One Health, "Disease X" & the challenge of "Unknown" Unknowns.

The emergence of SARS-CoV-2 and its rapid spread globally emphasizes the ever-present threat of emerging and re-emerging infectious diseases. In this review, the pathogen pyramid framework was utilized to identify the "unknown unknowns" associated with the emergence and rapid transmission of novel infectious disease agents. Given that the evolutionary origin of most of the emerging infectious disease agents can be traced to an animal source, we argue the need to integrate the "One Health" approach as a part of surveillance activities. The need for focusing on undertaking global and regional mapping activities to identify novel pathogens is discussed, given that there are an estimated 1.67 million unknown viruses, of which around 631,000 to 827,000 unknown viruses have the capacity to infect human beings. The emerging risks due to the ever-expanding interface between human, animals, both domestic and wildlife, and the environment are highlighted, these are largely driven by the need for safe habitation, growing food, developing infrastructure to support the increasing human population and desire for economic growth. The One Health approach provides a holistic way to address these cross-sectoral issues, by bridging institutional gaps, enumerating priority risk areas and pathogens, and highlighting putative risk factors for subsequent spillover events involving emerging and re-emerging infectious disease pathogens at the human-animal-environment interface.

Research priorities for control of zoonoses in South Africa.

BACKGROUND: Zoonoses pose major threats to the health of humans, domestic animals and wildlife, as seen in the COVID-19 pandemic. Zoonoses are the commonest source of emerging human infections and inter-species transmission is facilitated by anthropogenic factors such as encroachment and destruction of wilderness areas, wildlife trafficking and climate change. South Africa was selected for a 'One Health' study to identify research priorities for control of zoonoses due to its complex disease burden and an overstretched health system. METHODS: A multidisciplinary group of 18 experts identified priority zoonotic diseases, knowledge gaps and proposed research priorities for the next 5 y. Each priority was scored using predefined criteria by another group of five experts and then weighted by a reference group (n=28) and the 18 experts. RESULTS: Seventeen diseases were mentioned with the top five being rabies (14/18), TB (13/18), brucellosis (11/18), Rift Valley fever (9/11) and cysticercosis (6/18). In total, 97 specific research priorities were listed, with the majority on basic epidemiological research (n=57), such as measuring the burden of various zoonoses (n=24), followed by 20 on development of new interventions. The highest research priority score was for improving existing interventions (0.77/1.0), followed by health policy and systems research (0.72/1.0). CONCLUSION: Future zoonotic research should improve understanding of zoonotic burden and risk factors and new interventions in public health. People with limited rural services, immunocompromised, in informal settlements and high-risk occupations, should be the highest research priority.

A Theoretical Framework for Bolstering Human-Nature Connections and Urban Resilience via Green Infrastructure

Demand for resources and changing structures of human settlements arising from population growth are impacting via the twin crises of anthropogenic climate change and declining human health. Informed by documentary research, this article explores how Urban Resilience Theory (URT) and Human-Nature Connection Theory (HNCT) can inform urban development that leverages urban green infrastructure (UGI) to mitigate and meditate these two crises. The findings of this article are that UGI can be the foundation for action to reduce the severity and impact of those crises and progress inclusive and sustainable community planning and urban development. In summary, the URT promotes improvement in policy and planning frameworks, risk reduction techniques, adaptation strategies, disaster recovery mechanisms, environmentally sustainable alternatives to fossil fuel energy, the building of social capital, and integration of ecologically sustainable UGI. Further, the HNCT advocates pro-environmental behaviors to increase the amount and accessibility of quality remnant and restored UGI to realize the human health benefits provided by nature, while simultaneously enhancing the ecological diversity and health of indigenous ecosystems. The synthesis of this article postulates that realizing the combined potential of URT and HNCT is essential to deliver healthy urban settlements that accommodate projected urban population growth towards the end of the 21st-century.