies,Footnote ⁵¹ the principles of RRI can be a useful policy tool to reconcile the objective of global access to affordable and quality healthcare without stifling innovation.Footnote ⁵²

For example, in response to the COVID-19 pandemic, significant public funds were invested into the research and development (R&D) of innovations with the aim of securing global health for everyone everywhere. In 2020, an estimated €16 billion in pledges from governments and international donors worldwide were used to fund R&D of diagnostics, treatments, and vaccines for COVID-19.Footnote ⁵³ In 2021, a further estimated €20 billion was provided, largely from government sources, to continue to fund the global response to COVID-19.Footnote ⁵⁴ In addition to concrete funding, other public initiatives were introduced to further support international cooperation and collaborative efforts to develop health innovations. For example, the WHO and its partners launched the COVID-19 health technology access pool (C-TAP), a global initiative to facilitate access to data and open sharing of scientific knowledge by removing legal barriers such as intellectual property (IP) and other proprietary rights.Footnote ⁵⁵ The express intent of C-TAP was to accelerate the discovery of innovations through open science and to ensure that ‘the latest and best science benefits all of humanity … and made universally available’.Footnote ⁵⁶ A second initiative launched by the WHO and its partners known as the Solidarity Trial was an international collaborative clinical trial effort to rapidly assess promising treatment options by adopting an adaptive design that significantly reduced the time needed to generate the necessary evidence on safety and efficacy.Footnote ⁵⁷ Similarly, the United States Food and Drug Administration (FDA) launched its Coronavirus Treatment Acceleration Program to accelerate the development and approval of treatments by reducing the regulatory burden and increasing the efficiency of the evaluation process.Footnote ⁵⁸

The result of these publicly funded initiatives and investments into open and collaborative R&D efforts have largely proven to be successful. However, as various innovations approached market readiness, private rights and commercial return on investment interests began to overshadow the previously shared spirit of collective action towards achieving global public health.Footnote ⁵⁹ The assertion of IP and proprietary rights were used by the pharmaceutical industry to maintain market exclusivity by limiting access to the use of knowledge and know-how. Traditionally, IP rights have been justified in the pharmaceutical sector because of the time and cost associated with drug discovery and development.Footnote ⁶⁰ However, if the cost of research for COVID-19-related innovations have largely been subsidised by the public through public research grants and the time and risk for development has been significantly reduced through publicly funded initiatives, should IP rights be asserted on innovations that have largely already been paid for by the public? In response to a global pandemic, there must be legally supported mechanisms to ensure the pharmaceutical industry and national interests cannot undermine the ability to rapidly distribute essential medicines worldwide at the expense of environmental considerations. While commercial interests need to be recognised to incentivise innovation, private profits should not be subsidised by the public purse that supported the development of essential medical solutions.

The proactive approach of RRI to critically assess the broader impact of innovation on society in a responsive and reflexive manner makes the RRI framework particularly relevant to the healthcare context as a way to align the values, needs, and expectations of relevant stakeholders in a holistic and balanced manner.Footnote ⁶¹ Examples of stakeholders that form a part of the healthcare ecosystem broadly include patients, healthcare providers, public health authorities, funding agencies, and industry. However, in practice, the notion of alignment is often confounded with agreement, making the challenge of imparting the core values and reasoning of RRI and social impact into traditional science and technology research practices even more difficult to implement.Footnote ⁶² For example, despite the trend towards collaborations between academia and industry and the shared commitment to optimise the impact of research and innovation for the benefit of society,Footnote ⁶³ significant ‘cultural’ obstacles continue to hinder successful partnerships between stakeholders.Footnote ⁶⁴ The translation of policy into practice requires the reassembling of policy ideas into context-specific settings.Footnote ⁶⁵ To be successful, science-society policies need to recognise competing cultural norms and logics of different institutional and professional settings in order to connect the underlying reasoning of the policy objectives in a relatable way to different stakeholders.Footnote ⁶⁶

