




































Ecology, Economy and Society–the INSEE Journal 8(1): 5-11, January 2025 

COMMENTARY 
 

An Indian Perspective on One Health Prescriptions 
 

Madhuri Ramesh
 , Sheetal Patil, Adithya Pradyumna 

 
Abstract: This commentary offers a critical engagement with the Environment–
Health Nexus Policy Guide released by the United Nations Economic and Social 
Commission for Asia and the Pacific (ESCAP) and the International Institute for 
Sustainable Development (IISD) in 2022–23. We find that it strikes a hitherto-
elusive balance between concerns centred on human and environmental health. It 
can be also credited with adopting an intersectoral approach—essential for 
addressing current and emerging infectious diseases, especially those of zoonotic 
origin. We contend that it does not adequately engage with the implementation 
challenges faced by countries with resource constraints or dense human 
populations, such as those in South Asia, and typified by India. We hope that a 
perspective from India will help the global policy discussions on One Health to 
diversify itself.   

Keywords: South Asia, One Health, Environment-health nexus, Holistic health, 
Zoonotics 

 

1. INTRODUCTION 

As demonstrated by the COVID-19 pandemic, health crises often renew 
policymaking interest in managing the intersections of economy, ecology, 
and society—an approach known as One Health. This framework 
recognises that human, non-human, and environmental health are 
interconnected, and hence, it advocates integrated management across these 
domains. Many One Health policies are directed at the Global South, where 
dense human, livestock, and wildlife populations, coupled with 
overburdened public health services, make these regions particularly 

                                                
 Azim Premji University, Burugunte Village, Survey No 66, Bikkanahalli Main Rd, Sarjapura, 

Bengaluru, Karnataka, India 562125 (APU); madhuri.ramesh@apu.edu.in   

 Indian Institute for Human Settlements, 16th Cross Rd, Sadashiva Nagar, Armane Nagar, 

Bengaluru, Karnataka, India 560080; spatil@iihs.ac.in  
 APU; adithya.pradyumna@apu.edu.in  

Copyright © Ramesh, Patil, Pradyumna 2025. Released under Creative Commons 

Attribution © NonCommercial 4.0 International licence (CC BY-NC 4.0) by the author.  

Published by Indian Society for Ecological Economics (INSEE), c/o Institute of  Economic 
Growth, University Enclave, North Campus, Delhi 110007.  

ISSN: 2581–6152 (print); 2581–6101 (web).  

DOI: https://doi.org/10.37773/ees.v8i1.1481  

mailto:madhuri.ramesh@apu.edu.in
mailto:spatil@iihs.ac.in
mailto:adithya.pradyumna@apu.edu.in
https://doi.org/10.37773/ees.v8i1.1481


Ecology, Economy and Society–the INSEE Journal [6] 

vulnerable to the additional strain imposed by pandemics. One of the most 
comprehensive policies in this area is the Operationalising the Environment–
Health Nexus in Asia and the Pacific: A Policy Guide on Opportunities for Enhancing 
Health, Biodiversity, Food System and Climate Action, released in 2022–23 by the 
United Nations Economic and Social Commission for Asia and the Pacific 
(ESCAP) and the International Institute for Sustainable Development 
(IISD) (hereafter, the ESCAP-IISD policy guide). This, alongside economic 
support such as the recent USD 170 million loan from the Asian 
Development Bank to the Government of India, signals an important phase 
for advancing One Health initiatives in countries such as India.   

In this article, we highlight the key contributions of the ESCAP-IISD policy 
guide and briefly compare the initiatives taken by the Indian government 
thus far. We conclude by identifying three guiding principles for the 
successful implementation of One Health policies in the Global South.  

 

2. KEY FEATURES OF THE ESCAP-IISD POLICY GUIDE, 
2022 

The ESCAP-IISD Environment–Health Nexus Policy Guide, 2022, represents a 
significant advancement in establishing a framework for international and 
intersectoral collaborations in the Asia-Pacific region. In this article, we 
provide an overview of its key features. 

This guide begins by acknowledging the importance of ecosystem services 
in maintaining human and animal health across the terrestrial, aquatic, and 
marine realms. It further differentiates between holistic and episodic plans 
and emphasizes the former approach. A holistic plan promotes planned 
intersectoral collaboration to achieve comprehensive outcomes, whereas an 
episodic plan focuses on intersectoral collaboration primarily as a crisis 
response measure. 

