In the heart of South Asia, where dense populations coexist with rich biodiversity, the One Health approach should have been a natural solution to the region’s complex health challenges. Yet, instead of embracing a truly interconnected model, the region remains trapped in an outdated anthropocentric mindset, where human health takes precedence, while animal and environmental health are treated as mere accessories. This skewed approach does not just weaken our ability to prevent the next pandemic; it also accelerates ecological collapse and deepens the divide between humans and nature.

At its core, One Health is meant to be an equal partnership between human, animal, and environmental health. However, in South Asia, the concept has been reduced to a public health tool designed primarily to shield humans from zoonotic diseases. If a virus jumps from bats to humans, we panic. If antimicrobial resistance (AMR) spreads, we worry about losing life-saving drugs for human treatment. But when the same practices destroy ecosystems or devastate livestock populations, the response is strikingly muted.

Take, for instance, the recent rise in antibiotic-resistant bacterial infections across Nepal, India, and Bangladesh. Governments have started cracking down on antibiotic overuse in human medicine, yet the uncontrolled use of antibiotics in livestock and aquaculture remains largely unchecked. The result? Resistant bacteria continue to grow, eventually finding their way into human populations. The problem is treated only when it starts affecting people, not when it emerges in the food chain or the environment. This selective intervention is not One Health, it is One-Sided Health.

Blaming animals instead of fixing the system

Whenever a zoonotic disease outbreak occurs, the response is almost always reactive and aggressive, against animals. During bird flu outbreaks, poultry are culled by the millions, often without proper compensation for farmers. Stray dogs are mass-killed in the name of rabies control, despite evidence that vaccination programs are more effective. The moment a disease is traced to a wild species, there is talk of extermination rather than ecosystem restoration.

Consider the Nipah virus outbreaks in Bangladesh, where fruit bats, natural hosts of the virus are blamed for infecting humans. Instead of focusing on the deforestation that has driven bats closer to human settlements or on the unregulated farming practices that increase transmission risks, the primary response is fear-mongering and culling. If bats could speak, they would probably say: “We’ve been carrying this virus for centuries. You changed the rules of coexistence, not us.”

The environmental blind spot

The anthropocentric One Health approach in South Asia does not just ignore animals, it actively destroys the environment. Deforestation for urban expansion, mining, and intensive agriculture is treated as an economic necessity, even when it directly contributes to climate change, biodiversity loss, and increased disease transmission.

The 2023 extreme heatwaves in India, Nepal, and Pakistan severely impacted livestock, leading to heat stress, decreased milk production, and higher mortality rates. But instead of addressing the root causes - climate change, habitat destruction, and poor animal welfare policies -discussions remained limited to human casualties. Livestock losses were simply seen as economic setbacks rather than as indicators of a collapsing system.

Even pollution control policies favor humans disproportionately. Air pollution in Delhi is treated as a human respiratory issue, while its effects on soil health, crop yields, and wildlife are overlooked. Water pollution in the Ganges is framed as a religious and human health crisis, with little regard for the aquatic biodiversity being wiped out by industrial waste.

The rural-veterinary divide

The failure of One Health in South Asia is also a failure of equity. While urban centers receive funding for infectious disease research, rural communities where human, animal and environment interactions are most intense are left behind.

Veterinarians and livestock health workers are the first responders in rural South Asia, yet they are often excluded from One Health discussions. Disease surveillance remains focused on human hospitals, even though the next pandemic is more likely to emerge in a backyard farm or a live animal market than in a corporate office in Kathmandu or Mumbai. If One Health is to be effective, veterinarians must be placed at the same decision-making table as medical doctors and public health officials.

Towards a decolonized and decentralized One Health model

The current One Health approach in South Asia is not just anthropocentric, it is also colonial in its thinking. It mimics Western disease control models without adapting to the region’s realities. In Europe and North America, One Health strategies can afford to be more human-centric because strict regulations on wildlife conservation, livestock management, and environmental protection already exist. South Asia, however, lacks these foundational safeguards, making a human-first approach dangerous and unsustainable.

We need a decolonized and decentralized One Health model:

Human-centric to ecosystem-centric health

Disease prevention should start with habitat preservation, sustainable farming, and biodiversity conservation—not just with vaccines and drugs.

Indigenous ecological knowledge should be integrated into health policies, recognizing that communities living closest to nature often have the best understanding of disease dynamics.

Equal status for veterinary and environmental health 

Veterinary professionals must be given the same policy influence as human health experts.

Conservationists and ecologists must be included in health discussions, ensuring that environmental destruction is treated as a public health threat.

Invests in rural disease surveillance

More funding should go toward monitoring emerging diseases in farms, forests, and wet markets rather than waiting for hospital admissions to skyrocket.

Traditional livestock farming communities should be supported with training and resources to implement sustainable health practices.

Recognizes that health Is political

Governments must stop favoring short-term economic gains (such as deforestation and industrial farming) over long-term public health security. Global institutions must acknowledge the unique health-environment challenges of South Asia and support region-specific solutions rather than imposing Western models.

South Asia is not just a region of human populations; it is home to some of the richest biodiversity and most complex ecosystems in the world. Treating One Health as a human-first initiative is not just flawed—it is suicidal. The next pandemic will not wait for policy debates; nor will climate change pause for governments to reconsider their priorities.

It is time to unlearn the narrow, crisis-driven, and anthropocentric version of One Health that dominates South Asia and replace it with a truly integrated, justice-oriented, and ecosystem-driven approach. Otherwise, we will keep fighting the same battles—pandemics, antibiotic resistance, environmental collapse—without ever addressing the reasons they keep happening in the first place.

The question is no longer "Can we afford to think beyond humans?" The real question is "Can we afford not to?"

(The author is a veterinarian from Nepal with a keen interest in One Health, disease ecology, and sustainable livestock management. Views expressed are personal. He can be reached at ayush.adhikari2000@gmail.com or via LinkedIn: https://www.linkedin.com/in/ayushadh/ )