This study was based exclusively on the analysis of published scientific literature, publicly available policy documents, and secondary data obtained from international organizations and official institutional sources. No human participants, animals, or biological samples were directly involved, and no personal, identifiable, or confidential data were accessed or analyzed. Therefore, ethical approval from an institutional ethics committee or animal care and use committee was not required for this scientometric review, in accordance with national and international guidelines for research involving secondary data and document-based analyses.

The scientometric review was conducted between June and August 2025. Bibliometric data were retrieved from the Scopus database and complemented by a review of publicly available policy documents, national legal frameworks, and reports from international organizations. Although the literature analyzed originated from multiple countries, the analytical focus of this study was Ukraine, with particular emphasis on research, policy, and implementation of the One Health approach in the context of the ongoing armed conflict.

This study adopted a scientometric review design complemented by qualitative contextual analysis. The approach combined quantitative mapping of published scientific literature with purposive examination of policy documents, case studies, and secondary data sources. This mixed-method design was selected to characterize research trends, thematic distributions, and implementation challenges related to the One Health approach in Ukraine, particularly under conditions of armed conflict.

Bibliometric data were retrieved from the Scopus database, selected for its broad coverage of peer-reviewed international literature across health, environmental, agricultural, and interdisciplinary sciences. The literature search was conducted between June and August 2025. Search queries combined keywords related to the war in Ukraine, One Health, antimicrobial resistance, zoonotic diseases, food security, and environmental or ecological safety. The search strategy aimed to capture publications addressing at least one core One Health domain in the context of conflict, geopolitical disruption, or health system stress.

Publications retrieved from the database were screened at the title and abstract levels to assess thematic relevance. Records were retained if they addressed human, animal, plant, or environmental health and were relevant to war-associated impacts, biosecurity challenges, or disruptions of health, veterinary, or food systems. Publications focusing exclusively on unrelated political, economic, or non-health topics were excluded.

The final dataset used for the preliminary scientometric analysis comprised 548 publications, including 69 on zoonotic diseases, 397 on food security, 47 on environmental or ecological safety, and 35 on AMR. These records formed the basis for a descriptive assessment of publication volume and thematic distribution.

To enhance transparency in dataset construction, the processes of record identification, screening, and inclusion are summarized in a structured flow diagram (Figure 1). This diagram illustrates the stages of literature retrieval, relevance screening, eligibility assessment, and final inclusion without implying a systematic review methodology.

To complement the bibliometric findings and address limitations of gray literature, a purposive selection of case studies and policy documents was conducted. Case studies were selected to deepen the analysis of the practical impact of the war on One Health implementation in Ukraine, ensuring thematic relevance, scope diversity, and international significance. National legal and regulatory documents related to biosafety, biosecurity, public health, veterinary services, and environmental protection were retrieved from the official National Parliament portal of Ukraine (https://zakon.rada.gov.ua/laws/main/index) [17–19].

Secondary data were reviewed to contextualize the impact of the war on food availability and food security. Reports and datasets were obtained from international organizations, including the Food and Agriculture Organization of the United Nations (FAO), World Health Organization (WHO), World Organization for Animal Health (WOAH), European Commission, World Food Program, and World Bank, as well as relevant Ukrainian statistical sources [10, 11, 13, 22–25]. These data were used to support the interpretation of trends related to grain production, supply chain disruption, and food system resilience within the One Health framework.

Scientometric data were analyzed descriptively to assess publication volume and thematic focus across One Health domains. Findings from the bibliometric analysis were integrated with evidence from case studies, national legislation, and secondary data sources to provide a contextualized overview of One Health implementation in Ukraine. The synthesis focused on identifying structural gaps, operational challenges, and opportunities to strengthen multisectoral collaboration in conflict-affected, resource-constrained settings.

The One Health concept is a multidisciplinary, integrative framework that recognizes the intrinsic interconnection among human, animal, and environmental health. It emphasizes that optimal health outcomes can be achieved only through coordinated collaboration across multiple sectors, including human medicine and public health, veterinary medicine, ecology, and the biological sciences [25, 26]. The philosophy of One Health has evolved over centuries, reflecting both scientific advances and growing societal awareness of shared health determinants across species and ecosystems.

The evolution from “One Medicine” to “One Health” reflected a broader and more preventive understanding of health, emphasizing the interconnectedness of humans, animals, and the environment. Contemporary One Health initiatives aim to improve ecosystem health and address emerging global challenges, including zoonotic disease outbreaks, AMR, and the health impacts of climate change [16, 29–32].

