Controlling mountain-type zoonotic visceral leishmaniasis in China: Current progress and challenges through a One Health lens

Objective: Despite effective historical control, Mountain-Type zoonotic visceral leishmaniasis (MT-ZVL) resurged in China in the early 2000s, risking geographical expansion and increased incidence. This study assessed progress in applying the One Health approach for MT-ZVL control in endemic provinces and identified optimization for current control framework. Methods: Seven endemic provinces (2022 data) were assessed with a pre-developed evaluation tool by a weighted scoring method. Results were analyzed to identify progress and challenges and formulate recommendations. Results: The average total score was 47.77/100 (range: 38.59-61.72). Category scores ranked: Disease Control (58.28) > External Environment (50.22) > Internal Support (36.86). Within the External Environment, Social Conditions scored highest (90.43), while Natural Environment scored lowest (31.96). Within the Internal Support, Resource Allocation scored highest (75.71), and Financial Investment scored lowest (27.90). Within the Disease Control, Epidemic Surveillance and Reporting scored highest (72.00), while Control Effectiveness scored lowest (42.78). Conclusion: This study evaluated the current status of One Health implementation for MT-ZVL control in seven endemic provinces. The results indicate slow overall progress, with the lowest scores observed for operational capacity and the highest for disease control activities. To advance MT-ZVL control, endemic provinces in China should prioritize integrating the One Health concept into control policies, strengthening the establishment and implementation of multisectoral coordination mechanisms, promoting scientific and technological innovation, and optimizing key interventions such as canine management.