Because RRI focuses on the interdependent relationship between science, innovation, and society,Footnote ⁶⁷ the principles of RRI could be used to inform the concept of value in a One Health context to include a reflexive, inclusive, and responsive understanding of beneficial outcomes for human, animal, and environmental health. The scholarship on RRI continuously highlights that the concept of responsibility is multiple and changes its shape and meaning depending on the context of use.Footnote ⁶⁸ By adopting an RRI approach to engage each of the stakeholders in the One Health ecosystem to better understand what motivates them, a holistic innovation framework that incentivises collaborative participation can be developed.Footnote ⁶⁹ As recognised in the RRI literature, translating policy into practice has proven to be challenging.Footnote ⁷⁰ Similarly, translating One Health goals into practice could encounter similar difficulties if steps are not proactively taken to identify and create conditions necessary to adopt One Health practices that reflect the culture of the specific healthcare setting and ecosystem. By instilling a sense of ownership, control, and self-determination of what value-based outcomes means in a One Health context, there is a greater likelihood that a VBHC model co-created by the relevant stakeholders through an inclusive dialogue to better understand the reasoning and objectives underlying VBHC initiatives will be successfully adopted. To achieve this, the generally practiced stakeholder engagement activities such as focus groups, interdisciplinary involvement, public outreach, and semi-structured interviews remain the same.

Although the literature suggests these alone do not lead to successful implementation of science society policies,Footnote ⁷¹ the background training and education leading to and in support of the engagement activities aimed at contextualising the core values and principles of VBHC will create a common basis for stakeholders to engage in meaningful and responsive dialogue. By identifying and understanding the root cause, real or perceived, underlying the reluctance to implement and adopt VBHC initiatives, there is an informed basis to design, develop, and implement policy and legal structures that are responsive to stakeholder interests and concerns. This in turn will foster greater trust, accountability, and willingness to collaborate. Furthermore, as discussed in greater detail in the next section, a legally supported governance structure to incentivise and de-risk the adoption of VBHC initiatives would encourage all participants to be active, responsible, and accountable for achieving VBHC outcomes.

16.3.1 Dispelling Legal Misconceptions

One of these pressure points is the tension between ‘law according to the books’: what the law says according to those in the legal field; and ‘law in reality’: how the relevant stakeholders interpret or experience and put the law into practice in their particular setting. In the context of VBHC and One Health, and other data reliant initiatives, there is an observed reluctance by parties who have access to valuable data to allow and operationalise the use of the data to support the development of data-driven solutions by third parties.Footnote ⁷⁴ By understanding and dispelling misconceptions of what are perceived as opposed to actual legal barriers, there is a greater likelihood of achieving policy objectives and realising value propositions. For example, as recognised in the VBHC literature, access to available data is essential to determine metrics by which to align health outcomes with the impact of health interventions on the environment and society as part of the assessment of any VBHC framework.Footnote ⁷⁵ The inability to measure and determine what metrics demonstrate a value-based outcome, how should the metric be assessed, and over what period of time for the promised reward to be earned under the VBHC model becomes a significant barrier to adoption.Footnote ⁷⁶

The European Commission estimates that US$20 billion are spent every year to develop innovations and technologies that have already been developed elsewhere because existing knowledge is not being shared or made available.Footnote ⁷⁷ The reluctance to share and operationalise the use of existing data can only be understood and solved through meaningful engagement with the relevant parties that have control over the data. Based on the principles of RRI, if there is a mutual understanding by all stakeholders of both ‘law according to the books’ and ‘law in reality’, there is an informed basis to articulate and shape legally supported data sharing agreements to better align VBHC initiatives with stakeholder interests and concerns.Footnote ⁷⁸ For example, stakeholders have expressed concerns related to potential liability under existing data protection laws,Footnote ⁷⁹ as well as relinquishing intellectual property (IP) interests and entitlements to benefit should the use of data lead to some commercialisable success.Footnote ⁸⁰ There is also the confusion between IP rights and the broadly accepted policy mandate for data sharing, open science, and open access to support the advancement of scientific research and free exchange of knowledge.Footnote ⁸¹ Many large health and innovation-related organisations adopt a data sharing policy,Footnote ⁸² encouraging the sharing of available data in accordance with FAIR principles (findable, accessible, interoperable, and reusable) to foster scientific progress by reducing barriers for the reuse of available knowledge. However, the ‘IP status’ of data is not generally well understood but it is commonly recognised as proprietary information that has significant potential value.Footnote ⁸³ Because of this gap in knowledge and limited access to resources, guardians of valuable data are often paralysed into inaction and opt for the safest option, which is to not permit access to data under their control.Footnote ⁸⁴ If proprietary information necessary to create innovations and solutions cannot be adequately protected by traditional forms of IP, stakeholders are likely to safeguard their personal interests at the expense of sharing data despite the potential advantages of open science.Footnote ⁸⁵

