Abstract
The rapid expansion of urban centers has created unprecedented opportunities for zoonotic disease transmission, necessitating a shift from traditional siloed public health responses to integrated One Health (OH) approaches. This study evaluates the effectiveness of OH frameworks in preventing and mitigating zoonotic outbreaks within high-density urban settings across diverse geographical regions. Utilizing a retrospective cohort design, we analyzed outbreak data from 12 global cities between 2018 and 2023, comparing cities with established OH inter-sectoral task forces to those utilizing conventional independent health surveillance. Primary outcomes included the median time to detection (MTD), the time-varying reproduction number (Rt) during the first 30 days of transmission, and the efficiency of inter-sectoral data sharing. Our results demonstrate that cities with high OH integration achieved a 34% reduction in MTD (p < 0.01) and significantly lower peak Rt values compared to siloed counterparts. Furthermore, the integration of environmental and veterinary surveillance data was strongly correlated with earlier identification of spillover events in urban wildlife markets and animal exhibits. However, significant barriers remain, including data interoperability issues and ethical concerns regarding surveillance in marginalized urban populations. This research provides empirical evidence that One Health approaches enhance urban resilience against emerging infectious diseases, provided that ethical and rights-based frameworks are maintained. We conclude that institutionalizing cross-disciplinary communication and utilizing data-driven prioritization tools are essential for preventing the next pandemic in an increasingly urbanized world.