Operationalizing the One Health approach in a conflict-affected setting: A scientometric review of policy foundations, systemic gaps, and future pathways in Ukraine.

Background and Aim: The One Health approach integrates human, animal, plant, and environmental health through multisectoral collaboration and is increasingly recognized as essential for addressing zoonotic diseases, antimicrobial resistance (AMR), food security, and ecosystem degradation. Ukraine has formally adopted One Health principles through national strategies and international partnerships; however, the ongoing full-scale military conflict has profoundly disrupted health, veterinary, and environmental systems, challenging effective implementation. This study aimed to evaluate the current status, achievements, and constraints of the One Health approach in Ukraine, with particular emphasis on the effects of armed conflict on governance, surveillance capacity, and intersectoral coordination, and to outline strategic priorities for strengthening One Health resilience. Materials and Methods: A mixed-methods approach was used, combining bibliometric analysis of Scopus-indexed literature on zoonoses, AMR, food security, and environmental safety with targeted case studies and a review of policy documents. National legal frameworks, international guidelines, and reports from global organizations were systematically analyzed to assess institutional capacity and operational readiness. Results: Ukraine has established a solid policy foundation for One Health, notably through the national Strategy for Biosafety and Biosecurity, which is grounded in the One Health principle and aligned with quadripartite frameworks. Active initiatives address priority zoonoses (rabies, leptospirosis, tuberculosis), AMR surveillance, and food safety. Nevertheless, implementation remains fragmented. Armed conflict has caused extensive damage to laboratories, displaced the workforce, created surveillance blind spots, and disrupted multisectoral communication. AMR trends have intensified due to healthcare strain, while environmental and plant health components remain under-integrated despite their relevance to food security and long-term resilience. The Ukrainian experience demonstrates that policy commitment alone is insufficient in the context of conflict. Effective One Health operationalization requires institutionalized governance mechanisms, interoperable surveillance systems, and sustained investment in human resources and laboratory infrastructure. Environmental and plant health integration remains a critical gap. Conclusion: Reinforcing the One Health framework is essential for Ukraine's recovery and long-term health security. Sustained international technical and financial support, coupled with national institutionalization of One Health principles, is crucial to rebuilding integrated surveillance, mitigating biological risks, and enhancing resilience in conflict-affected settings.