Adaptive One Health Culture: From Multisectoral Collaboration to Sustainable Zoonotic Disease Management

Background Emerging and endemic zoonotic diseases continue to pose major challenges to global health, food security, livelihoods, and sustainable development. Although the One Health approach has strengthened surveillance, preparedness, and multisectoral collaboration for zoonotic disease management, many initiatives remain dependent on externally funded projects and temporary coordination mechanisms. Consequently, adaptive collaborative and participatory capacities and capabilities are often difficult to sustain once projects conclude or outbreaks subside, highlighting the need for conceptual frameworks that explain how adaptive zoonotic disease management practices become institutionalized within communities, organizations, and national One Health systems. Aims To develop an integrated conceptual framework explaining how adaptive collaborative capacities and capabilities for sustainable zoonotic disease management emerge, mature, and become institutionalized and community driven through repeated participatory implementation. Methods An integrative conceptual synthesis was conducted, drawing upon One Health, implementation science, systems thinking, resilience theory, social-ecological system theory, adaptive management, organizational learning, organizational culture, participatory governance, and community co-management. Concepts from these complementary disciplines were synthesized into a unified theoretical framework describing the development of Adaptive One Health Culture through repeated participatory implementation. Results The synthesis identified a fundamental sustainability gap between implementing One Health interventions and institutionalizing adaptive collaborative practice for long-term and effective sustainable zoonotic disease management. To address this gap, the Adaptive One Health Culture framework introduces cultural incubation as the developmental mechanism through which repeated implementation-learning cycles progressively embed systems thinking, multisectoral collaboration, adaptive governance, organizational learning, community co-creation and co-management, and continuous improvement within communities and organizations. The framework distinguishes complementary community and organizational dimensions of adaptive culture and conceptualizes implementation as a process of knowledge generation that strengthens preparedness, prevention, and adaptive capacity for future zoonotic disease threats. Conclusions Adaptive One Health Culture provides a novel conceptual framework for understanding how sustainable collaborative capacities for zoonotic disease management become institutionalized over time. By integrating complementary theoretical perspectives into a coherent implementation framework, it advances One Health implementation science while providing a foundation for future research, policy development, programme design, One Health leadership, and the strengthening of resilient One Health systems capable of sustaining adaptive zoonotic disease management.