Ukraine faces multiple interrelated challenges, including zoonotic disease outbreaks, environmental degradation, intensive agricultural production, and emerging AMR, all of which require a comprehensive, multisectoral health framework.

According to the updated definition proposed by the One Health High-Level Expert Panel, Ukraine’s One Health model comprises four core components: human health, animal health, plant health, and environmental health. These components are closely linked and interdependent, forming an integrated system that sustainably balances and optimizes the health of people, animals, and ecosystems [16]. Figure 2 illustrates these core components in the Ukrainian context.

Key agencies, stakeholders, and their functional interactions within the One Health framework are presented in Table 2. These institutions collectively span all four One Health sectors, underscoring the need for coordinated multisectoral governance.

The One Health approach has been implemented in Ukraine with substantial support from international partners, including FAO, USAID, and WOAH, through initiatives such as African swine fever (ASF) STOP (COST Action) [38], PREDICT [39], READY [40], and the One Health Workforce programs [41, 42].

A dedicated project, supported by a grant from the US Civilian Research and Development Foundation (CRDF Global) and funded by the US State Department, was implemented to develop a national plan for One Health implementation. Within this framework, three interagency One Health meetings and workshops were held in Madrid in April 2017 and in Odessa in September 2017 and 2018 [34].

At the state level, the One Health approach is implemented in accordance with the Order of the Cabinet of Ministers of Ukraine dated November 27, 2019 (No. 1416-r), which approved the Strategy for Ensuring Biological Safety and Biological Security based on the One Health principle for the period up to 2025, along with its associated action plan [17]. The strategy was developed in the context of the Association Agreement between Ukraine and the European Union, the European Atomic Energy Community, and their Member States. The Agreement was ratified by Law No. 1678-VII on September 16, 2014.

According to an FAO report on Ukraine, “One Health has become a cornerstone of zoonosis prevention in Ukraine, particularly in addressing ASF, rabies, leptospirosis, and AMR” [13].

In 2021, with support from the Centers for Disease Control and Prevention and the WHO, a workshop was held to prioritize animal and human pathogens using the One Health approach. The objectives of the workshop were to prioritize zoonotic diseases of greatest concern in Ukraine in accordance with the International Health Regulations (IHR, 2005) and to develop subsequent action plans in collaboration with international partners [21, 25, 43].

Following this prioritization exercise, a WHO seminar on implementing the Joint Risk Assessment Tool was held [1, 15, 33]. During the seminar, scientists and practitioners from public health and veterinary medicine assessed the risks of tularemia, rabies, and leptospirosis spreading in Ukraine under martial law.

Between 2019 and 2022, within the framework of the Organization for Security and Cooperation in Europe biosafety project, a draft Law of Ukraine titled “On the System of Biological Safety and Biological Security in Ukraine” was prepared, along with several subordinate legislative acts [1, 17]. A joint working group on biological legislation was established and conducted the reclassification of biological agents in line with international requirements. National biosafety standards were also developed during this period.

Zoonotic and emerging disease surveillance and diagnostic activities in Ukraine are conducted by multiple scientific and scientific-practical institutions. These institutions operate under the Ministry of Health of Ukraine, the State Service of Ukraine for Food Safety and Consumer Protection, the National Academy of Agrarian Sciences, and the National Academy of Medical Sciences of Ukraine (Figure 3) [34].

The Public Health Center of the Ministry of Health maintains a network of 25 regional Centers for Disease Control, which are responsible for infectious disease surveillance, AMR monitoring, and chemical, biological, radiological, and nuclear (CBRN) emergency management. On the animal health side, the Scientific and Research Institute for Laboratory Diagnostics and Veterinary and Sanitary Expertise of the State Service of Ukraine for Food Safety and Consumer Protection, together with a network of 25 regional laboratories, conducts surveillance of animal infectious diseases, zoonoses (in co-operation with the Ministry of Health network), AMR, pesticide and toxicant residues, and food safety and security.

The institutions described above have implemented several major scientific projects, including UP-4 (risk assessment of selected especially dangerous pathogens potentially carried by migratory birds over Ukraine, 2016–2017), UP-9 (analysis of ASF virus transmission in domestic pigs and wild boar using genome sequencing and phylogenetic analysis, 2017–2018), and UP-10 (regional field-to-table risk assessment of ASF spread across Ukraine via wildlife and consumer trade routes, 2018–2020) [44].

