Editorial
Nursing and the one health paradigm: toward a sustainable approach in Africa
La enfermería y el paradigma de una sola salud: hacia un enfoque sostenible en África
A enfermagem e o paradigma de uma saúde única: rumo a uma abordagem sustentável na África
Ydalsys Naranjo-Hernández1* 
https://orcid.org/0000-0002-2476-1731
1Doctor of Nursing Science. Master in Bioenergetic and Natural Medicine. First Degree Specialist in Community Nursing. Senior Researcher at the Biomedical Research Unit. Full Professor, Department of Nursing, Higher Polytechnic Institute of Bié, Cuito. Bié, Angola.
* Corresponding author. Email: 
idalsisn@gmail.com
Received: 2025/11/21
Approved: 2025/12/25
Published: 2026/01/15
In the promotion of global health and to contribute to strengthening intersectoral cooperation, prevention, and resilience in the face of the health risks of the 21st century. Among emerging infectious diseases, whose high numbers of cases are striking, many are zoonotic and therefore have serious consequences for human health. For this reason, in 2004 health experts met and focused their attention on the relationships of mutual dependence among human, animal, and environmental health. Based on the recognition of these relationships, they emphasized the priority of an interdisciplinary and international approach to addressing these threats.(1) As a result of this meeting, the Manhattan Principles declaration was issued,(2) containing twelve recommendations.
The declaration was ratified by the Food and Agriculture Organization (FAO), the World Organisation for Animal Health (OMSA), the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), and other international bodies. Subsequently, from the perspective of “One World, One Health,” other expert meetings analyzed the causes of the spread of zoonotic infectious diseases.(1,3)
The “One Health” approach is essential in addressing global health challenges, as it recognizes the interdependence among human health, animal health, and the balance of ecosystems.(3) Its adoption enables an integrated view of health problems by linking the care of human health with the protection of the natural environment. This perspective aligns with the 2030 Agenda and the Sustainable Development Goals.
The implementation of the “One Health” approach requires conceptual recognition and concrete actions that integrate the health, environmental, and agricultural sectors. In Africa, there is a paradox in that, despite its rich biodiversity, the continent is particularly vulnerable to the transmission of zoonotic diseases. This situation is further exacerbated by processes such as urbanization, deforestation, and human migration.(4) Recent epidemics, from Ebola to COVID-19, provide evidence that health risks are not confined by borders or species.
In the contexts of African countries, the presence of nurses as part of the health workforce is essential; their active participation is key to sustaining health programs, community education, vector control, and environmental management.(5) Nurses occupy a unique position in addressing inequalities in health care, which would support the adoption of a sustainable management approach across the continent. This holistic perspective has its roots in the humanistic thinking of Florence Nightingale, who emphasized the role of the environment in disease prevention. Hence, the current emphasis on the close relationship between the nursing profession and the “One Health” approach.
To consolidate the “One Health” approach, transdisciplinary education is essential to train leaders with expertise in environmental health, zoonotic diseases, risk management, and intersectoral cooperation, which would strengthen responses to health emergencies and climate change.(4–6) The establishment of national “One Health” observatories would make it possible to anticipate risks, coordinate policies, and optimize available resources. In this context, the nursing specialty would provide key information on the local determinants of population health.
Therefore, it is essential for nursing personnel to develop their research and leadership competencies and to become integrated into intersectoral networks for surveillance and environmental sustainability. Continuing education is a pathway to expand their professional scope and to strengthen their responses to health and ecological crises. In this way, nursing would be consolidated as a bridging profession between science, communities, and the ethics of comprehensive care.(5,6)
The “One Health” paradigm is also an invitation to rethink traditional models of health care and to orient them toward prevention, equity, and shared social responsibility. From rural communities to urban settings, nursing personnel are a key link in health education, environmental surveillance, and the participatory management of natural resources. These actions, which integrate local and scientific knowledge, strengthen community autonomy and resilience in the face of natural disasters, food insecurity, or epidemic outbreaks.(4)
The integration of the “One Health” perspective into professional practice also entails an ethics of care that links human well-being with environmental well-being. In practice, this principle is reflected in the implementation of vaccination campaigns, the promotion of agroecological practices, community education on water hygiene, and vector control. These actions are also aligned with the core values of nursing: respect, social responsibility, and commitment to life.(5–7) Each intervention becomes an act of planetary health, in which caring for people also means preserving the ecosystems in which they live.
Nursing—as a specialty—with its person-centered approach and experience in community-based work, can and must lead the transition toward sustainable health models in Africa. The adoption of the “One Health” model implies recognizing that human health depends on the balance of the planet, and that the future of the African continent is built upon the integration of science, nature, and community. This paradigm represents a historic opportunity for nursing to consolidate its leadership
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2. Wildlife Conservation Society, The Rockefeller University. The Manhattan Principles [Internet]. New York: WCS; 2004 [cited 2025 Jul 27]. Available from: https://www.onehealthcommission.org/documents/filelibrary/library_references/reports/Manhattan_principles_2004_D578C2BB55C0C.pdf
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7. Şahin NE, Öner M. Nurse educators' knowledge and opinions about the “One Health” approach. Int Nurs Rev [Internet]. 2024 [cited 2025 Ago 1];71(4):1113-20. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11600494/pdf/INR-71-1113.pdf
Conflict of interest
The author declares no conflicts of interest.
Author's contributions
Ydalsys Naranjo-Hernández: conceptualization, methodology, resources and writing - original draft.
Funding
Instituto Superior Politécnico de Bié, Cuito. Bié, Angola.
Esta obra está bajo una licencia internacional Creative Commons Attribution4.0/International/Deed.