“The whole One Health movement has since become much stronger and has gradually entered into the mainstream,” says Nabarro. “We’re now seeing the value of One Health in food safety, for example, or in the long-term future of livestock rearing around the world.”
Nabarro points to USAID’s Emerging Pandemic Threats program, started in 2009, as one of the most sophisticated applications of One Health. With four complementary branches — Predict, Prevent, Identify, Respond — this program catalogs urban and natural disease hot spots, characterizes human and ecological drivers of disease and funds One Health initiatives worldwide. A project sponsored in Uganda in 2010, for instance, brought together park rangers, wildlife specialists and the ministries of Agriculture and Public Health to subdue an anthrax outbreak in hippopotamuses.
“This program perfectly highlighted why we need a transdisciplinary, One Health approach,” says Mac Farnham, an assistant professor of veterinary medicine at the University of Minnesota who worked on the case. “The wildlife folks are mandated to care for wildlife, human health works to prevent anthrax from moving into people and agriculture wants to prevent the disease from getting into livestock.”
Room for Growth
Despite the gains, there is still bountiful room for growth in the development and, particularly, the application of One Health principles.
Osofsky notes that the training of health professionals remains defined by specialization, and that a more interdisciplinary approach — curricula developed jointly across medical, veterinary and agricultural schools, for instance — is an important next step in making One Health more effective.
“One Health programs should look at all sectors — livestock, the environment, food chains and so forth. They were never meant to be anthropocentric.” — Steve Osofsky“A lot has to do with how we train health professionals,” agrees Farnham. “Currently, it takes quite a bit of added effort to get people from different disciplines together and to develop a common understanding.” In African countries where disease outbreak has remained a chronic problem, Farnham praises the One Health Central and East Africa initiative. Funded by USAID, the program’s 10-year strategic plan aims to strengthen preventive health networks by coordinating research, surveillance and response efforts across universities and academic departments in six African countries.
Even more difficult than educational barriers has been the continuous challenge of hewing lofty One Health concepts to real-world situations. The concepts include important but vague guidelines, such as recognizing that human health programs can greatly contribute to conservation efforts. “The point about the original Manhattan Principles was that they are generic, which means they are broadly applicable,” says Nabarro. “But, at the same time, it also means that they need a lot of work to shoot from generic into action. This shift, from principle to practice to accountability, has been quite demanding.”
The challenge is especially evident in efforts to establish organizational partnerships. In a recent case, a $15 million grant provided to synchronize one country’s avian influenza response withered on the vine when two years of discussion failed to solidify any accord between national agencies. “These institutional arrangements,” says Nabarro, “don’t just grow overnight.” But he remains hopeful that, in time, they will grow.
Osofsky, too, maintains a guarded optimism about the long-term potential for One Health, though he expresses concern that many projects are too narrowly focused on zoonoses. “One Health programs should look at all sectors — livestock, the environment, food chains and so forth. They were never meant to be anthropocentric.”
He also points out the surprisingly low profile of One Health, given the age of the concept and the scale of the threats. “It’s a very well-kept secret,” he says. By growing awareness of the principles of One Health and advancing them in practice, he and many others hope to bring the power of interdisciplinary collaboration and cross-fertilization to creating better solutions to some of the most challenging problems of our time. 
UPDATED 06.28.13: This article originally incorrectly identified Steve Osofsky as senior policy advisor for wildlife health at the Wildlife Conservation Society.
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