Toward a decolonial One Health: Findings from a participatory action research initiative with indigenous, Campesino, and Afro-descendant communities in the Amazon.

The One Health approach is central to addressing pandemic and planetary crises. However, its framework, predominantly shaped by perspectives from the Global North, has significant limitations with respect to equity and effectiveness in the Global South, particularly in Latin America and the Caribbean. This article develops a critical and decolonial One Health perspective structured around arguments aimed at overcoming four central limitations of the current framework: 1) the predominance of perspectives from the Global North that prioritize health security over local endemic problems; 2) instrumental or superficial forms of community participation that reinforce power asymmetries; 3) the lack of interculturality and the marginalization of ancestral knowledge; and 4) the limitations in addressing the structural and interconnected causes of health problems. Results are based on the One Amazon project, a One Health participatory action research initiative conducted with Indigenous, Campesino, and Afro-descendant communities in Colombia, Ecuador, and Peru between 2021 and 2024. Drawing on mixed qualitative and quantitative data, including participatory mapping, semi-structured interviews, and population surveys, the article demonstrates how these methods yielded empirically grounded insights into health, territory, and governance in Amazonian communities. Results show that collaborative research, focused on local needs and involving genuine participation from Amazonian organizations and their communities, including community co-investigators, intercultural dialogue that values ancestral knowledge, and a focus on territorial sovereignty, generated more relevant and sustainable solutions. Ultimately, the findings indicate that a decolonization process grounded in socio-environmental and epistemic justice would enhance the transformative potential of the One Health approach by enabling knowledge from the Global South to inform and enrich the global health agenda.