Time for an ecosystem approach to public health? Lessons from two infectious disease outbreaks in Canada.

Ecosystem approaches recognize the complexity of many contemporary public health challenges and offer an alternative for dealing with problems that have proven intractable and unresponsive to conventional public health strategies. Infectious disease outbreaks are among the most dramatic aspects of systems failure, and the Canadian cases of SARS (Severe Acute Respiratory Syndrome) in Toronto, and the E. coli outbreak in Walkerton, serve as useful illustrative examples. This paper examines some of the limitations of current public health approaches, the fundamental tenets of an alternative, transdisciplinary ecosystem approach, and changes necessary for implementation, including those in philosophical approach, communications and education, and, finally, institutions and governance.