A striking feature of the ESCAP-IISD policy guide is its departure from 
conventional understandings of health. Instead of viewing health and well-
being as isolated factors, the guide conceptualises them as outcomes shaped 
by social and environmental processes. This approach avoids the common 
pitfall of prioritizing ecological concerns at the expense of social justice—a 
problem that pervades biodiversity conservation to date (for example, see 
Wilson (2016) and the response by Buscher et al. (2016)). By adopting this 
holistic framing, the guide incorporates ecological concerns as a core 
feature of health initiatives. Additionally, it alerts us to the dangers of 
framing any debate within One Health as a zero-sum game, and instead, it 



[7] Ramesh, Patil, Pradyumna 

advocates for a careful combination of integration and trade-offs based on 
national or regional requirements. 

Another useful feature of the ESCAP-IISD policy guide is its emphasis on 
implementing time- and cost-effective measures, such as establishing 
integrated datasets to prioritize highly vulnerable communities or regions. It 
also highlights how tools such as integrated health–environment impact 
assessments can be used to plan interventions effectively. Further, it 
endorses a rights-based approach to health and well-being, which 
underscores the importance of capacity-building. This approach aims to 
improve the participation of local communities in a variety of roles, ranging 
from frontline surveillance and disease monitoring to the implementation of 
national strategies. 

 

3. ONE HEALTH IN INDIA 

In India, dedicated One Health policies are a relatively recent development, 
but concerns relevant to this domain have been addressed by a wide range 
of human, animal, and environmental health policies (Figure 1). Some 
examples of each are described here: 

With respect to public health, the National One Health Mission (NOHM), 
2024, stands out as it focuses on integrated surveillance, data-sharing, and 
response. However, its effectiveness could be enhanced through better 
integration with the older National Health Policy, 2017. The National 
Programme on Climate Change and Human Health, launched in 2019, 
aligns with the principles of One Health by integrating environmental and 
animal health considerations with public health interventions. The 
programme covers a range of areas, including zoonotic disease surveillance, 
research on climate-driven health risks, and capacity-building for cross-
sectoral One Health collaboration.  

In the domain of animal health, several national programmes contribute 
significantly to the One Health framework, such as the National Animal 
Disease Control Programme, 2019, the National Livestock Health and 
Disease Control Scheme, 2019, and the National Animal Disease Reporting 
System, launched in 2013. These initiatives focus on domestic animals and 
their interlinkages to One Health. The current National Wildlife Action 
Plan, 2017–31, plays a corresponding role with respect to managing wildlife 
species. Although it does not explicitly mention the One Health approach, 
it highlights the importance of long-term studies on wildlife diseases, 
including zoonotic ones. 



Ecology, Economy and Society–the INSEE Journal [8] 

Figure 1: Key policies, programmes and institutions related to One Health 
in India 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Source: Authors 

On the environmental front, the Environment (Protection) Act, 1986, aims 
to safeguard people from environmental hazards, including air and water 
pollution, but its implementation requires significant improvement. Other 
initiatives, such as the National Mission on Sustainable Habitat, 2010, the 
National Water Mission, 2011, the Clean Air Mission, 2019, and the Clean 
India Mission, 2014, also seek to improve the linkages between 
environmental and public health. 

 

 

Environmental health 

• Environment Act, 1986, and 
pollution control boards 

• Biological Diversity Act, 
2002, and biodiversity au-
thorities 

• Environment Impact As-
sessment Notification, 2006 

• Forests-related regulations 

Human health 

• National Health Mission; Governmental health services 

• Government health insurance schemes 

• Integrated disease surveillance programme 

• National Programme for Prevention and Control of  Non-
Communicable Diseases, 2010  

• Maternal and child health-related programmes 

• National Programme on Climate Change and Human Health, 2019 

• Health research institutes 

National 
One Health 

Mission 

Animal health 

• Wildlife Protection Act, 1972 

• National Animal Disease Control Programme, 2019 

• National Livestock Health and Disease Control scheme, 2013 

• National Wildlife Action Plan, 2017 

• (Proposed) Centre of  Excellence in Wildlife Health 

• Reporting systems 

One 
Health 
in India 



[9] Ramesh, Patil, Pradyumna 

4. GUIDING PRINCIPLES FOR DEVELOPING COUNTRIES 

Overall, the ESCAP-IISD policy guide reiterates that the One Health 
approach is about recognizing and managing the intersections between 
environmental and health factors for both humans and non-humans. As a 
result, it emphasizes the need to focus on long-term priorities rather than 
limiting efforts to episodic responses following outbreaks. However, several 
lacunae still exist in terms of implementation. We suggest three guiding 
principles to drive implementation efforts, particularly in countries such as 
India, which contend with resource constraints and dense populations: 

