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Understand Singapore's implementation of the One Health approach and its strategies for addressing zoonotic diseases and emerging infectious diseases.
Last updated 31 March 2025
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Overview of One Health
What is One Health?
One Health is an integrated, unifying approach that aims to sustainably balance and optimise the health of people, animals and ecosystems. It recognises the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.
As defined by the One Health High-Level Expert Panel (OHHLEP), the One Health approach mobilises multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development.
One Health approach for better health for all (Illustration by OHHLEP)
This definition takes One Health from theory to practice through 4Cs: Communication, Coordination, Collaboration, and Capacity building. The approach is supported by four major international organisations, the Food and Agriculture Organisation of the United Nations (FAO), World Organisation for Animal Health (WOAH), UN Environment Programme (UNEP), and World Health Organisation (WHO).
The concept of One Health is not new, as there has always been a need for the human, animal, and environmental health agencies to work together to address cross-sectoral areas.
Key One Health issues
One Health encompasses a wide range of interconnected issues affecting humans, animals, and the environment. These include:
Zoonotic diseases: Both emerging and re-emerging, as well as those endemic to the Southeast Asian region;
Neglected tropical diseases and vector-borne illnesses;
Challenges to food safety and security; and
Antimicrobial resistance (AMR).
To illustrate at the global level:
Risk drivers such as climate change and international trade and travel of people, animals, and food supply contribute to habitat expansion for disease vectors like mosquitoes, leading to increases in associated illnesses.
Zoonotic diseases can jeopardise food production, affecting livelihoods and economic stability.
Water sources used for consumption, leisure, and other purposes that are contaminated pose health risks to both people and animals.
AMR pathogens can spread rapidly through various channels, including communities, food chains, healthcare settings, and the environment, complicating treatment for both humans and animal. For more information on Singapore’s National Strategic Action Plan on AMR, please refer here.
Singapore’s One Health approach
Why is there a need for a One Health approach in Singapore?
Singapore made early moves to adopt the One Health approach in 2012 to safeguard human, animal, and environmental health. This early adoption has enhanced surveillance, preparedness, and response programmes.
Singapore is committed to strengthen the One Health approach, emphasising early prevention and detection of health risks especially infectious diseases, by working closely with local and international partners for One Health initiatives.
The past outbreaks of SARS-CoV-2 and group B streptococcus have further emphasised the threat of emerging and re-emerging infectious and zoonotic diseases. Southeast Asia, including Singapore, is a hotspot for emerging diseases. The region has faced numerous public health emergencies and outbreaks, such as SARS-CoV-1, MERS-CoV, and Nipah virus. To address these challenges effectively, a multidisciplinary One Health approach is crucial. This approach aims to balance and optimise the health of humans, animals, plants, and the environment in a sustainable manner.
Singapore’s One Health framework and One Health office establishment
Singapore’s One Health framework comprises the Communicable Diseases Agency (CDA), National Environment Agency (NEA), National Parks Board (NParks), PUB, Singapore’s National Water Agency, and Singapore Food Agency (SFA). We work together on multisectoral collaborative initiatives at the human-animal-environment interface to address public health concerns and to prevent, prepare against, respond to, and learn from public health threats.
Singapore’s One Health Framework
The inter-agency One Health Co-ordinating Committee (OHCC) provides strategic direction and sets priorities for One Health issues in Singapore. The OHCC champions inter-agency coordination and collaboration for One Health issues, including the progress and effectiveness of the One Health action plans. The OHCC comprises senior-level representatives, ensuring commitment and decision-making.
The inter-agency One Health Working Group works under the direction of the OHCC to formulate, coordinate, implement and review programmes, initiatives, and action plans. Sub-working groups or project teams are established when necessary to focus on specific areas of One Health issues.
The One Health office serves as a coordinating secretariat for One Health initiatives in Singapore. Its roles include acting as the primary point of contact for enquiries on One Health matters, facilitating inter-agency collaboration, and supporting the implementation of One Health strategies across relevant sectors.
Participation in international and regional One Health initiatives
International One Health initiatives: Quadripartite One Health Joint Plan of Action
To inform and drive One Health efforts at the globally, the Quadripartite One Health Joint Plan of Action (OH-JPA) was published by the Quadripartite - FAO, UNEP, WHO, and WOAH, in collaboration with the OHHLEP. The plan establishes five priority areas for One Health: enhancing capacities to strengthen systems, reducing risks from emerging and re-emerging zoonotic epidemics and pandemics, controlling and eliminating endemic zoonotic, neglected tropical and vector-borne diseases, curbing the silent pandemic of AMR, and integrating the environment into One Health.
