Ethical considerations for a more equitable approach to One Health in forced migration

Abstract Background: The exclusion of animals from humanitarian responses to forced migration out of concern for the transmission of zoonoses, diseases transmissible between animals and humans, leads to risk taking and trade-offs, whereby forced migrants choose between retaining access to their animals for nutrition, livelihoods and mental health, or relief assistance. To address these concerns, the interdisciplinary One Health approach can be utilised, which nominally ‘optimises’ animal, ecosystem and human health. The most common interpretations of One Health have remained largely anthropocentric; however, considering animals as either assets or threats to human health and wellbeing, rather than important contributors to a more holistic approach to health, and therefore, lack normative guidance for researchers, policy makers and responders to address moral dilemmas in humanitarian response. Objective: This review aims to provide an overview of current ethical considerations in, and proposals for, One Health, and how these may be applied to the approach in forced migration contexts. Methods: This manuscript is based on a thematical analysis of a scoping review of peer-reviewed publications investigating ethics in One Health, in particular as related to forced migration, presenting the ethical challenges within One Health in forced migration contexts, and the current status of ethical debate. Main findings: There is a growing body of literature on ethics in One Health, recognizing the importance of a more equitable and inclusive multispecies approach to health; to date, this has not been applied to the interlinked and connected challenges faced by human and animals made most vulnerable in forced migration contexts. Conclusion: An ethical framework for One Health in forced migration may guide moral challenges in humanitarian responses, by extending moral concern to the non-human world based on Ethics of Care and two factor egalitarianism approaches in forced migration contexts. This paper focuses primarily on the inclusion of animals in One Health in forced migration, acknowledging the remaining gap in expanding the moral circle of concern to ecosystems. One Health impact statement The topic discussed is of global importance to trans- and interdisciplinary research, policy and practice related to animal, ecosystem and human health in forced migration. Ethics in One Health is likely to become more relevant in the context of increasing interspecies’ health inequities and impacts as a result of the climate crisis, geopolitical developments, and resulting forced migration and other displacement. Where animals are excluded from humanitarian responses out of a concern for public health, these restrictive practices and policies may instead exacerbate infectious and other disease risks and vulnerabilities, requiring a more inclusive and collaborative approach across disciplines to health in these settings, which may be supported by an appropriate ethical approach to the equitable consideration of animals, ecosystems and humans.