The One Health approach has become a prominent paradigm in global health, promoting integrated action across human, animal, and environmental systems. Despite its conceptual strength and broad institutional endorsement, its translation into sustained governance and practice has been uneven. This viewpoint argues that the main challenges faced by One Health are not conceptual but structural. Drawing on critical analysis, it examines how sectoral governance arrangements, depoliticised notions of integration, operational ambiguity, siloed professional education, and crisis-oriented policy logics constrain implementation. The paper further argues that treating integration as a primarily technical task obscures underlying issues of power, accountability, and epistemic boundaries. As an alternative, One Health is reframed as articulation work, emphasising the deliberate construction of interfaces, communication infrastructures, and shared practices across enduring institutional boundaries. Approached as a maturing project, One Health requires long-term investment in education, organisational learning, and governance mechanisms that enable collaboration to become routine rather than exceptional.
Júlio Belo Fernandes (2026) studied this question.