Roadmap to a One Health agenda 2030.

The current fragmented framework of health governance for humans, animals and environment, together with the conventional linear approach to solving current health problems, is failing to meet today's health challenges and is proving unsustainable. Advances in healthcare depend increasingly on intensive interventions, technological developments and expensive pharmaceuticals. The disconnect grows between human health, animal health and environmental and ecosystems health. Human development gains have come with often unrecognized negative externalities affecting ecosystems. Deterioration in biodiversity and ecosystem services threatens to reverse the health gains of the last century. A paradigm shift is urgently required to de-sectoralize human, animal, plant and ecosystem health and to take a more integrated approach to health, One Health (OH). The Sustainable Development Goals (SDGs) offer a framework and unique opportunity for this. Through analysing individual SDGs, we argue the feasibility of an OH approach towards achieving them. Feasibility assessments and outcome evaluations are often constrained by sectoral politics within a national framework, historic possession of expertise, as well as tried and tested metrics. OH calls for a better understanding, acceptance and use of a broader and transdisciplinary set of assessment metrics. Key objectives of OH are presented: that humans reconnect with our natural past and accept our place in, and dependence on our planet's ecosystems; and that we recognize our dependence on ecosystem services, the impact of our development thereon and accept our responsibility towards future generations to address this. Several action points are proposed to meet these objectives.