4.1. Focus on Pragmatic Goals  

First, the policy guide lacks clarity regarding the operational approach for 
implementation. In this regard, it appears that the ESCAP-IISD policy 
guide prioritizes idealistic goals over pragmatic solutions. This has been a 
repeated stumbling block, as it is unrealistic to expect countries to 
restructure their existing national bureaucracies to support the holistic 
interventions required to implement One Health. Instead, a more feasible 
approach would involve using integrated assessment tools, establishing data 
management platforms, and designating nodal officers at the provincial 
level. In India a recent announcement of the One Health and Climate Hub 
by the State Government of Tamil Nadu is a step towards an approach to 
tackling climate-induced health challenges by enhancing preparedness for 
emerging health risks, strengthening resilience, and promoting sustainable 
health systems (Government of Tamil Nadu, 2024). 

4.2. Focus on the Right to Healthcare 

The second area of concern is that the policy guide does not sufficiently 
emphasize the right to healthcare. This should be prioritized, especially in 
rural and forested areas, from both a pragmatic and justice-oriented 
perspective. Strengthening healthcare systems in such regions would garner 
public support for One Health initiatives and thereby improve reporting, 
detection, and management of zoonotic diseases. Further, it would prevent 
additional burdens on forest-dependent communities, many of whom 
already face restrictions on dietary and livelihood choices due to strict 
biodiversity conservation laws. In other words, an explicit 
acknowledgement of the rights of these communities to access both forests 
and healthcare services is important to ensure equitable outcomes. This 
would also align the One Health approach with existing national policies for 
tribal welfare and development. 

 

 



Ecology, Economy and Society–the INSEE Journal [10] 

4.3. Focus on Community Participation 

Finally, community-based training programmes are essential to ensure that 
disease surveillance networks are both extensive and cost-effective in these 
regions. These programmes should be designed to reach culturally and 
linguistically diverse communities with low literacy levels. They should also 
establish points of connection with the public healthcare system for both 
humans and animals, including testing centres, clinics, and hospitals.  

Nevertheless, this does not detract from the valuable contributions made by 
the ESCAP-IISD policy guide to ongoing discussions on One Health. 
Moreover, there remains a clear need for national policies to closely 
consider environmental determinants of diseases and integrate them into 
health planning, both in India and the Asia-Pacific region at large.  

ACKNOWLEDGEMENTS: We thank our respective institutions, Azim 
Premji University and the Indian Institute for Human Settlements, for 
supporting this work. However, the content and opinions expressed are 
ours and do not necessarily reflect the views of our institutions. 

Ethics Statement: This study complies with requirements of ethical 
approvals from the institutional ethics committee for the conduct of this 
research. 

Conflict of Interest Statement: No potential conflict of interest was 
reported by the author. 

REFERENCES 

Buscher, Bram, Robert Fletcher, Dan Brockington, Chris Sandbrook, William 
Adams, Lisa Campbell, et al. 2017. “Half-Earth or Whole Earth? Radical Ideas for 
Conservation, and their Implications.” Oryx 51(3): 407-410. 
https://doi.org/10.1017/S0030605316001228  

ESCAP and IISD. 2022. Operationalizing the Environment-Health Nexus in Asia and the 
Pacific: A Policy Guide on Opportunities for Enhancing Health, Biodiversity, Food System and 
Climate Action. Economic and Social Commission for Asia and the Pacific. 
https://www.unescap.org/kp/2022/policy-guide-environment-health-nexus  

Government of India. n.d. National One Health Mission. Office of Principal Scientific 
Advisor to the Government of India. https://www.psa.gov.in/innerPage/psa-
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_________. 2017. National Health Policy 2017. Government of India. 

_________. 2022. National Programme on Climate Change and Human Health. 
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[11] Ramesh, Patil, Pradyumna 

Government of Tamil Nadu. 2024. Establishment of “One Health and Climate 
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https://wii.gov.in/nwap_2017_31

