Towards a plural One Health Economics: why One Health needs Political Economy too
One Health is perhaps the very definition of interdisciplinarity. It calls for a systematic crossing of perspectives—between human, animal, and environmental health, and between the many disciplines that study them. Yet, even within a single discipline like economics, we find a wide diversity of approaches. This plurality should not be lost; rather, it should be leveraged to strengthen One Health thinking.
Until now, most contributions presented in this forum have drawn from what can be termed mainstream economics: an approach that emphasizes formalized cost-benefit assessments and the evaluation of the added value of One Health interventions. These tools are useful, especially when it comes to quantifying health impacts or comparing policy options. However, they sometimes abstract away from political, institutional, and historical contexts, and this is where political economy comes in. Political Economy seeks to understand how power, institutions, and social norms shape economic behavior and health outcomes. Political economy of health has proven crucial for making sense of the (dys)functioning of health systems, and the (in)efficiency of public health interventions. For example, Bridget O’Laughlin’s work on HIV in Southern Africa shows how public health policies often focus narrowly on individual behaviors while overlooking the broader institutional and structural determinants of health. In the context of One Health, political economy can thus help explain why some policies—despite being economically sound—fail to be implemented. It sheds light on institutional inertia, conflicting interests, and unequal capacities across actors and sectors.
This is precisely the lens advocated by Bruno Boidin in his article, One Health approaches in Southern countries: what place for political economy? (2024, in French). Focusing on sub-Saharan Africa, Boidin begins by pointing out that economic evaluations are still scarce in One Health approaches and when included, they tend to rely on standard cost-benefit logic. Political economy—especially in its institutionalist variant—is largely absent. Boidin shows how this absence narrows both the scope and the potential of One Health. He argues that dominant economic frameworks reduce One Health to a question of resource optimization—how to minimize risks and maximize returns. But this logic overlooks deeper questions: How are decisions made? Whose interests are served? Which institutions shape the feasibility of integrated health strategies?
Political economy offers tools to examine how institutions evolve over time. It focuses on feedback mechanisms, shifting institutional arrangements, and the changing balance of power among actors, making it particularly well-suited to understanding the dynamic and contested processes that shape health systems. Within this framework, the concept of institutional complementarities proves particularly fruitful for understanding the challenges of implementing One Health. It refers to the idea that institutions function not in isolation but in interdependence—each one’s effectiveness depending on its coherence with others. Boidin mobilizes two distinct versions of this concept. The first, normative, as developed by Robert Boyer (2007) and the “Regulation School”, sees complementarities as a basis for designing stable and efficient institutional arrangements that collectively enhance health outcomes—for instance, when environmental, educational, and health policies reinforce one another. The second stems from Amable and Palombarini’s neo-realist approach (2009), which suggests that complementarities reflect institutional equilibria shaped by the interests of dominant social groups. In this view, stability may persist not because it is socially optimal, but because it consolidates power. This helps explain why certain health interventions become institutionalized while others remain marginal. In many African contexts, Boidin highlights how social rules and policy tools reflect these dominant arrangements: targeted free care policies, performance-based financing mechanisms, vertical programs focused on major pandemics (HIV, malaria, tuberculosis, Covid-19), or the promotion of community-based health insurance in the 1990s and 2000s. These strategies are not neutral; they express a particular vision of health and of who gets to decide how health systems are structured. Understanding these embedded logics is essential if One Health is to move beyond rhetoric and achieve its integrative promise.
Boidin’s article invites us to widen the One Health Economics lens. One Health is not just a matter of optimizing interventions across sectors—it is also a matter of understanding why some synergies fail to materialize. For that, we need tools that engage with politics, institutions, and values. Political economy offers just that—and deserves a place of its own right in the One Health toolbox.
Boidin, B. (2024). Les approches One Health dans les pays du Sud, quelle place de l’économie politique?. Mondes en développement, 207(3), 71-86.

References
Amable, B., & Palombarini, S. (2009). A neorealist approach to institutional change and the diversity of capitalism. Socio-Economic Review, 7(1), 123–143. https://doi.org/10.1093/ser/mwn026
Boyer, R. (2007). Growth strategies and poverty reduction: The institutional complementarity hypothesis. PSE Working Papers. HAL. https://halshs.archives-ouvertes.fr/halshs-00587703
O’Laughlin, B. (2015). Trapped in the Prison of the Proximate: Structural HIV/AIDS Prevention in Southern Africa. Review of African Political Economy, 42(145), 29–45. https://doi.org/10.1080/03056244.2014.996435
OpenEdition vous propose de citer ce billet de la manière suivante :
Marc Leandri (23 mars 2025). Towards a plural One Health Economics: why One Health needs Political Economy too. One Health Economics (OHE). Consulté le 8 juillet 2025 à l’adresse https://1healthecon.hypotheses.org/493
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