Hope Ferdowsian

CABI One Health (2023)

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

COMMENTARY

A silent call for a socially and ecologically

just One Health approach
Hope Ferdowsian1,2

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

One Health Impact Statement

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

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

Correspondence: 1Phoenix Zones Initiative, 13170-B Central Avenue SE, PMB 385, Albuquerque, NM, 87123, USA; 2Department of Internal
Medicine, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA
Corresponding author: Hope Ferdowsian. Email: hrf@phoenixzonesinitiative.org
Submitted: 15 December 2022. Accepted: 07 February 2023. Published: 15 March 2023
© The Author 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in
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Hope Ferdowsian CABI One Health (2023) https://doi.org/10.1079/cabionehealth.2023.0005 
plants, and the broader environment, and the need for collaboration
within human and animal medicine, public health, and the social
and biological sciences (Mackenzie and Jeggo, 2019; Osofsky
et al., 2003). The term emerged throughout various institutional
contexts, including veterinarian Calvin Schwabe’s use of the term
“One Medicine” to argue for a more interdisciplinary approach to
medicine (Cassidy, 2017).
It would take more time to realize that the SARS outbreak was a
missed opportunity to challenge long-standing assumptions about
our relationships with each other, other animals, and our shared
environments. Perhaps the threat did not seem as acute then as
it does now. Fewer than 800 people died of SARS, and within six
months of its identification, the World Health Organization (WHO)
declared the global outbreak of SARS over (WHO, n.d.). But,
by late 2019, another virus with a crown emerged. It was soon
identified as SARS-CoV-2, the coronavirus that causes Covid-
19. Although the precise origins of SARS-CoV-2 are uncertain,
most experts believe it emerged through another spillover event
involving a bat and one or more animals at a live market (Hu et al.,
2017; Maxmen, 2022; Worobey et al., 2022).
The natural world has many barriers to prevent pathogen
transmission between humans and other animals. Space and
time, normal weather and migration patterns, biodiversity, and
healthy social and ecological relationships all provide natural
barriers to disease emergence. Destroying these natural barriers—
through changes in ecosystems and land use, intensive farming,
and trade—can lead to spillover events and more diseases.
More deeply, the commodification of animals in food and clothing
production, research, entertainment, and other areas of society has
disrupted normal barriers that protect humans and other animals.
For nonhuman animals, the risks of commodification extend beyond
the toll of novel viruses to include the fear, pain, and suffering that
come with captivity, invasive procedures, and being killed.
Unfortunately, many scientists believe that Covid-19 is not the
“big one” (Davey, 2020). Today, the threat of a silent spring looms
even larger than it did when Carson’s words first highlighted our
interdependence with other animals, plants, and the rest of the
natural world.
Justice as a prerequisite for health
The notion of One Health traces back in time to ancient civilizations
and Indigenous Traditional Knowledge (Evans and Leighton, 2014;
Jack et al., 2020), and the concept made its way to medicine
by the nineteenth century when physician-pathologist Rudolph
Virchow noted that there is no clear dividing line between the
basis for human and animal medicine (Lindenmayer and Kaufman,
2021). Now adopted by intergovernmental organizations and
international financial institutions, One Health is increasingly used
in international agreements, funding decisions, research, and
development programs. Unfortunately, these approaches often
remain trapped in the myopic paradigm of human invasion and
dominance that Carson warned of.
As other authors have noted, modern One Health approaches
encompassing agriculture, public health, disease control, and
conservation measures are commonly rooted in colonial
engagement and ignorant of local human knowledge and
nonhuman knowledge (Laine and Morand, 2020). Too often,
conventional One Health approaches reinforce ongoing human,
animal, and environmental commodification in food production,
research, international trade, and other areas of society—fueling
inequality, violence, and the triple planetary crisis of climate
change, air and water pollution, and biodiversity loss (Ferdowsian,
2018; Ferdowsian, 2021; Sellars et al., 2021; UNFCCC, n.d.).
For example, over the last several decades, the model of food
production embedded in industrialized countries—and bolstered
by international finance institutions—has spread across the
world. Intensive animal farming has increased entangled threats
2
to captive and free-living animals, workers, and communities
disproportionately comprised of immigrants and people of color,
and the environments upon which these individuals depend
(MacDonald, 2021). Until recently, more attention has centered
on mitigating the risk of emerging infectious diseases in these
industrial systems of exploitation than on eliminating their root
causes through just transitions away from these industries
(Bruun, 2021; MacDonald, 2021). Intergovernmental operational
frameworks and finance mechanisms linked to One Health have
yet to incorporate the latter approach (The World Bank, 2018; FAO
et al., 2022).
One Health approaches that ignore the primary drivers of
interlinked threats to humans, animals, and the environment are
as incomplete as the reductionist patient model that I learned in
