One Health in Mesoamerica: historical legacies, current challenges, and strategic directions.

BACKGROUND: Mesoamerica, a biodiversity hotspot extending from Mexico to Panama, faces intersecting health challenges rooted in colonial-era transformations and amplified by contemporary environmental change. This perspective paper demonstrates how historical legacies interact with current ecological and social drivers to shape zoonotic disease vulnerability across the region. APPROACH: We integrate historical analysis of colonial disease introduction with an examination of current environmental, climatic, and social determinants of disease transmission. Findings from a structured multisectoral participatory workshop organized by the GLACIER Project Consortium in Guatemala in 2023, involving participants from academia, government, non-governmental organizations, and community representatives across Mesoamerica, were synthesized together with a narrative review to develop community-centered One Health strategies for the region. KEY FINDINGS: European colonization of the Americas during the 15th-18th centuries, introduced devastating pathogens and fundamentally altered disease ecology through the introduction of livestock, human-associated pathogens, vectors, and reservoirs, establishing transmission patterns that persist today. Contemporary vulnerabilities arise from: deforestation and agricultural expansion facilitating vector proliferation and wildlife-human contact; informal and unregulated animal movement enabling the spread of transboundary diseases; climate change altering vector distribution and creating novel health threats; fragmented health systems with inequitable access; and poverty-linked structural conditions amplifying disease transmission. Despite growing One Health discourse regionally, meaningful integration across human, animal, plant, and environmental health sectors remains limited, as evidenced by recent disease resurgences and continued institutional gaps in surveillance and cross-border coordination. STRATEGIC RECOMMENDATIONS: Six priority action lines emerged from the workshop discussions and their thematic synthesis: strengthening intersectoral governance and regional cooperation; implementing integrated surveillance systems; ensuring community participation and intercultural inclusion of Indigenous knowledge; expanding culturally appropriate health education; promoting community-engaged applied research; and integrating sustainable territorial management. Success requires political commitment beyond economic capacity, positioning communities as decision-makers, and alignment with international frameworks including the FAO-WOAH-WHO-UNEP Joint Plan of Action. CONCLUSIONS: Mesoamerica's interconnected health challenges demand One Health approaches acknowledging historical context while centering vulnerable communities. Regional cooperation, community empowerment, and sustained political will-rather than wealth alone-determine effective disease prevention and health equity.