Beyond frameworks: The political economy of One Health integration in Africa

Abstract Background : Africa’s post-pandemic moment has produced an abundance of One Health frameworks but limited critical engagement regarding which integrative arrangements actually work, for whom, and at what scale. Continental frameworks articulate the case for cross-sectoral coordination, yet implementation remains fragmented, and the evidence base for specific policy levers is uneven. Methods : We conducted a purposive narrative review of peer-reviewed literature published between 2020 and 2025, complemented by policy documents from continental and regional bodies. Sources were selected to illustrate both integrative possibilities and documented failure modes of cross-sectoral implementation in Africa. Results : We synthesise evidence across four pathways – health systems, climate-smart agriculture, community-led conservation, and institutional coordination – with digital transformation, gender inclusion, and indigenous knowledge as cross-cutting enablers rather than parallel domains. For each pathway, we engage critically with both flagship successes and their documented limitations. These include evidence gaps in AI-enabled surveillance platforms, governance critiques of community conservation finance, persistent shortfalls in domestic health financing, and a coordination paradox in which continental frameworks have multiplied faster than implementation capacity. Conclusions : Across all four pathways, the binding constraints on One Health integration are political and fiscal rather than conceptual. We identify three policy levers most likely to translate integrative rhetoric into measurable outcomes: mandatory inter-ministerial reporting on shared indicators, legal recognition of community institutions, and ringfenced domestic financing. One Health impact statement This synthesis is relevant to African policy makers, funders, and practitioners working at the intersection of public health, agriculture, conservation, and governance in a period when the external funding environment is shifting rapidly. By examining evidence from four interconnected pathways in parallel, we show that cooperation across the human, veterinary, plant, environmental, and social science sectors surfaces integrative failure modes, such as digital surveillance systems that improve detection without changing outcomes, or conservation finance that celebrates community leadership while eliding governance critiques, that single-sector analyses miss. This synthesis combines peer-reviewed evidence with policy documents, practitioner reports from African-led institutions, and critical scholarship on community governance. We argue that mandatory joint reporting, legal recognition of community institutions, and ringfenced domestic financing are the near-term reforms most likely to translate One Health integration from rhetoric into measurable outcomes.