Abstract:Background: Climate change and environmental disruptions have increased the potential for both novel and re-emerging zoonotic diseases to spill over into human populations. It is crucial to understand the intersections between climate change, animal, and human health, particularly in island states such as Singapore, to strengthen existing systems for early detection and long-term prevention and preparedness against zoonotic disease risks. Objectives: We aimed to prioritise potential areas for action and feasible responses to strengthen zoonotic disease prevention and risk mitigation efforts in Singapore. Methods: We conducted a Delphi analysis informed by: (i) online public and expert surveys with 129 participants exploring knowledge, practices, and risk perceptions of zoonotic diseases, analysed using descriptive statistics; and (ii) 40 semi-structured interviews to expand on zoonotic disease risk perceptions and existing initiatives, analysed thematically. Delphi panel members, including animal and human healthcare providers, animal welfare group representatives, and public health specialists, joined three rounds of consultations to examine the evidence, identify and prioritise risks, and propose implementable strategies to strengthen national risk mitigation and preparedness. Results: While existing measures appeared effective in mitigating major zoonotic disease risks, participants emphasised the importance of adopting a whole-of-system approach for better communication, collaboration, and overall preparedness. Expert consensus focused on strengthening cross-sectoral capacity and collaboration, adopting context-sensitive health messaging, and investing in community empowerment as priority strategies to enhance zoonotic preparedness in Singapore. Conclusions: Findings highlight the importance of adopting a whole-of-system approach centering the interconnectedness of human, animal, and environmental health, positive public engagement, and sustainable and adaptive approaches to addressing zoonotic and ecological threats.
Keywords: Climate Change and Planetary Health, Zoonotic preparedness; One Health; Empowerment; Health Systems; Whole-of-System
