When COVID-19 swept the globe in 2020, the shock exposed not only a viral threat but the fragility of systems — from supply chains and food security to governance and global finance.
For Andrea Winkler and John Amuasi, co-chairs of the newly launched One Health Commission sponsored by The Lancet, one of the world’s most prestigious medical journals, it was a turning point. As Amuasi explained, the pandemic “shifted our trajectory and understanding around One Health,” forcing the Commission to expand its consideration beyond pathogens shared by animals and people, so-called zoonotic diseases, to also entertain issues of climate, biodiversity, antimicrobial resistance, and food systems.
The evidence is stark. More than 70% of emerging infectious diseases are zoonotic in origin. COVID-19 alone has cost the world tens of trillions of dollars in costs and lost productivity. Although it is possible that the next big threat may again be viral (e.g., many scientists are worried about the H5N1 influenza virus currently circulating in North American cattle, poultry, and wildlife), it could also be from shocks to the food system, pollution, antimicrobial resistance, or biodiversity collapse.
As a scientist who has studied infectious diseases for decades, I would underscore that these risks are not separate silos but interacting pressures. Ignoring that interconnectedness is precisely how governments and markets have been blindsided in the past.
A Landmark Report With Broad Implications
The Lancet’s One Health Commission, launched in Oslo in 2019 and composed of 35 experts across disciplines and regions, has now released its long-awaited final report. It redefines One Health not as a niche veterinary concern but as a global framework for managing systemic risks. In this respect, it is much closer to an idea that has been circulating in academic and policy circles for several years under the banner of planetary health.
This matters for business and political leaders because One Health is rapidly becoming a policy doctrine. It is written into the new Pandemic Agreement, endorsed by the World Health Organization and its partners, and is gaining traction with the G20 and development banks. Increasingly, international financing and trade rules will require governments — and by extension, companies — to align with this integrated approach.
As Winkler explained, “One Health clearly has left its infancy, where it was just the intersection of human-animal health, mainly zoonotic. Actually, One Health needs to be around everything. And this is why we use the socio-ecological system approach to explicate what we mean by health and what needs to be there and which factors need to be considered.”
What’s New in the Lancet Report
Several innovations make this report a milestone:
- The environment elevated: The Commission gives the natural environment equal weight alongside human and animal health, emphasizing the “triple planetary crisis” of climate change, biodiversity loss, and pollution.
- Beyond pandemics: One Health now encompasses non-communicable diseases, antimicrobial resistance, food systems, and climate resilience. In 2019 alone, antimicrobial resistance was associated with nearly 5 million deaths; air pollution killed 4.2 million in 2019.
- Economic critique: In the Commission’s words, “the prevailing, anthropocentrically oriented global economic system, in which growth is measured in terms of gross domestic product (GDP), is inherently antithetical to the One Health goal of equitable, sustainable, and healthy socioecological systems.” Instead, the report points to frameworks like the Wellbeing Economy and Doughnut Economics as better suited to balancing prosperity with planetary health.
Why This Is Policy-Relevant Now
One Health is no longer an academic idea. It is being institutionalized through the One Health Quadripartite, a coalition of WHO, the UN Food and Agriculture Organization, the World Organisation for Animal Health, and the UN Environment Programme. The Commission coordinated closely with this group to ensure alignment.
The concept is also embedded in the Pandemic Agreement signed in May 2025, which calls for stronger surveillance, prevention, and governance systems grounded in One Health principles. That makes the Lancet Commission’s findings timely, offering governments and businesses a reference document for operationalizing treaty commitments.
The Business Risks of Ignoring One Health
For business leaders, the risks are not theoretical:
- Pandemic disruptions: COVID-19 showed the cost of underpreparedness.
- Supply chain shocks: Diseases in livestock or crops can ripple through food and manufacturing systems.
- ESG (Environmental, Social, and Governmental) pressure: Investors and regulators are expanding disclosure requirements to cover biodiversity, ecosystem health, and antimicrobial resistance.
- Reputation and liability: Negligence on environmental and health impacts increasingly carries legal and brand consequences.
From my perspective, the private sector is still underestimating the exposure of supply chains to ecological shocks. Animal and crop diseases don’t just affect farmers; they ripple through manufacturing, logistics, and consumer markets.
Opportunities for Business and Government
But the same dynamics that generate risk also open profitable new markets. The Commission highlights efficiency gains and new markets:
- Integrated surveillance: Italy’s West Nile virus program, which combined animal and human monitoring, saved over €160,000 in six years compared to human-only surveillance.
- Public–private partnerships: Companies can collaborate in areas like wastewater monitoring, digital health tools, and food system resilience.
- New markets: Demand is growing for diagnostics, pollution control, sustainable agriculture, and One Health-aligned technologies.
The Call to Action
The Commission issues ten recommendations, from building governance frameworks to embedding “One Health in All Policies.” Crucially, the appendices spell out who should act, at what level (local, national, global), and on what timeline, offering a roadmap that stakeholders can adopt.
Winkler is realistic about the challenge: “We have not just said what needs to be done, we’ve also called out who should be doing what and how and when. Very super ambitious, but if only a certain percentage of what we suggest could be taken up, that to me would be success.”
Indeed, the question is not whether One Health will become embedded in global governance — that process is already underway — but whether businesses and governments will adapt proactively or scramble to catch up and whether One Health can be defined prescriptively enough to ensure it drives measurable policy change rather than drifting into an all-purpose slogan.
The Bottom Line
The Lancet’s One Health Commission reframes health as a property of socio-ecological systems. For governments and companies, this is not a distant aspiration but an imminent policy reality. The pandemic agreement, ESG frameworks, and financing rules are already moving in this direction. The only real choice left to governments and companies is whether to treat One Health as a compliance burden or as a strategic framework for resilience and growth.
As Amuasi told me, “Who knows what’s going to come along and shape not only our knowledge and understanding, but also the relevance of One Health to global geopolitics.” The world may not have the luxury of waiting.
For leaders in business and government, the message is clear: resilience is no longer about managing the next quarter — it is about managing the next crisis. And One Health is the framework.
