Towards integrated One Health surveillance: A systematic review and critical synthesis of infectious disease and antimicrobial resistance surveillance systems

Abstract There is an increasing demand for integrated One Health surveillance of infectious illnesses and antimicrobial resistance (AMR) across interconnected human, animal and environmental systems. But multisectoral participation does not necessarily mean operational integration because the extent to which existing surveillance systems integrate data, governance, interpretation and reaction is uncertain. This systematic study conducted according to PRISMA 2020 principles, critically analysed the structure, integration level, technology, implementation aspects and performance evidence of One Health surveillance systems. A comprehensive search was performed in major bibliographic databases and institutional repositories for material in English published between January 2000 and December 2025. We identified fifty-five papers that addressed at least two connected One Health areas. Using a structured template, we retrieved study characteristics, surveillance domains, sectoral participation, technology, governance, data integration, reported functions, barriers and enabling variables. Methodological appraisal was performed utilising the appropriate JBI, AMSTAR-2 and AACODS tools for the design. Around half of the selected articles were published in 2021–2025 indicating a recent substantial increase in research on One Health surveillance. AMR was the most commonly represented surveillance domain, followed by zoonotic illness, environmental monitoring, food-sector and genomic surveillance. Human, animal and environmental sectors were well covered, whereas wildlife, vector and plant-health surveillance were still rather limited. Most systems were somewhat interconnected (61.8%) and 23.6% were highly integrated, whilst 14.5% were minimally integrated. A consistent gap was discovered between the participation of multisectoral entities and the operational integration through interoperable data platforms, coordinated governance, collaborative interpretation and response. Genomics, wastewater surveillance, GIS technologies and digital platforms increased surveillance capacity, but institutional fragmentation, workforce limitations and resource inequities persisted as barriers to integration. Few studies directly assessed detection timeliness, response performance, cost-effectiveness or public health effects, which is important. Evidence presented here suggests increased multisectoral participation and technological innovation, but there is not enough data to demonstrate that integrated One Health surveillance enhances surveillance effectiveness or health outcomes. The study suggests a One Health Surveillance Integration-Action Framework, a synthesis that links multisectoral engagement, operational coordination, data integration, joint intelligence and coordinated action.