Barriers to, Efforts in, and Optimization of Integrated One Health Surveillance: A Review and Synthesis.

Insufficient data from existing surveillance systems underlie societal tolerance of acute and slow-onset health disasters that threaten, harm, and kill vast numbers of humans, animals, and plants. Here we describe barriers to integrated "One Health" surveillance, including those related to a lack of medical services, professional divisions, incompatible vocabularies, isolated data sets, and territorial borders. We draw from publications of experts who justify broader and more integrated surveillance, education, and stewardship focused on preventing and mitigating disease emergence and re-emergence. In addition, we highlight efforts from Illinois, the United States and the broader world, pointing to examples of relevant education; ways to acquire, compile, and analyze diagnostic and syndromic data; mapping of diseases of humans and animals; and rapid communication of findings and recommendations. For the future, we propose using needed outcomes for health and sustainability to set priorities for One Health programs of education, surveillance, and stewardship. Professionals and paraprofessionals should gather, interpret, and widely communicate the implications of data, not only on infectious diseases, but also on toxic agents, malnutrition, ecological damage, the grave impacts of warfare, societal drivers underlying these problems, and the effectiveness of specific countermeasures.