One health summit kopie

Johannes Bircher MDEmeritus Professor

University of Bern Switzerland

GRF Davos

One Health Summit 2013

20.11.2013 Jbi, www.psim.ch

A New Definition of Health Based on Biological and Anthropological Principles

GRF Davos

One Health Summit 2013

Johannes Bircher MDEmeritus Professor

University of Bern Switzerland

1 www.psim.ch

Jbi, www.psim.ch 220.11.2013

About 2,600 years ago Zi Lu asked Confucius: “If the King of Wei invites you to administer his government, what needs to be done first?” Confucius answered: “What is necessary is to rectify the terms.“ (Lunyu 13.3)

Why do we need to define

health?

Confucius and Zi Lu

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Purpose of the Presentation

1. To propose a new definition of health entirely based on biological and anthropological principles.

2. To investigate the consequences of this definition for One Health.

20.11.2013

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Methods

1. An intuitive, empirical, interactive and iterative process aligned with the multi-grounded theory approach (Goldkuhl et al. 2010)

2. The results were extensively tested in personal interactions and in lectures at scientific meetings.

3. The resulting definition of health was then called “Meikirch Model”.

20.11.2013


Demands of life

1. Physiological demands: nutrition, homeokinesis, procreation, etc.

2. Psychosocial demands: self-realization, flourishing, integration,

participation3. Environmental demands: physical, chemical and

microbiological threats, sustainable development

Meikirch Model

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Meikirch Model

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Personally acquired

resources

Biologically given resources

Demands of life

.

In order to respond to these demands of life each person has two types of resources.

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Meikirch Model

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Personally acquired potential

Biologically given potential

Demands of life

These resources must be available also in the future.


potential

timedeathbirth

personally acquired*

biologicallygiven

The two curves are idealized.

Time Course of the Two Potentials

* The personally acquired potential may compensate in part for defects of the biologically given potential, but not vice versa.


IndividualIndividual determinants

of health



Demands of life

Meikirch Model


SocietySocial determinants of health


of health



Demands of life

Meikirch Model


EnvironmentEnvironmental determinants of health



of health



Demands of life

Meikirch Model





of health



Demands of life

Meikirch Model

One Health

13

Wording of the Meikirch Model

“Health is an emergent state of wellbeing resulting from successful transactions between individuals’ biologically-given and personally acquired potentials and the physiological , psychosocial and environmental demands of life.”

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of health



Demands of life

Meikirch Model

One Health

The multiple nonlinear relationships among the different components specify health as a

complex adaptive system.

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of health



Demands of life

Important relationships

for health

One Health

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of health



Demands of life

Important relationships

for health

Improvement of these relationships will

substantially contribute to health.

One Health


Two Theories to Look at Health: A first Approximation

Newton-based Science Complex Adaptive System

Thinking is reductionistic Thinking is empirical, “holistic”A human being functions like a complicated machine.

A human being functions as a whole.

Insight results from analysis of function of smaller and smaller parts of the body.

Insight results from the study of the relationships among the different components of health.

Effective treatment, or replacement of diseased parts results in healing.

Healing emerges from a sense of purpose and a positive evolu-tion of the system as a whole.

Cure is feasible, it depends on successful treatment.

Prognosis is always uncertain.Systems evolve autonomously.


Soft scienceHard science

IndividualIndividual

determinants of health



Demands of life

emph

asiz

es neglects

Modern Medicine

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The Meikirch Model in India

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1.Currently the Meikirch Model is applied in a rural health program for indigenous people in Orissa, India.

2.As a result people built more latrines, increased vaccination rates, used more mosquito nets, took mother-child care more seriously and ate healthier foods.

3.In summary, the Meikirch Model proved to be a strong motivator for health.

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Conclusions 11. The Meikirch Model is a definition of health

worked out with the multi-grounded theory.2. It postulates that health is determined by five

components which interact nonlinearly with each other. Therefore health must also be regarded as a complex adaptive system.

3. The Meikirch Model postulates that optimal health prevention and health care must take all components of health into account.

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Conclusions 24. For the Meikirch Model the systems theory

should complement Newton-based science. 5. Today’s medicine focusses more on the biolo-

gically given than on the personally acquired potential. This leads to suboptimal results.

6. The Meikirch Model, applied to rural villages in Orissa, India revealed that it has strong motivating effects for health.

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Conclusions 37. If 2’600 years ago Confucius was right,

rectification of the term “health” might lead to a new era of improved health worldwide.

8. Once the One Health paradigm will be based on the Meikirch Model, it may become more conclusive and more forceful.

20.11.2013


THANK YOU

FOR YOUR

ATTENTION

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