One Health in the Context of Global Health. Collaboration between veterinary and human health domains in non-pandemic times.

Summary Historically, the oldest healers were often priests who cared for humans and animals, with which integrative thinking about human and animal health began long ago. Nowadays, human and animal medicine have developed their own autonomous domains. For which animal health deals specifically with communicable diseases (including zoonoses), food safety, management of animal populations (farm animals, companion animals, sports), animal welfare and environmental problems related to animals. As a result of this separation, human and animal diseases are treated as separate entities, which has led to reduced communication between the human health domain and the animal health domain. In recent times the One Health (OH) approach illustrates how the connection and interrelationship between health of people, animals and plants has impact on Global Health (GH). Transmission of microorganisms takes place in and between the three domains of people, animals, and plants, within which all organisms in ecosystems live together. Cooperation between all domains and economic sectors is therefore important pillar of the OH approach. The most accessible application of the OH approach relates to immunity and has led to main interventions of large-scale immunization efforts through vaccinations. Although vaccines are a small part of the OH approach, they are important in crises where they play a key role in controlling the transmission of diseases between humans and animals and have a concrete impact on their shared environment and contribution to global health. However, collaboration among the wide diversity of stakeholders and steps towards implementing the OH approach faces many challenges. Professionals in both the human and animal domains have developed knowledge and gained experiences that can be used as input for learning and working together to create solutions for GH challenges. Therefore, the question rises in what situations, based on the OH approach, does collaboration between the two domains is adding value to the creation of GH solutions? Should there be collaboration in all situations and at all times e.g. for less obvious applications, like vaccine development for non-zoonotic pathogens? The aim of this thesis is therefore to create an overview of barriers and facilitators for knowledge sharing and collaboration between the human and animal domain by answering the following question: What are the opportunities, barriers, and approaches for collaboration, based on the OH approach, and how are they acted upon in practice especially when developing vaccines for nonzoonotic pathogens?