Zoonotic diseases represent a growing global health threat, with approximately 60% of human infectious diseases originating from animals. While the One Health approach recognizes the interconnectedness of human, animal, and environmental health and has been widely promoted as a framework for addressing these threats, its real-world implementation remains inconsistent and under-theorized. This critical narrative review synthesized peer-reviewed articles and policy documents from PubMed, Scopus, Web of Science, and Google Scholar (2004–2026) using a political economy framework to analyze One Health implementation barriers for zoonotic disease prevention. This critical review evaluates the conceptual and practical limitations of One Health, moving beyond descriptive summaries to analyze why sectoral approaches persist despite decades of advocacy. We systematically examine the structural, political, and resource-related barriers that hinder effective integration, including fragmented governance, insufficient funding mechanisms, and lack of standardized metrics for evaluating success. Through critical analysis of case studies (rabies, avian influenza, brucellosis, and antimicrobial resistance), conditions under which One Health interventions succeed or fail is identified. Key gaps in the literature are highlighted, including the need for rigorous economic evaluations, equity-focused implementation research, and integration of climate adaptation strategies. This review concludes that while One Health remains conceptually valuable, its transformative potential will only be realized through fundamental restructuring of institutional incentives, sustained political commitment, and context-sensitive strategies that address underlying social determinants of disease.
Wamile et al. (Tue,) studied this question.