16.3.2 Leveraging the Law to Safeguard Stakeholder Concerns

By involving and consulting with stakeholders at the outset, there is an opportunity to identify and characterise the observed hindrances and opportunities from the perspective of the relevant stakeholders to have an informed understanding of how each stakeholder group perceives the role of law and regulations that impact the use and sharing of existing data. This type of engagement will allow for a better alignment of objectives with the expectations of stakeholders. Legal mechanisms can be used to support what VBHC and One Health initiatives want to achieve by defining the ‘rules of engagement’ to safeguard the interests and concerns underlying the reluctance to operationalise the use of available data. Like a marionette puppet, pulling on one string to address a concern of a single stakeholder might get one step closer to the desired outcome, but the rest of the stakeholders that make up the healthcare ecosystem need to readjust and have an incentive to readjust to accommodate the change to get to a new equilibrium. The law can be a useful tool to help strike a balance and define a legally protected framework where the stakeholders can reach an understanding on what conditions need to be in place to continue to function within the new norm. Value-based agreements have slowly gained traction globally in the healthcare context and require a mutually shared understanding of the financial and operational impact of adopting a new model delivering healthcare.Footnote ⁸⁶ Without a bespoke legal framework to alleviate real and perceived challenges, One Health-informed VBHC initiatives will encounter implementation challenges no matter how sound the model may theoretically be. The relationship between RRI and the sustainable implementation of VBHC practices requires the law to de-risk and incentivise the partners between the stakeholders. In other words, the law can be used as a tool to manage and reduce the real and perceived risk associated with achieving VBHC outcomes. For example, contractual obligations can be used as neutral arbiters to compel and capture the value of sharing data on the one hand while protecting against free-riding and unauthorised use of the data on the other through the threat of enforcement measures.

16.3.3 Leveraging Public Procurement to Drive One Health Policy

The public procurement framework also has a key role to play in realising the One Health objectives as part of Europe’s strategy to achieve smart, sustainable, and inclusive growth through R&D.Footnote ⁸⁷ For example, in 2016, new rules governing the innovation partnership procedure introduced in the EU Public Procurement Directive enabled public authorities to combine the development and purchase of successfully developed innovative products.Footnote ⁸⁸ By comparison, the procedure that preceded the innovation partnership where the pre-commercial procurement of R&D services is followed by a separate procurement process for the large-scale commercial rollout of the product itself would not have been suitable to incentivise the development of One Health value-based innovations because it failed to take into account any benefits beyond the technological capabilities of new innovations.Footnote ⁸⁹ With the introduction of the combined development and procurement procedure, innovations with high social, environmental, and ecological value can be strategically procured as part of a collaborative R&D process to address societal challenges such as One Health approach to human healthcare, while respecting wider socio-economic, environmental, and policy agendas.Footnote ⁹⁰ The Guidance on Innovation Procurement document states that innovation partnerships can only be used to procure solutions tailored to address a specific challenge identified by the authority where the market ‘does not offer a satisfactory solution or where an adaptation of existing solutions is unlikely to meet the needs’.Footnote ⁹¹ A strong argument can be made that innovation partnerships are a viable solution for a public buyer to enter into long-term partnerships with suppliers of innovation to co-develop innovative solutions that adopt a One Health perspective. Through the innovation partnership framework, public authorities will have a legal basis to exercise decisive influence over stakeholders to achieve One Health objectives through the procurement of innovations that prioritise One Health considerations. The purchasing power of public authorities combined with the health and care decisions that naturally follow from choosing to purchase one solution over another makes public procurement an extremely influential tool that public authorities can wield to strategically steer different stakeholders towards achieving One Health objectives. Value-based procurement integrates the concept of quality health and care with environmental, societal, and ecological impact and translates them into tender criteria that can include technical merit as well as One Health characteristics to drive long-term goals beyond traditional considerations of cost, making this a useful tool, for example, with ATMPs that do not fit with the traditional cost model.

