What if doctors and veterinarians worked together?

It is a big step that has been taken, yet it has gone unnoticed: by appointing the new Health Risk Watch Committee, on 1er August, the Minister of Health, François Braun, stipulated that he should adopt “a ‘global health’ approach”. This means devoting as much attention and energy to human illnesses as to animal illnesses, pollutants and climatic disturbances. Hooray! The authorities seem to have understood that our societies will not be able to manage future health crises if they do not combine the expertise of veterinarians and ecologists with that of the medical profession. It is still necessary that all these beautiful people learn to speak the same language…

It is to this difficult project that Amandine Gautier, doctor of political science and creator of several courses at VetAgro Sup, the veterinary and agronomic school of Lyon, has devoted herself for several years. The co-author of Getting out of crises” (Editions Quae) will be one of the speakers at the One Health evening on September 27 in Lyon, of which “the Obs” is a partner.

You have created several diplomas at VetAgro Sup intended to encourage exchanges between doctors, veterinarians and ecologists. How does it work?

It is most often a question of submitting textbook cases to them – we imagine, for example, a serious health crisis due to a zoonosis [maladie qui se transmet des animaux aux humains, comme le Covid, NDLR] unknown. Very quickly, they realize that in situations where decisions have to be made, medical, veterinary and ecological ethics are not at all similar: some will focus on the human consequences of zoonosis, others on the treatment of animals, the latest on degraded ecosystems… This can create dilemmas, even sometimes quite violent conflicts of values ​​between them. But we get them to think together and negotiate to make creative decisions. In terms of health, we have indeed entered an era of complexity and uncertainty. The time for “one-size-fits-all” solutions is over!

We have the impression that, culturally, doctors tend to look down on veterinarians, who still ignore ecologists…

Things are changing, fortunately. But it is true that it took intensive lobbying by the veterinary profession for one of them [Thierry Lefrançois] joins the scientific council, one year after the start of the Covid-19 crisis. However, the animal origin of the pandemic was beyond doubt! In France, veterinarians are not considered a medical profession: they are “service providers”. This makes them, in fact, almost non-existent in the Ministry of Health. However, unlike the medical profession, they have a certain habit of crises: mad cow disease, swine fever, avian flu… The profession knows how to act in emergency situations and could inspire new policies.

Human health does not exist without animal health

It must be said that, for a long time, the interest of animals was non-existent…

When a health crisis arose, human interests were indeed prioritized in a sometimes brutal way. Remember the gigantic pyres for cattle during the mad cow crisis. Even recently, in 2012, it was discovered that the Bargy ibex, a wild and protected species in the Alps, had contaminated the milk of Reblochon with brucellosis. [maladie bactérienne dangereuse pour l’humain]. In this case, breeders and the agri-food sector were in favor of the pure and simple eradication of the ibex, while animal protection associations and tourism professionals demanded a more nuanced treatment. But the authorities, very sensitive to economic arguments, ordered its massive slaughter. Result: the French Office for Biodiversity eliminated the oldest ibexes, but dispersed the others – which are also the most contaminating – in the Alpine massif… I think that a real dialogue between the different actors would have made it possible to avoid this situation, which has since improved somewhat.

Is this difficulty in communicating a French specificity?

I do not know. In our country, we like to claim an interdisciplinary approach, less often to implement it! Very concretely, there is a fundamental divergence between the field of the human sciences, seen as “literary”, and that of the exact sciences. However, a global health policy needs a dialogue between breeders, hunters, veterinarians, doctors, environmentalists… For this dialogue to take place, we need experts who know each other’s cultures, values, representations and who have understood where the points of misunderstanding lie between them and the possible bridges. What’s more, you need people capable of analyzing how the same crises are handled abroad, with different solutions. We must decompartmentalize in all directions.

Gilles Bœuf: “Separating human and animal health no longer makes sense”

So France is late?

On the issue of One Health [la « santé globale », NDLR], it is rather ahead of its neighbours, in particular because of the important role of veterinarians. So let’s rejoice, even if we are only at the beginning of the dialogue! Next year, we are setting up a cycle of advanced studies in global health, a course of excellence with the School of Advanced Studies in Public Health (EHESP) and AgroParisTech, intended to train the “onehealthologists” of tomorrow. All of them will continue to be doctors, veterinarians or ecologists first and foremost, because I don’t believe in the “Global Health” specialty which would group together all the others. But everyone will have become accustomed to listening and negotiating with those who have divergent interests. You will see, this will prove extremely valuable in creating the public health policies of the next few decades.

Find the complete program of the One Health conference and register by clicking here.

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