Operationalizing One Health: Environmental Solutions for Pandemic Prevention.

Human pressure on the environment is increasing the frequency, diversity, and spatial extent of disease outbreaks. Despite international recognition, the interconnection between the health of the environment, animals, and humans has been historically overlooked. Past and current initiatives have often neglected prevention under the One Health preparedness cycle, largely focusing on post-spillover stages. We argue that pandemic prevention initiatives have yet to produce actionable targets and indicators, connected to overarching goals, like it has been done for biodiversity loss and climate change. We show how the Driver-Pressure-State-Impact-Response framework, already employed by the Convention on Biological Diversity, can be repurposed to operationalize pandemic prevention. Global responses for pandemic prevention should strive for complementarity and synergies among initiatives, better articulating prevention under One Health. Without agreed-upon goals underpinning specific targets and interventions, current global efforts are unlikely to function at the speed and scale necessary to decrease the risk of disease outbreaks that might lead to pandemics. Threats to the environment are not always abatable, but decreasing the likelihood that environmental pressure leads to pandemics, and developing strategies to mitigate these impacts, are both attainable goals.