Additional support has been provided through the German Biosecurity Program, including the German–Ukrainian Biosecurity Initiative for Zoonosis Risk Management Near the External EU Border (2021–2025) and OSCE-funded projects to establish sustainable veterinary surveillance systems for especially dangerous pathogens (2022–2024).

Available data underscore the significant burden of zoonotic diseases in Ukraine and highlight the need for an integrated One Health approach.

Leptospirosis

Leptospirosis, a bacterial zoonotic disease transmitted through contact with contaminated water or soil, has been reported in Ukraine. In 2023, the human leptospirosis notification rate reached 1.06 per 100,000 population, exceeding rates reported in many European Union countries [45]. This finding indicates a substantial public health concern and the need for enhanced surveillance and control measures. However, disease incidence and surveillance data remain complex because infections in natural foci cannot be fully controlled [46–49].

Zoonotic diseases impose a substantial economic burden on livestock production in Ukraine. Diseases such as brucellosis, TB, and mastitis cause direct losses through reduced productivity and higher veterinary costs, as well as indirect losses from trade restrictions and public health interventions [31, 32].

Although available data demonstrate significant public health and economic impacts, they remain insufficient for comprehensive risk assessment and evidence-based policy formulation. Therefore, enhanced surveillance, improved data integration, and strengthened intersectoral collaboration are urgently required.

Ukraine has made notable progress in strengthening its AMR surveillance infrastructure. With WHO support, the Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR) network expanded to include 67 laboratories across 22 regions by 2023, all of which adhered to European Committee on Antimicrobial Susceptibility Testing methodologies [21, 33, 61, 62].

Nevertheless, high resistance rates to third-generation cephalosporins and carbapenems among Gram-negative bacteria, including Klebsiella pneumoniae and Escherichia coli, remain a major concern [59]. This conflict has further intensified AMR challenges, with increased detection of MDR and Extensively drug-resistant organisms, including NDM-1-producing K. pneumoniae, in both civilian and military healthcare settings [63, 64].

Destruction of healthcare infrastructure, with more than 1,700 facilities damaged or destroyed by July 2024, has further constrained AMR surveillance and control efforts [1, 21]. International collaborations, particularly with the Centers for Disease Control and Prevention, continue to support initiatives in laboratory strengthening, infection control, and antimicrobial stewardship [63, 65].

Armed conflict acts as a systemic disruptor that amplifies vulnerabilities across all One Health sectors. In Ukraine, war has damaged healthcare, veterinary, and environmental monitoring infrastructure; disrupted supply chains; displaced populations; and increased exposure to environmental hazards [23]. Overburdened hospitals have accelerated AMR transmission [63], while damaged water and sanitation systems increase infectious disease risks. Environmental contamination from industrial destruction, unexploded ordnance, and toxic waste creates long-term health threats that remain insufficiently monitored [57, 66].

Conflict imposes profound structural, economic, and institutional pressures that directly hinder One Health implementation. Evidence from other conflict-affected regions shows that war reduces surveillance capacity, disrupts disease reporting, and weakens laboratory infrastructure essential for zoonotic disease detection and AMR monitoring [73]. In Ukraine, targeted attacks on civilian infrastructure, territorial occupation, and restricted service delivery have intensified these challenges [63].

Financial instability further compounds systemic weaknesses as national budgets are reallocated toward military and emergency needs. Funding for surveillance systems, diagnostics, vaccination programs, and environmental monitoring becomes limited, reducing the capacity to implement integrated One Health activities [57]. Long-term budget deficits have resulted in economic losses estimated at hundreds of billions of dollars. International donors, including WHO, FAO, WOAH, USAID, and the EU, have become primary funding sources for essential One Health–related functions, though such support remains vulnerable to geopolitical shifts and donor fatigue.

Despite these constraints, Ukraine has demonstrated resilience by integrating One Health principles into its biosafety strategy, national AMR action plan, and veterinary service modernization. However, implementation remains uneven because of infrastructure losses, workforce shortages, fragmented data systems, and insufficient funding for laboratory reconstruction. Conflict-driven changes in wildlife movement, livestock abandonment, environmental contamination, and reduced access to preventive veterinary care further increase zoonotic spillover risks, as documented in other war-affected regions [73].

