The nasal ecosystem as a sentinel interface for One Health surveillance in an era of converging crises

Abstract The interconnectedness of human, animal, and environmental health demands surveillance systems capable of predicting cross-boundary threats. We propose a solution already inside us: the nasal microbiome. Positioned at the interface of environmental exposure, zoonotic transmission, and immune regulation, the nasal microbiome could serve as an early-warning system for pandemics, antimicrobial resistance (AMR), and climate-driven health impacts. Emerging evidence supports its predictive capacity, but many applications remain conceptual and require systematic validation. We therefore outline a roadmap for standardising nasal microbiome monitoring across One Health sectors, with the potential to shift global disease surveillance from reactive to proactive and enable timely interventions before threats escalate.