17.4.1 Expanding the Scope of Public Health Law

Law has evolved to encompass, albeit incompletely, the diversity of the human condition. One of the ways in which it has done and continues to do this is through the integration of human rights norms into legal, political, and social systems, especially as related to equality. However, the question remains whether and how public health and public health law can evolve beyond its anthropocentric foundations. There are at least two ways in which public health can develop informed by One Health or similar approaches: through incorporating the moral standing of animals and the ecosystem into how we conceptualise public health and public health law; or, at the very least, acknowledging that the well-being of the ecosystem and animals has an instrumental importance.Footnote ³⁹ An intrinsic view of ecosystems and animals suggests that they are an end in and of themselves; they have intrinsic value.Footnote ⁴⁰ This has been recognised in a very limited way in some countries. For example, in Aotearoa New Zealand, the Te Urewera (a former national park) and the Whanganui River have been recognised as having intrinsic value and afforded status as, respectively, a legal entity and legal person.Footnote ⁴¹ Critics argue that this status is more about creating a mechanism to manage relationships between humans, rather than anything else (a relational view).Footnote ⁴² A relational view is perhaps a middle ground between intrinsic and instrumental in that it focuses on the perception of people, individually or collectively, that they have a relationship(s) with the ecosystem and responsibilities arising from that relationship. Empirical research has indicated that this view is more often seen in non-Western cultures.Footnote ⁴³ An instrumental approach to public health law suggests that ecosystems and animals only have value in terms of being a means to the end of achieving the conditions to maximise human health or human well-being. These views can and do overlap for some people and relational is sometimes subsumed as instrumental if it is framed to confer a health benefit for the person from that relationship (i.e. mental health).Footnote ⁴⁴ Currently, public health law (domestic or global), unsurprisingly considering its western Enlightenment foundations (discussed above), is fundamentally instrumental. The focus, therefore, is on the well-being of animals and the ecosystem because of its instrumental value for human health (physical or mental).Footnote ⁴⁵ One Health could be characterised as an integrated approach straddling intrinsic value, relationality, and instrumentalism in emphasising the importance and inter-connectedness of the health of people, animals, and the environment. While some would, and do, emphasise the instrumental benefits of One Health, One Health creates a model that embraces relationality and intrinsic value. It has the potential, if fully realised, to move away from bio-medical reductionalism that some have argued is an issue for One Health, as much as it is for public health law.Footnote ⁴⁶

One Health challenges public health law to think about the limitations of an instrumentalist view of animals and the ecosystem where the balance remains focused on short-term human interests as mediated by capitalism. Contesting the Enlightenment thinking that permeates public health and public health law is critical for ecosystems, animals, and human interests. It is also an important step in de-colonising public health as a field and how public health law is conceptualised and employed.