Overall, Ukraine’s experience illustrates how armed conflict and financial instability undermine the operationalization of One Health by weakening governance structures, disrupting multisectoral communication, limiting surveillance capacity, and preventing long-term investment in health security. Strengthening One Health in conflict-affected settings, therefore, requires sustained international financing, capacity-building initiatives, and post-conflict reconstruction strategies that explicitly integrate human, animal, and environmental health. Without such support, fragile systems will struggle to prevent emerging zoonoses, contain AMR, and monitor environmental degradation, threats that extend beyond national borders.

Effective One Health implementation depends on robust governance structures that enable intersectoral collaboration and data sharing [57]. In the short-term, Ukraine should establish a National One Health Steering Committee comprising representatives from the Ministry of Health, the Ministry of Agrarian Policy, the Ministry of Environmental Protection, veterinary services, academic institutions, and civil society organizations. This committee would coordinate multisectoral activities, review existing legal frameworks, and facilitate regular intersectoral meetings [19].

In the medium-term, governance efforts should focus on institutionalizing One Health functions within permanent government structures and regional coordination hubs to ensure continuity. Long-term governance strategies should prioritize legislative integration that mandates data sharing and collaborative decision-making across sectors, and align national policies with European Union regulations and international health standards [62].

Ukraine faces persistent and emerging risks from zoonotic diseases such as rabies, avian influenza, and other emerging pathogens. Short-term priorities include conducting One Health Zoonotic Disease Prioritization workshops, mapping high-risk areas, and piloting Joint Risk Assessments to guide targeted interventions by FAO, WHO, and other partners. Medium-term objectives include scaling up integrated surveillance systems that link wildlife, livestock, and human health data and establishing multidisciplinary rapid response teams. Long-term goals include continuous risk mapping that integrates ecological, climatic, and demographic variables and the deployment of early warning systems to predict and prevent outbreaks [57, 62].

A shortage of trained professionals across the human, veterinary, and environmental health sectors is a major barrier to One Health implementation in Ukraine. Short-term actions should expand existing training opportunities, including FAO-supported online One Health courses, and strengthen laboratory capacity for coordinated diagnostic testing.

Medium-term strategies include embedding One Health principles into university curricula and continuing professional development programs, as well as establishing research initiatives focused on priority health threats. Long-term objectives emphasize creating national or regional centers of excellence for One Health research and innovation, fostering interdisciplinary collaboration, and retaining skilled professionals through structured career pathways and professional networks [4].

AMR poses a significant threat to both human and animal health in Ukraine. The National Action Plan on AMR (2018) provides a foundation for integrated stewardship across human, veterinary, and environmental sectors. Short-term priorities include strengthening AMR surveillance and laboratory diagnostic capacity.

Medium-term measures focus on implementing antimicrobial stewardship programs in clinical and agricultural settings, monitoring environmental contamination, and promoting rational antimicrobial use. Long-term interventions emphasize sustained surveillance, research into alternative therapies, and integration of environmental risk management into AMR mitigation strategies [57].

Community participation is critical to the success of One Health interventions. Short-term strategies include public awareness campaigns targeting priority zoonoses and AMR, particularly in rural and conflict-affected areas. Medium-term approaches include participatory surveillance initiatives and community-based risk-reduction programs. Long-term strategies aim to institutionalize health education in schools and local communities, fostering a sustained culture of prevention and risk awareness [4].

Sustainable financing is essential for long-term One Health implementation. In the short-term, Ukraine should leverage international donor funding and align investments with the National Action Plan for Health Security. Medium-term strategies include integrating One Health activities into national and sectoral budgets. Long-term objectives include establishing a dedicated One Health Fund to support continuous operations, research, and infrastructure development.

Monitoring and evaluation should be embedded across all phases of the One Health Action Plan. Key indicators include the frequency of multisectoral meetings, surveillance coverage, the number of trained personnel, community awareness levels, and budget allocations. A mid-term review at 3 years and a final evaluation at 10 years are recommended to support adaptive management and continuous improvement.

The proposed One Health Action Plan provides a comprehensive roadmap to strengthen health security in Ukraine through coordinated human, animal, and environmental health interventions. By adopting phased, intersectoral strategies and investing in governance, surveillance, workforce development, and community engagement, Ukraine can enhance its capacity to prevent, detect, and respond to emerging health threats. Alignment with international frameworks, such as the One Health Joint Plan of Action and the IHR, ensures consistency with global best practices and supports national resilience and recovery.