Adoption and implementation of one health in Bangladesh: Governance structures, system strengths, challenges and future directions.

Bangladesh is characterized by a high density of human and animal populations, frequent human-animal interactions, rapid urbanization, environmental degradation, wildlife habitat destruction, poor biosecurity, intense animal farming and climate change. All of these factors contribute to an elevated risk of zoonotic disease emergence and antimicrobial resistance (AMR). These interconnected challenges underscore the need for an integrated One Health approach. Since 2008, Bangladesh has progressively institutionalized the One Health approach through civil society engagement, government endorsement of the One Health Strategic Framework, and the establishment of the One Health Secretariat (OHS). Ongoing refinement of the One Health Strategic Framework, strengthened multisectoral collaboration, expanded laboratory networks, coordinated workforce training and enhanced data sharing reflect steady progress toward a sustainable and integrated approach. Despite these advances, significant challenges and limitations persist that hinder effective and sustainable One Health implementation across One Health sectors. Collaboration among animal, human and environmental health sectors remains largely project-driven, short-term and donor-dependent. Institutional silos, inequitable distribution of responsibilities, inadequate inter-ministerial coordination and limited application of One Health frameworks continue to constrain consistent joint planning and resource sharing. Major challenges include insufficient strengthening of One Health governance; a shortage of empowered mid-level One Health leaders to sustain efforts; inadequate resources and limited long-term financial commitment from the government; insufficient engagement of environmental and climate sectors; limited sustained institutional commitment; uncertainty among stakeholders regarding ownership and responsibility; inadequate coordination at sub-national and community levels, limited integration of One Health principles into academic curricula and community programs; inadequate professional training on One Health and low levels of community awareness. Formalizing and strengthening One Health governance, empowering the institutional authority of the OHS, developing future One Health leaders, ensuring sustained political and financial commitment and integrating One Health principles into national planning instruments are essential for sustainable implementation. In addition, establishing a National One Health Institute with a clear country-specific vision, mission, and long-term commitment would substantially strengthen national capacity to detect, prevent, and respond to One Health threats.