Public health law has, in addition to being anthropocentric, also been primarily domestic in its orientation,Footnote ⁴⁷ despite its overlap with imperialist colonisation practices.Footnote ⁴⁸ This too reflects the limitations of existing legal structures with the primacy accorded to the sovereignty of nation states. Public health law has increasingly acknowledged this global context.Footnote ⁴⁹ Gostin et al., as part of the Lancet Commissions, have recently argued: ‘Health risks in the twenty-first century are beyond the control of any government in any country. In an era of globalisation, promoting public health and equity requires cooperation and coordination both within and among states.’Footnote ⁵⁰ The pandemic context led to the introduction, and post-SARS pandemic revision, of the International Health Regulations (IHR). The IHR imposes obligations on signatory states to undertake surveillance, investigation, reporting, and coordination of emerging pathogens.Footnote ⁵¹ The expansion of the scope of public health law to include non-communicable diseases has led to international legal instruments such as the Framework Convention for Tobacco Control 2003.Footnote ⁵² While the impacts of global infectious pathogens on human health are clear and have been experienced through epidemics and pandemics across the centuries, environmental degradation, until recently, had only localised impacts. This is changing: the impact of climate change and widespread environmental degradation have global impacts on human health that cross national boundaries. The centred definition of public health law with powers resting with the state has resulted in public health law being slow to recognise and respond to these changes. There has been some limited recognition of the transboundary impact of climate change and environmental degradation on human health; for example, the Association of Southeast Asian Nations – ASEAN Agreement on Transboundary Haze Pollution.Footnote ⁵³ Gostin et al., conclude:

In keeping with the positivist limitations on public health law, the discussion in this report predominantly focuses on how states can use law, singularly or in collaboration with other nations to achieve global public health ends, including through coordinating with non-state actors. However, it does not recognise non-state actors as potential regulators of public health practice.

17.4.2 Decentred Approaches to Public Health Law

One Health practices draw on interdisciplinary expertise in recognition of ‘the interdependence between human, animal and environmental health’.Footnote ⁵⁵ Gostin and Bloche acknowledge the importance of these non-state actors as a source of information.Footnote ⁵⁶ Nevertheless, they identify the state as the sole-regulator.Footnote ⁵⁷ We challenge the view that One Health practitioners merely inform the state, and instead argue that their actions are a form of regulation. Decentring our understanding of this field better reflects their contributions. This section begins by examining the themes that underpin Gostin et al.’s centred definition of public health law and then Black’s decentred conceptualisation of regulation. We argue that Black’s work applies to public health law. Indigenous Land Management (ILM) in Australia is used as a case study to explore the legitimacy of a decentred conception of public health law.

18.2.1 South Africa’s Endorsement of One Health in Theory

The South African National Department of Health (DOH) established the National One Health Forum (NOHF) in 2014 to detect, respond and prevent zoonoses, to comply with the International Health Regulations with respect to the detection and response to zoonotic events in South Africa through improved sectoral collaboration to secure optimal animal, human and environmental health.Footnote ⁸ Local participation mirrored the international tripartite arrangements of the WHO, the FAO and the WOAH; membership of the NOHF includes DALRRD, DOH and DFFE, supplemented by research institutions, academia, vet industry, environmental health officials, and NGOs. The expressed purpose of the forum is to pursue optimal health for people, animals, and the environment, with terms of reference addressing the following priority areas: surveillance programs, gaps and challenges, training needs, to ensure safe food supply, communication, outbreak and disaster preparedness, and identify research gaps.

