One Health models are lacking an indigenous perspective
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q2015 (Published 16 September 2024) Cite this as: BMJ 2024;386:q2015
- Arthur W Blume
, professor
- art.blume{at}wsu.edu
Indigenous world views have long appreciated and valued the interdependence of the natural world, and have contributed to a holistic and egalitarian frame of reference for understanding healthy relationships.1 The One Health movements emerged to integrate research and surveillance of human health with that of the natural world and have been proposed as holistic alternatives to the existing colonial model that may help to avoid zoonotic transmission of infectious diseases and health consequences from climate change.234 Some One Health oriented researchers have seen the value of including Indigenous peoples in the research,5 with many assuming that Indigenous peoples would gravitate toward One Health movements. However, none of the One Health models, as currently defined, researched, and practised, appropriately emphasise these holistic assumptions; nor is Indigenous knowledge related to health and wellness reflected in One Health models.5 Rather than interpreting how One Health models can help Indigenous peoples, it is time to consider how Indigenous peoples could help One Health models.
Holistic models of health cannot succeed if inherent global inequities and the hierarchical, reductionist, and dualistic assumptions of current models are not challenged. Hierarchical conceptualisations of social orders and of the relationship of humans with the natural world inevitably have led to global inequities and contributed to an anthropocentric approach to health that is suggested to be a barrier to advancing One Health models.4 Reductionism inevitably contributes to a focus on the health of an individual rather than holistic planetary systems affecting health. An interdisciplinary approach is necessary to achieve a One Health approach to global health,6 but disciplinary reductionism—a process in which health related disciplines have disincentivised interdisciplinary collaborations—has resulted in silos that hinder this process. Dualism of thought has constructed artificial boundaries between disciplines, the observable and unobservable world, and the natural and human world. This duality has inevitably led to prioritisation of the observable, material, human world1 and, in turn, the commodification of the health of humans, animals, and the environment.78 One Health needs to challenge colonial assumptions of reductionism, dualism, and hierarchy that have valued the needs of certain individuals over those of the collective whole.
Two eyed seeing
This brings us back full circle to the implied affinity One Health models may have with Indigenous peoples when the holistic, egalitarian, and interdependent assumptions of Indigenous knowledge have been largely ignored. A Canadian review examining whether One Health models might be helpful to First Nations communities found that Indigenous knowledge related to health and wellness were not reflected in One Health models. The researchers assert that One Health models would be potentially helpful to advance Indigenous health, appealing to “two eyed seeing” in which reductionistic science and Indigenous ways of knowing may be used simultaneously to promote healing.5 Another review concluded that Indigenous peoples should be more directly involved in One Health oriented research9 and help researchers in their own process of two eyed seeing.
Globally, there has been a great deal of recent interest expressed in Indigenous ways of knowing (ie, sciences) because of the inability of science to adequately tackle health risks related to climate change and human encroachment on nature in ways that risk zoonotic transmission. Scientists may culturally misinterpret Indigenous ways of knowing by filtering their interpretations through colonial cultural lenses that assumes reductionism, dualism, and hierarchy. The One Health movement would benefit from equitable partnerships where scientists humbly listen to Indigenous peoples who understand holistic models of science, viewing health through Indigenous lenses. An Indigenous perspective posits that one planetary health begins with equity that moves away from a history of inequitable colonial assumptions.
Acknowledgments
This opinion was written while in-residence at the Brocher Foundation as a research fellow.
Footnotes
Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I served as an Indigenous consultant to WHO.
Provenance and peer review: Not commissioned; not externally peer reviewed.