The case for investing in One Health: Lessons from Bangladesh

In the bustling live bird markets of Dhaka, where vendors sell chickens mere meters from where children play, the invisible threads connecting human, animal, and environmental health become starkly visible. This scene illustrates why FAO has long championed One Health as an urgent investment imperative for our interconnected world.

When crisis becomes catalyst

Bangladesh's One Health journey began in the face of crisis. When highly pathogenic avian influenza swept across Asia in 2003, this densely populated nation of 169 million people found itself at the epicenter of a global health emergency. With one of the world's highest livestock densities – 2 684 poultry per square kilometer – and millions of people in daily contact with animals, Bangladesh was a tinderbox waiting for a spark.

The response was remarkable. Rather than tackling the crisis in silos, Bangladesh brought together its health, livestock, and wildlife sectors in an unprecedented collaboration. This wasn't just crisis management – it was the birth of a movement that would position Bangladesh as a global One Health pioneer.

The economics of integration

From FAO's perspective, the Bangladesh experience validates a fundamental economic truth – investing in One Health is financially smart. Bangladesh's poultry sector alone produces 510 million birds annually, worth billions to the economy. When disease strikes, costs cascade across sectors and regions.

More compelling are the benefits of prevention. Bangladesh's investment in coordinated surveillance systems, joint training programmes, and integrated laboratories has created early warning capabilities that detect threats before they explode into pandemics. Every dollar spent on prevention saves multiples in response costs.

In Bangladesh, where 27.4 percent of households depend on agriculture, animal husbandry, or fisheries, One Health approaches protect entire economic ecosystems. Farmers trained in both animal health and food safety don't just reduce disease risks – they access higher-value markets demanding safer products.

Beyond borders: The regional imperative

Bangladesh shares a 4 095-kilometer border with India – one of the world's longest and most porous. Daily, thousands of people and animals cross this frontier, creating opportunities for disease transmission across borders. Traditional health approaches that end at national borders are obsolete in this interconnected reality.

The country sits at the heart of major migratory bird routes, connecting breeding grounds in Siberia to wintering areas in Southeast Asia. Wildlife trafficking routes channel exotic species through Bangladesh to markets across Asia. Climate change is shifting disease patterns, creating new hotspots for vector-borne diseases.

Innovation born from necessity

Necessity has driven Bangladesh to develop groundbreaking One Health innovations that seamlessly integrate community engagement, technology, and professional expertise.

The country's "Upazila-to-Community" (U2C) approach exemplifies this integration through a transformative, gender-sensitive programme that delivers government livestock services directly to rural farmers, with particular focus on reaching women. This initiative combines grassroots community reporting with professional veterinary surveillance, creating a comprehensive early warning system that captures disease signals at the village level while ensuring expert verification and response. Beyond surveillance, these community-centered interventions have proven instrumental in reducing antimicrobial use on poultry farms, directly addressing antimicrobial resistance at its source.

Technology serves as the backbone for coordinated response through the Bangladesh Animal Health Intelligence System, developed with FAO technical support. This unified platform channels real-time data from livestock markets, veterinary hospitals, and community reports to alert human health authorities about potential zoonotic threats, demonstrating how digital solutions can bridge sectors effectively.

At the point of care, digital innovations are transforming antimicrobial stewardship. The mobile application Rx Vision, now being piloted in animal pharmacies across Bangladesh, enables dispensaries and drug sellers to digitally verify prescriptions before selling antimicrobials to livestock owners, creating a crucial checkpoint in the antimicrobial supply chain.

Perhaps most innovative is Bangladesh's approach to workforce development through the Bangladesh Antimicrobial Resistance Response Alliance (BARA). This veterinarian-led movement is committed to combating AMR by training and sensitizing livestock farmers throughout their networks. The BARA community has been instrumental in reducing unnecessary antimicrobial use in poultry, thereby decreasing resistant organisms that affect human health.

Climate change: The amplifying factor

Climate change transforms the One Health investment equation from important to urgent. Bangladesh, ranked among the world's most climate-vulnerable nations, offers a preview of challenges facing much of the developing world. Rising temperatures alter disease patterns, with malaria and dengue expanding into previously unaffected areas.

The Sundarbans exemplify these interconnections. Climate-driven sea-level rise and saline intrusion threaten this UNESCO World Heritage site. As habitats shrink, wildlife-human interactions increase, elevating spillover risks for zoonotic diseases. Only integrated One Health strategies can address these complex challenges.

Return on investment: proven results

The COVID-19 pandemic provided an unexpected test of Bangladesh's One Health investments. The country's infrastructure – joint training programmes, coordinated surveillance systems, inter-sectoral communication networks and commitment from civil society organizations – proved invaluable for pandemic response. Animal health laboratories pivoted to support human COVID-19 testing, while One Health-trained professionals led contact tracing and outbreak investigation.

Bangladesh's experience reveals broader benefits: strengthened health systems that respond more effectively to any health threat; improved food safety that opens export markets; enhanced agricultural productivity from healthier livestock; reduced healthcare costs from prevented diseases.

A global imperative

Bangladesh's One Health journey from crisis response to systematic approach offers hope and guidance for our interconnected world. Despite resource constraints, coordinated investments across health, agriculture, and environment sectors have yielded measurable benefits.

FAO is actively supporting One Health investments in Vietnam, Indonesia, and other nations, adapting lessons learned in Bangladesh to local contexts. The key insight: successful One Health programmes require government ownership, multi-sectoral coordination, and sustained financing.

The next pandemic is inevitable. Where it emerges will depend partly on chance. How quickly we detect and respond to it will depend entirely on our investments in One Health systems. We can continue responding to health crises reactively, paying enormous costs in lives and economic damage. Or we can follow Bangladesh's lead, investing proactively in integrated systems that prevent crises while building resilient, healthy communities.

From FAO's perspective, the case is clear: One Health investments aren't just smart policy – they're essential for our collective survival and prosperity in an interconnected world.