18.2.2 The Department of Forestry, Fisheries and the Environment

In May 2016 a zoonoses prioritisation exercise was attended by an expert group and work is underway in 2024 to develop a One Health Framework and Implementation Plan Adoption of One Health by the DFFE. The DFFE formally recognises One Heath as a significant tool in environmental management, claiming it as an integrating unifying approach that aims to sustainably balance and optimise the health of people, animals, and ecosystems.Footnote ⁹ That department has recognised four focus areas for One Health implementation: Chemicals and Waste Management, Biodiversity and Conservation, Fisheries Management, and Air Quality Management.Footnote ¹⁰ However, despite this program framework, and although the DFFE recognises increased risk of diseases transmission through climate change, negative impacts to biodiversity through land-use change, over-exploitation, pollution, and invasive species impacts, One Health as a management tool barely warrants a mention in a whole raft of recent conservation policy documents made public by the Department. The 2020 ‘High Level Panel Report of Experts for the Review of Policies, Legislation and Practices on Matters of Elephant, Lion, Leopard and Rhinoceros Management, Breeding, Hunting, Trade and Handling’,Footnote ¹¹ for example, mentions One Health once in 582 pages of wildlife policy analysis (and only in reporting a stakeholder proposal that it be adapted as a management tool).Footnote ¹² The ‘White Paper on the Conservation and Sustainable Use of South Africa’s Biodiversity’ does not make a single reference to the concept.Footnote ¹³ Similarly, the ‘Policy Position on the Conservation And Ecologically Sustainable Use of Elephant, Lion, Leopard and Rhinoceros’, finalised in April 2024, makes no mention of One Health whatsoever.Footnote ¹⁴ It is clear that the concept is far from being the ‘significant tool in environmental management’ claimed by the DFFE, much less that it is providing ‘an integrating unifying approach that aims to sustainably balance and optimise health of people, animals and ecosystems’ as asserted by the DFFE.Footnote ¹⁵

18.2.3 The Department of Agriculture, Land Reform and Rural Development

The agricultural policy ambitions of DALRRD are set out in the Integrated Growth and Development Policy for Agriculture, Forestry and Fisheries.Footnote ¹⁶ The Agricultural Policy Action Plan (APAP) seeks to operationalise the policy framework into concrete steps. There is no mention of One Health in the APAP, probably reflecting a pre-Covid, pre-SARS era when zoonotic diseases were not recognised as significant public health concerns.

The DALRRD Ministerial Representative on the South African Veterinary Council has since recognised that, ‘We have a common goal of optimal health for humans and animals, and to ensure a sustainable environment for our future existence. The One Health approach brings together expertise and resources to achieve this goal.’ However, there is no explanation evident of how this is to be achieved in practice. Notably, DALRRD did not present at the 2024 National One Health Forum Workshop, and there is not a single mention of One Health as an operational tool or performance measure in the DALRRD Annual Performance Plan 2023/24.Footnote ¹⁷

18.3.1 Sustainable Use as Government Policy

In 2011, the National Planning Commission published the National Development Plan, a comprehensive analysis document that sought to map out a poly-centric policy framework to reduce poverty in South Africa. It recognised nine central socio-economic challenges requiring integrated solutions.Footnote ¹⁸ It also recognised that threats to the environment ‘are real and growing’,Footnote ¹⁹ and that, ‘[a]lthough climate change is the chief ecological challenge, others closely linked also pose serious risks such as water scarcity, pollution, food production and safety and depleted fishing stocks’.Footnote ²⁰

The Bill of Rights of the South African Constitution sets out a right to a safe environment, protected for benefit of present and future generations,Footnote ²¹ to be achieved, inter alia, through the fulfilment of positive duties by the state to effect reasonable legislative and other measures directed at the achievement of the specific rights and the general principles of the Constitution. The right to environment in Chapter 2 of the Constitution sets out:

Clearly the quest for economic growth as a foundation of poverty alleviation exists in tension with protecting and restoring a degraded environment, and this tension is evident in the wording of Section 24(b)(iii). Yet the government did not formalise a definition of the sustainable use of natural resources until June 2023.Footnote ²² In the interim, South Africa developed a substantial and diverse range of mature and sophisticated businesses that exploit the environment in new ways, most importantly in this context through the increasing domestication and commodification of wildlife. Such exploitation, which now constitutes a material component of the ‘biodiversity economy’ and is recognised as such in the National Biodiversity Framework, is premised on the notion of private ownership of wild animals originally established by the Game Theft Act 105 of 1991.Footnote ²³ South Africa’s controversial captive lion breeding industry, with the associated revenue generators of lion cub petting, human interactions with sub-adult animals, canned hunting and lion bone export is an example of this extreme form of private ownership of wild animals. ‘Put and take’ trophy hunting of managed wildlife species, and the ranching of wildlife for sport hunting, trade, and game meat are further examples.

