The Syndemic and One Health Nature of Pandemics: Arguments for Renewed Attention to Intelligence Management

The Syndemic and One Health Nature of Pandemics: Arguments for Renewed Attention to Intelligence Management

João Paulo Magalhães, Tiago Correia, Inês Fronteira, Mohsin Sidat, Fernando Passos Cupertino de Barros, Cláudio Tadeu Daniel-Ribeiro, Antonio Pedro C. Delgado, Paulo Ferrinho
DOI: 10.4018/978-1-7998-8011-0.ch001
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The interdependence of humans, animals, plants, and their social and abiotic environment is highlighted by past and recent pandemics. A good example to understand and tackle threats to ecosystems is the COVID-19 pandemic. A syndemic is a complex and multilevel phenomenon of epidemics interacting synergistically at individual, societal, and environmental levels. Understanding the syndemic nature of pandemics will facilitate the adoption of a One Health approach to improve planetary health. To address the eco-complexity underlying One Health issues, the development of intelligence management systems through a planetary perspective is of key importance. This requires the capacity to capture, process, and communicate data on human, animal, and plant health and well-being, and on their social and environmental determinants. The implementation of such systems will need political commitment at all levels of action, deployment of adequate resources and expertise, reliable and comprehensive data flowing pathways through interoperable, flexible, and secure data sharing systems.
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The interdependence of humans, animals, plants and their social and abiotic environment is highlighted by past and recent pandemics, and it is most relevant in understanding and tackling threats to ecosystems (Acharya et al., 2021; Amuasi et al., 2020; Waugh et al., 2020).

Indeed, balanced ecosystems are important to support adequate interactions between humans and animals and protect and prevent the hazards of animal to human and human to animal transmission of diseases (Corman et al., 2019; Corvalan et al., 2005). Human action has been a major force behind the disruption of ecosystems, leading to pollution (e.g., air, light, thermal, noise, soil) through different agents (e.g. plastic, non-disposable tools, radiations). The outcomes are manifold and include loss of biodiversity, induced desertification, and deforestation, changing seasonal meteorological patterns, increase in illegal wildlife trading, changes in patterns of human and animal migration, the global increase in density and spread of entomological disease vectors, and blurred boundaries and distance between species. As a result, pandemics, climate disasters and other adverse events, from which populations may never fully recover, are likely events in the coming years (Kluge & Monti, 2021; Pérez‐Escamilla et al., 2020; Singla et al., 2020). The COVID-19 pandemic is a dramatic illustration of this.

Two different yet complementary concepts allow to better grasp such human-nature interdependence: syndemic and One Health.

The term syndemic was first introduced by Singer (1996) to describe and better understand synergistic interactions between endemic and/or epidemic, communicable and/or non-communicable (NCD) and not necessarily neglected (ND) diseases, and their social and environmental determinants. Some examples of syndemic approaches include ‘SAVA’ (Substance Abuse, Violence, and AIDS) (Singer, 1996), ‘VIDDA’ (Violence, Immigration and associated isolation, Depression, type 2 Diabetes, and Abuse) (Mendenhall, 2012), or ‘PHAMILIS’ (Physical Health problems, Abuse, Mental Illness, Loss, Instability, and Substance use) (Marcus & Singer, 2017). Although the concept has remained relatively unchanged at the definitional level, several developments have argued for more accurate meanings of synergistic interactions, as it can encompass mutually or serially causality and synergism (see Tsai, 2018 for a synthesis).

Key Terms in this Chapter

Abiotic Factor: Non-living chemical and physical elements of the environment that affect living organisms and the functioning of ecosystems.

Biotic Factor: Living organism that shapes its environment.

Information: Facts that have been arranged and/or transformed to provide the basis for interpretation and conversion into knowledge.

Epidemic: The occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related events clearly in excess of normal expectancy.

Syndemic Theory: Two or more epidemics interacting synergistically and contributing, as a result of their interaction, to the clustering of excess burden of disease in a location or population, more than just the sum of both and simple additive associations.

Policy: Guide to action to change what would otherwise occur based on resources allocation

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