One Health Integration for Climate-sensitive Threats in Mediterranean Health Security

Background

Climate change, ecological disruption, rapid mobility and urban density have increased the complexity of health threats in the Mediterranean region. Heat events, vector expansion, zoonotic risks, environmental hazards increasingly cross the boundaries of public health, veterinary surveillance, and environmental monitoring. A One Health approach may improve health security by integrating these domains within a preparedness framework.

Methods

A structured review examined how One Health principles are operationalised in health security planning across Mediterranean settings. The review focused on surveillance integration, intersectoral governance, laboratory coordination, early warning systems, workforce preparedness, and crisis communication. Evidence was synthesised thematically to identify recurrent implementation barriers and enabling conditions.

Results

Four consistent weaknesses were identified. First, surveillance systems remained fragmented, with limited interoperability across human, animal and environmental sectors. Second, emergency planning often addresses climate-sensitive and zoonotic threats in parallel rather than through a unified risk framework. Third, laboratory and field response capacities were uneven, particularly at the local and cross-border levels. Fourth, workforce preparedness for joint investigation and coordinated response was underdeveloped. More effective models were characterised by formal interagency protocols, integrated data flows, decentralised alert capacity and routine multisectoral training.

Conclusions

Health security in the Mediterranean requires a shift from sector-specific preparedness to operational One Health governance. Integrated surveillance, shared risk assessment, joint workforce training and cross-border coordination should be treated as core public health functions. Strengthening these capacities may improve early detection, response effectiveness, resilience to climate-sensitive and zoonotic threats.

Key messages

• Health security in the Mediterranean necessitates a transition from sector-specific preparedness to operational One Health governance, emphasizing integrated surveillance, shared risk assessment.

• Surveillance systems are fragmented, lacking interoperability among human, animal, and environmental sectors. Emergency planning typically addresses climate-sensitive and zoonotic threats.