Description
Introduction
Through tackling upstream drivers, there is a unique opportunity to go beyond managing disease outbreaks, which overwhelmingly affect disadvantaged populations, and stop potential pandemics before they spill over to humans. This means understanding the activities which bring humans, livestock and wildlife into close contact like livestock rearing, wildlife trade and consumption, deforestation and urban expansion. Nature for Health (N4H) is a unique partnership of leading authorities in environment and health and pioneering country partners working collaboratively to address ecological and anthropogenic factors that increase risks of disease spillover.
N4H’s Phase I scoping initiates six country-based projects aimed at collaborative systems change in this complex, multi-perspectival work, where equity must be a significant focus. N4H emphasizes the need for collective leadership and empowering marginalized stakeholder groups to actively contribute to the One Health dialogue and overcome some of the invisible power structures that have heretofore prevented this.
This presentation profiles key aspects of the systemic engagement process, the lessons learned and challenges encountered in each country’s scoping work.
Methodology
N4H work in each country begins with a 3–6-month systemic inquiry to analyze their situation of concern, identify key problems, best solutions, and plan for implementation of demand-led, co-designed, desirable, feasible solutions. The purpose-developed “Systemic thinking and practice: A practical guide to Nature for Health’s scoping work” outlines an iterative systemic process and essential elements with specific tools that country teams may adapt to their context to move from planning into action.
Results and discussion
Increasing numbers of OH initiatives have emerged globally and nationally. However, a significant implementation gap exists at community level, due to chronic lack of investment, limited awareness, knowledge and understanding, fragmented institutional landscapes, lack of policy integration, and existing bias towards sectoral approaches. In rare instances where integrated solutions were employed, they are generally not tested beyond local scale.
N4H aims to achieve more holistic policymaking by creating further evidence for links between biodiversity, pollution, climate and health, and by working on the ground to demonstrate how cross-sectoral approaches can be integrated into measures to address health risks through preventative OH approaches. N4H catalyzes integrated policymaking, evidence-based action on the ground and capacity development across sectors at local, national and regional levels to foster OH approaches that fully integrate environmental dimensions to prevent health risks.
Lessons learned and challenges encountered in Phase I countries (Ecuador, Ghana, Mongolia, Rwanda, Vietnam and Zambia) as they employed systemic practice in participatory processes (December 2023-April 2024) will be highlighted.
Conclusion
Pandemics kill inequitably. They require rapid systems change and developing new ways of seeing and doing. They require focus on equity, collective leadership and reduction of siloed thinking. COVID-19 demonstrated this leadership was about creating space for innovation. The most successful aspects combined bottom up, top down and middle out styles of leadership. Systems change was required at multiple scales, each interacting with the others. Sometimes those interactions helped, and sometimes they hindered. N4H provides opportunity for a novel approach to understand relationships between equity, leadership and systems change.
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