Regional One Health initiatives
Singapore actively participates in One Health initiatives regionally and internationally, notably leading ASEAN initiatives such as drafting guidelines on antimicrobial use in livestock and co-hosting the World One Health Congress in 2022. The ASEAN Leaders' Declaration on One Health Initiative, adopted in May 2023, establishes the ASEAN One Health Network (AOHN), commits to analysing One Health implementation, and develops the ASEAN OH-JPA. The AOHN, launched in June 2024, aims to strengthen multisectoral collaboration with key functions including identifying priorities, facilitating knowledge exchange, and promoting One Health perspectives. The OH-JPA outlines the implementation plan for the One Health approach in ASEAN Member States. Its objectives include guiding the AOHN, serving as a reference for national plans, and strengthening cross-sectoral collaboration.
Additional regional and international One Health resources can be found below under “Resources”.
One Health inter-agency collaboration and case studies
Priority areas and key examples of One Health collaboration in Singapore include:
Developing information-sharing mechanisms and platforms among One Health agencies;
Implementing capacity building and joint training courses geared towards professional development;
Developing protocols to provide coordinated responses to public health threats in peace time and emergencies; and
Developing communication frameworks for One Health agencies.
Case study: Singapore Field Epidemiology Training Programme
The Singapore Field Epidemiology Training Programme (S-FETP), a partnership of the Saw Swee Hock School of Public Health and the National Centre for Infectious Diseases, hosts multi-sectoral tiered training programmes for officers interested in field investigation practice. The programme aims to ensure that health security extends beyond human health to involve good hygiene, sanitation, environmental health, wildlife ecology, animal and veterinary health, food safety, vector control and social resilience.
To safeguard public health, a whole-of-society approach is taken towards capacity building. Training in field epidemiology methods, community engagement and holistic education form vital parts of Singapore’s defense against emerging threats. S-FETP serves as a valuable resource with domain expertise and networking to fulfil just such a role for professionals and public. Real experiences of COVID-19 and pandemic preparedness have strengthened Singapore’s resolve to prevent the spread of infectious diseases and build community readiness for outbreaks.
Masterclasses are conducted by experienced One Health trainers and epidemic intelligence service faculty. Through group work, trainees investigate wide-ranging issues and help create a profile of community health, which provide important clues to the at-risk groups needing targeted interventions. This training platform is specially designed to build a sustainable field epidemiology workforce that meets the challenging future of public health fraught with emerging threats.
Case study: One Health Zoonotic Disease Prioritisation workshop for One Health agencies
The One Health Zoonotic Disease Prioritisation (OHZDP) process utilises a multisectoral, One Health approach, bringing representatives from human, animal, and environmental health sectors, and other relevant partners to prioritise zoonotic diseases of greatest concerns that should be jointly addressed by human, animal, and environmental sectors.
The coordination of the OHZDP process, led by NParks, culminated in a three-day zoonotic disease prioritisation workshop from 19 to 21 April 2023 in Singapore. Participants from the One Health agencies i.e. Ministry of Health (MOH), NEA, NParks, SFA, PUB, Singapore’s National Water Agency, and external facilitators from the US Centers for Disease Control and Prevention, and the FAO attended the workshop. Joining them as external advisors were experts in various fields, ranging from environmental biotechnology to infectious diseases.
The workshop aimed to prioritise zoonotic diseases in Singapore and develop next steps and action plans to address the priority zoonotic diseases in collaboration with the One Health agencies. Participants discussed various zoonotic diseases, developed criteria for evaluation and scored each disease based on the criteria. After three days of discussion, the agencies finalised the list of zoonotic diseases in Singapore and prioritised them for inter-agency collaboration. Participants then discussed the next steps and action plans to address the priority zoonotic diseases focused on One Health coordination and workforce, communications and outreach, preparedness and response planning, laboratory and surveillance capacity, and capabilities.