These activities are premised on an extractivist interpretation of sustainable use, which relies on a reading of Section 24(b)(iii) of the Constitution which favours the ‘use of natural resources’ wording over the provisions requiring the promotion of conservation, the protection of the environment for the benefit of future generations, ecologically sustainable use and justifiable economic social and economic development (own emphasis). Such views presuppose that the benefits of income-generating activities which are demonstrably harmful to animals and the environment transcend other considerations in the Bill of Rights, such as genuine conservation,Footnote ²⁴ the right to live free from violence,Footnote ²⁵ and the right to dignity.Footnote ²⁶ Many of the activities which intensify the production and exploitation of wildlife come with other policy risks, and they arguably fail to accord with established court jurisprudence recognising that,

Despite this clear statement of the law by the nation’s highest court which explicitly rejects an instrumental view of wild animals as commodities, government support for sustainable use of ‘faunal resources’ remains resolute.Footnote ²⁸ In 2023, the Minister of Forestry, Fisheries and the Environment promulgated the Game Meat Strategy of South Africa.Footnote ²⁹ This strategy seeks to, inter alia, ‘unlock the full potential of the natural game meat industry’, with product that is ‘ethically produced with less or no impact on the environment or biodiversity’, and which is ‘safe, traceable and produced within the regulatory framework governing the wildlife sector and food safety protocols’.Footnote ³⁰ This sounds good in practice, but South Africa’s wildlife ranching industry does not materially fulfil the requirements above. The DFFE’s own 2018 ‘Report on Intensive and Selective Game Breeding’ noted that, ‘intensive management and selective breeding of game poses a number of significant risks to biodiversity at the ecosystem and species levels … and may compromise the current and future contribution of the wildlife industry to biodiversity conservation’.Footnote ³¹ The harms inherent in intensive wildlife production include landscape fragmentation, hazardous chemicals, concentration of desired species, killing and/or removal of conflict species, the disruption of normal predation, biological invasion, pest control resistance, rare wild species removal, deleterious gene expression, reduction of genetic material and associated diversity, outbreeding depression, physiological stress, species domestication, the disruption of natural selection and reduced meat for human consumption.Footnote ³² Given this extensive list of identified harms, it is not surprising that a central recommendation of the ‘Report on Intensive and Selective Game Breeding’ was to phase out intensive wildlife production, a recommendation entirely inconsistent with the sustainable use business model of much of the wildlife ranching industry in South Africa.

Here we see then a practical demonstration that the pursuit of the human leg of the One Health triad, in this illustrative case of the sustainable use doctrine manifesting in the DFFE’s Game Meat Strategy, has very real and apparent detriment to the other two legs. Given that the Game Meat Strategy also proposes self-regulation of the industry, it is apparent that the pursuit of this form of sustainable use can hardly be understood to fulfil the One Health Framework at all. Indeed, this is arguably the case for many elements of the biodiversity economy: the intensification practices on which wildlife ranching, captive breeding, and ‘put-and-take’ trophy hunting depend often pose significant risks not only for animals but also for human and environmental health.

18.3.2 One Health in Practice and Intensive Animal Agriculture

We know now that the intensification of production of wild animal species, in systems that increasingly mirror methods of agricultural production, can lead to practices inconsistent with the sound management of biodiversity.Footnote ³³ Habitat fragmentation, intolerance for predators, selective breeding for unnatural traits, and overstocking of preferred species have negative impact on both biodiversity and animal health. The transport of animals, intensive confinement, poor genetics, and inappropriate diet can also escalate disease risk. These issues are not confined to wildlife ranching. They manifest most significantly in the context of intensive animal production for food. Furthermore, the looming public health challenges of zoonotic disease and anti-microbial resistance are most obviously illustrated in the context of intensive animal agriculture. Concentrated animal feeding organisations are now comprehensively recognised as potential reservoirs for both animal and human disease, posing a substantial and immediate risk to public health.Footnote ³⁴ They are also the largest sectoral contributors to both terrestrial and marine pollution,Footnote ³⁵ as well as a significant driver of both biodiversity loss,Footnote ³⁶ as well as climate change.Footnote ³⁷ There are increasing calls for specific preventative interventions to address diseases like Highly Pathogenic Avian Influenza (HPAI) and Severe Acute Respiratory Syndrome (SARS). Indeed the revival of One Health as a relevant policy framework owes much to the challenges posed by these diseases.

