A framework for facilitating sustainable One Health collaboration across sectors at the national level in the...

BACKGROUNDOne Health (OH) is a multisectoral approach that aims to optimise health of people, animals and the environment, recognising their interconnection. Despite gaining political support in recent years, examples of successful OH implementation among governmental institutions across the European Union/European Economic Area (EU/EEA) remain limited.AIMTo identify key enablers and barriers to collaboration across human, animal and environmental health sectors, and provide a framework to support national OH operationalisation in the EU/EEA.METHODSSemi-structured interviews were conducted with 26 experts from national public health institutes in 15 EU/EEA countries, recruited through European Centre for Disease Prevention and Control networks. Transcripts were analysed through qualitative content analysis.RESULTSCollaborations between human and animal health sectors were reported, but greater integration of the environmental sector is needed to strengthen OH partnerships. Analysis of opportunities and challenges highlighted key interlinked elements that can facilitate sustainable OH implementation. Strong political leadership emerged as pivotal to drive policy coherence in nexus areas, embed collaborative activities within core funding, and facilitate cross-sectoral partnerships at the technical level.CONCLUSIONThis qualitative study provides an overview of enablers and barriers to OH collaboration at the national level. The findings constitute the basis for an empirically derived framework emphasising the cyclical relationship between political leadership and cross-sectoral technical collaboration. Incremental steps, starting with strengthening existing cross-sectoral relationships, have the potential to generate self-reinforcing progress and enhance emergency preparedness. These empirical insights provide a foundation for developing and evaluating OH policies in EU/EEA countries, complementing existing international guidelines.