Case study: Singapore's national strategic action plan on antimicrobial resistanceonal strategic action plan on antimicrobial resistance
Coordinated by the Antimicrobial Resistance Coordinating Office (AMRCO)
Singapore developed the National Strategic Action Plan (NSAP) on AMR through a One Health approach, recognising the interconnected nature of AMR across human, animal, food, and environmental sectors. The plan is built on multisectoral collaboration, with the One Health AMR Working Group (AMRWG) coordinating efforts across sectors. It focuses on five core strategies: education; surveillance and risk assessment; research; prevention and control of infection; and optimisation of antimicrobial use, underpinned by principles of local partnership and international collaboration.
A five-year joint workplan was established to guide the NSAP's execution, with AMRCO under CDA overseeing coordination, implementation, monitoring and evaluation in partnership with One Health agencies. Since its launch in November 2017, initiatives implemented include joint reporting of AMR and Antimicrobial utilisation surveillance findings across One Health agencies, the development of guidelines for appropriate antimicrobial use in primary care and in companion animals, and the launch of public education campaigns on antibiotic use. The One Health AMRWG also established a One Health AMR research programme to foster cross-sector research in transmission pathways, knowledge and practices of key players, and the socioeconomic impact of AMR in Singapore.
The NSAP has led to improved awareness of AMR, strengthened surveillance systems, enhanced infection prevention and control measures, and improved antibiotic stewardship across sectors. Importantly, it has further strengthened intersectoral collaboration and partnership in Singapore.
This case study demonstrates Singapore's comprehensive, multisectoral approach to combating AMR, emphasising collaboration and integration across various health domains, and serves as a model for other countries seeking to address the complex challenge of AMR through a One Health approach.
For more information on Singapore’s NSAP on AMR and AMRCO, please refer here.
Case study: Singapore wastewater surveillance programme
In a remarkable display of whole-of-nation coordination, Singapore emerged as an early pioneer in wastewater surveillance for COVID-19 detection. Since February 2020, the National Environment Agency's Environmental Health Institute (NEA EHI) launched wastewater surveillance for COVID-19. This innovative programme exemplifies how environmental monitoring, public health surveillance, and water management can work in perfect synergy to protect community health.
The initiative brought together key agencies in a coordinated effort: NEA EHI leads the scientific development, sampling network expansion and laboratory testing, PUB provides access to wastewater samples through its extensive water reclamation network, and MOH uses the data to guide public health actions. This multi-agency collaboration proved particularly valuable during critical phases of the pandemic, enabling early detection of COVID-19 cases in workers' dormitories and residential areas.
From modest beginnings of eight sampling sites, the network has expanded to over 500 locations nationwide, including residential areas, student hostels, and welfare homes. This remarkable growth was made possible through strong inter-agency partnerships.
The programme's success has been further enhanced by collaborations with HTX, academic institutions (NTU, NUS, SCELSE), and industry partners. Innovative solutions like the Autosampler Live Monitoring System and the NEA-Wastewater Aliquoting Valence Engine, combined with cutting-edge research and testing capabilities from local universities and commercial laboratories, enable the analysis of up to 5,000 samples weekly at peak operations.
The system's versatility extends well beyond COVID-19. Since mid-2023, the infrastructure has been successfully adapted to monitor other health threats, including Zika and Mpox. This demonstrates how Singapore's One Health approach can be effectively pivoted to address various public health challenges. Our expertise and established capabilities have earned Singapore a place in global health surveillance networks, including WHO's CoViNet and the Global Wastewater Consortium, positioning us as a valued contributor to international public health resilience while maintaining a robust early warning system for emerging health threats in our community.
References:
National Environment Agency. (2020). NEA Leads Scientific Team In Wastewater Surveillance Trials For Assessment Of COVID-19 Transmission. https://www.nea.gov.sg/media/news/news/index/nea-leads-scientific-team-in-wastewater-surveillance-trials-for-assessment-of-covid-19-transmission
National Environment Agency. (2022). Linkedin.com. https://sg.linkedin.com/posts/national-environment-agency_neaofficers-inneavation-neaengineers-activity-6973804906184921088-7kGD
Resources
Situational and risk assessment report for One Health hazards
The reports below demonstrate Singapore's integrated approach to addressing health challenges at the human-animal-environment interface by One Health agencies.
Key features:
Multi-sectoral risk assessment
Updates on monitored public health events
Multi-domain risk evaluations
Brief updates on emerging One Health events
To read more, please access the reports here.