Yet, little is being done to address the root causes of these zoonoses. The numbers of animals raised and killed for food globally continues to rise, now at 83.3 billion terrestrial animals per year at the last count.Footnote ³⁸ Most of these animals are raised in intensive confinement facilities. The UN forecasts that demand for meat will continue to rise, and growing calls for transitions to plant-based food systems are yet to yield meaningful change in practice.Footnote ³⁹ The animals used in these systems cannot be understood to enjoy even the narrow definition of health (freedom from disease), much less the broader definition that gives regard to their mental wellbeing. Indeed, these facilities are typically the antitheses of healthy, high-welfare animal husbandry. To the extent it is being applied to this massive and unsustainable industry, the One Health framework is used to motivate not for structural reform (reduction in intensive animal production) but for symptomatic technology solutions (new vaccines to counter disease and new genetics for improved ‘natural’ resistance).Footnote ⁴⁰ Yet there is no escaping the environmental costs: the pollution impacts and reduction in the food balance by growing feed for animals instead of food for people simply cannot be ignored.

In 2023, the South African animal production sector battled a range of farmed animal diseases including blue tongue, African swine fever, highly pathogenic avian influenza (HPAI) and African Horse Sickness.Footnote ⁴¹ DALRRD has active programs to manage HPAI, yet despite these programs in 2023 the poultry industry lost 8.5 million birds due to disease and or pre-emptive culling.Footnote ⁴² There has been a prolonged national shortage of vaccines, leading to material animal health issues, further highlighting the vulnerability of this sector to animal disease. Yet, the DALRRD website continues to promote the production of pigs, sheep, goats, and cattle as part of that organisation’s development agenda. The stated aim of the Animal Production directorate is

In 2021 DALRRD proposed further amendments to Meat Safety and Animal Improvement Acts which would have facilitated the intensification of wildlife production. This initiative is entirely contrary to the DFFE policy of reversing the intensification of wildlife ranching. There is no acknowledgement within the agricultural policy framework of the environmental and human health harms implicit in these strategies, much less an effort to align policy within a multi-centric framework such as One Health.

18.4.1 One Health Not Applied in South Africa’s Policy Framework

Although both the DFFE and to a lesser extent DALRRD profess to embrace the One Health framework in principle, we see in practice that it is not employed in any meaningful way to inform policy. It is virtually invisible in both the wildlife and agricultural policy frameworks. Unless it is actively adopted in the policy frameworks of environmental conservation, agriculture, and health, it is difficult to imagine how it can have any impact whatsoever. One other alternative might offer more prospects for adoption, and that is to embed One Health in the poly-centric policy framework of a ‘just transition’. This will be explained further in the final sections of this chapter.

18.4.2 Anthropocentric Bias in Implementation

The One Health framework aspires to frame a dialogue about balancing different requirements which manifest harm and benefit over different time scales. It seeks to reconcile short-term easily quantifiable commercial benefits to humans (human food supply, for example) with externalised harms to non-humans (animal health, which in the broader sense includes welfare) and negative impacts on the greater environment (eliminating pollution and promoting conservation). It is an attractive idea that these three outcomes can and should be aligned, but at an implementation level, we find they often exist in tension. The pursuit of low-cost food derived from animal sources continues to come at significant cost to animal health and the broader environment. These costs are now so severe, ironically, that they are starting to feed back and impact human health, through poor diet, zoonotic disease, degraded water and air, destruction of biodiversity, and climate change. Far from balancing the needs of the One Health triad, our modern global economy continues to externalise costs onto vulnerable groups, animals and the environment, and the calls for reform find their origins not in a One Health analysis, but principally in anthropocentric concerns about human needs.