Integrated approaches to health: A paradigmatic, methodological and operational comparison of EcoHealth, One Health and Planetary Health.

While clinical medicine essentially concentrates on the human body and its parts, public health focuses on the health of human populations and their social and environmental determinants. Integrated approaches to health extend the focus of attention to humans in their socio-cultural and ecological environment and their mutual interdependencies, paying attention to inter-species interdependencies. Since the beginning of the 21st century, ecosystem approaches to health (EcoHealth), One Health and Planetary Health have emerged as integrated approaches that relate to and expand public health and related fields. In this article, we aim at clarifying their respective definitions, philosophical foundations and methodological positions. This clarification is important because the way we define integrated approaches to health shapes research, teaching methods and their translation into policy and practice. Key methods and case studies are summarized and compared. Among the three integrated approaches, EcoHealth and Planetary Health operate largely in academic networks and non-governmental organizations (NGOs). One Health is currently operationalized at the level of international organizations, regional organizations and national governments. Integrated approaches to health require urgent adoption and implementation, as they are pivotal for complex problem-solving regarding challenges such as pandemic prevention, climate change, biodiversity loss and antimicrobial resistance.