Evaluating the implementation of One Health in surveillance systems: the case of the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS)

In recent years, there has been growing interest in the integration of One Health (OH) principles to better monitor the occurrence of zoonotic infectious agents and antimicrobial resistance (AMR). However, the added value of applying the OH approach to surveillance programs has rarely been formally evaluated, making it difficult to identify and document best practices. The aim of this study was to assess OH integration within the Canadian Integrated Program for Antibiotic Resistance Surveillance (CIPARS), a national surveillance program established in Canada in 2002 to monitor antimicrobial use (AMU) and AMR along the food chain. Two evaluation tools were used: (1) the OH-ness assessment tool of the Network for Evaluation of One Health (NEOH) framework and, (2) the Evaluation of Collaboration for Surveillance (EcoSur). Data were collected using desktop review, group discussions ( n = 2) and complementary individual interviews ( n = 9) with CIPARS team members. The results were shared and validated by the participants. The OH-ness index from the NEOH tool was 0.53, suggesting a moderate integration of OH principles overall. Both infrastructural and operational dimensions scored between 0.6 and 0.8, demonstrating an efficient conceptualization of the program to meet its objectives as well as effective teamwork. However, the assessment revealed a lack of integration of different disciplines within the core team and of the environment component in surveillance activities. Scores from the ECoSur tool were higher for the quality of collaboration between sectors for operations (82%) than for management (68%) and support (65%). The results highlight the strengths and weaknesses of CIPARS and can help inform the implementation of similar surveillance models for AMR and infectious diseases. The application of two evaluation tools also demonstrated their distinctiveness, complementarity, and capacity to evaluate aspects specifically relevant to OH integrated surveillance programs.