medical school. Fortunately, this patient model has since been
augmented by an emphasis on the connections between health
and justice (McKenzie et al., 2020). Within medicine and public
health, there is now broad consensus that physical and mental
health outcomes are determined by whether one’s rights are
recognized—through social, economic, environmental, legal, and
political frameworks (Mann et al., 1994; Farmer, 1996; Gostin
et al., 2019; Dawes et al., 2022).
It is now also clear that nonhuman animals need access to basic
rights to be healthy (Cavalieri, 2001; Garner, 2002; Wise, 2002;
Sunstein, 2003; Ferdowsian, 2018; Ferdowsian, 2021; Sellars
et al., 2021). To meet the needs of nonhuman animals, the law
and treatment of animals will need to change. Currently, humans
are viewed as subjects of law, whereas other animals are viewed
as instrumental objects for human use (Wettlaufer et al., 2021).
Although there have been some advancements in animal welfare
laws nationally and internationally, nonhuman animals still do
not have legally recognized rights. And there is still no worldwide
international treaty governing the treatment of animals (Georgetown
Law Library, n.d.; Global Animal Law Association, n.d.), which
impedes their ability to achieve social, physical, and psychological
health and well-being (Ferdowsian, 2018; Ferdowsian, 2021;
Sellars et al., 2021).
Likewise, although there have been advancements in human
rights law—and a recent resolution recognizing the human right
to a clean, healthy, and sustainable environment (Human Rights
Council, 2021)—nations including the United States have yet to
ratify key international human rights treaties (Abaya et al., 2022;
OHCHR, n.d.). Enforcement of international law remains an issue
in multiple areas of the world where women, children, and racial,
ethnic, and other minorities are deprived of their rights. Integration
of these concerns in One Health approaches lags, though
frameworks that emphasize Indigenous Traditional Knowledge,
gender equity, and rights-based action plans have been proposed
(Garnier et al., 2020).
A One Health view could help to address many of our problems,
but only if it places rights and justice—within our species and with
other species—at the center of global and local policy, research,
and practice. Needed now are international, national and local
social, economic, and legal frameworks that move beyond
anthropocentrism, commodification, and simple disease measures
to incorporate the rights, health, and well-being of humans, other
animals, and the rest of the natural world. Human-centered
frameworks are insufficient to tackle interconnected problems
that pose an existential threat to human and nonhuman beings
(Ferdowsian, 2021).
As a human rights and public health physician, I have seen what
is possible. In the eastern part of the Democratic Republic of the
Congo (DRC), one can plainly see how the invasion of human
and animal communities by foreign mining companies has fueled
war and human-animal conflict, sexual violence against the most
vulnerable women and children, and air and water pollution
(Mukwege and Nangini, 2009; Beyers et al., 2011). Physical scars
from machetes and posttraumatic stress after rape or combat can
Hope Ferdowsian CABI One Health (2023) https://doi.org/10.1079/cabionehealth.2023.0005
be traced to social and ecological destruction. Publicly available
data have indicated that regions affected by “rape with extreme
violence” are rich in mineral resources and under the control of
armed forces (Mukwege and Nangini, 2009).
But in the same area of DRC, a sustainable alliance led by
local leaders and communities also serves to reduce conflict
and violence, protect human and animal lives, and fuel the
empowerment of women and girls. For example, female rangers
in Virunga National Park have broken away from headlines
about violence to protect animals and plant life living in the park
(Nieddu, 2016). In surrounding areas of the park, Virunga Alliance
has brought together public authorities, civil society, and other
stakeholders to address poverty, sustainability, and stability—
despite ongoing challenges posed by exploitative industries (Parc
National des Virunga, n.d.). Two nations away, colleagues have
shared how local diversified plant-based agriculture and renewable
energy projects can help to lift a rural Ethiopian community out of
poverty, reduce malnutrition and disease, and improve the chances
that a child can learn and survive. These stories are manifestations
of a socially and ecologically just One Health approach that Carson
described using different words.
Interventions that Carson inspired—collective action and
thoughtful innovation, guided by humility and empathy—are as
relevant today as they were when she penned Silent Spring.
Within the fields of human and veterinary medicine, public health,
and other professions touched by One Health, students and
practitioners can take note. Leaders can ensure that educational
competencies, professional expectations, research standards, and
policy initiatives reflect a socially and ecologically just One Health
approach. Academic, national, and international institutions can
also exhibit leadership through their own policies, projects, and
partnerships. After all, embedded throughout Carson’s writing is
the view that each of us has the power to alter current and future
lives—for better or worse.
CONFLICT OF INTEREST
The author has no conflicts of interest to declare.
ETHICS STATEMENT
The author confirms that the research meets any required ethical
guidelines, including adherence to the legal requirements of the
study country.
FUNDING STATEMENT
The author has no funders to declare.
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