Description
Context: The Sundarbans in the Bay of Bengal is a transboundary delta, and the largest mangrove forest on earth, both in Bangladesh and India. A pilot study was conducted in this delicate ecosystem of South Asia to understand the pathways of human-animal-ecosystems interfaces for mapping the wider determinants of human, animal and ecosystems health. The study was essentially conceived to see how the one health approach could be designed in ecologically vulnerable contexts for fostering a climate resilient health systems to halt and reverse environmental degradation and also ensure public health safety and security.
Methodology: The pilot study followed two steps as part of its method; first, a situation analysis was done in the Sundarbans to systematically assess the ecological vulnerabilities of the Sundarbans ecosystems and their implications on society and economy in general and the cascading effects on health and wellbeing of people in particular. Second, the method of design science was adopted to model a one health-based intervention for a climate resilient health systems. The study consulted several key stakeholders, and primary and secondary sources to gather information, data and insights.
Findings: There is a gap in the current policy responses at the neglect of wider determinants of health, impeding collaboration of health systems with other key sectors (education, urban development, environment and forestry for example). This makes health systems detached from the causal factors of disease production in social, ecological, and environmental landscapes, and addresses diseases through facility specific solutions and emergency medicines. The causality mapping done for both climatic and anthropogenic factors informed that the loss of biodiversity is endangering the health of humans, animals, and ecosystems in the Sundarbans. It is found that biodiversity is acting as an equilibrium between the ecosystems sustainability and economic development.
Intervention design/conclusion: Based on the findings, the study delineated the path of sustainable development at the interface of human-animal-ecosystems to promote human health and well-being, protect against pathogens (pandemic security), and halt and reverse environmental degradation. Using the Health in All Policies (HiAP) approach, it modelled a system-wide one health intervention design for future policy uptakes and programmatic actions.
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