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In the South Mediterranean and Middle East region, interactions between humans, animals, and the surrounding environment are frequently close. This fact is mainly manifested in traditional farming settings (by sedentary, semi-sedentary, and nomadic communities) as well as where livestock intensification has been introduced. A combination of complex factors in these settings (e.g. challenges in country infrastructures and cross-sectoral collaboration/ coordination, traditional habits, poor social information, etc.) contribute to the emergence and, occasionally, to the endemic pattern of zoonoses. The phenomenal growth of international travel and trade, population displacement, and unhygienic settlements has increased the speed and ease with which pathogens and vectors can cross continents and cause outbreaks and epidemics. Programmes for the prevention and control of zoonoses have been implemented in several countries in this region; however, the expected results have not always been realised. The conflicts and civil unrest affecting certain countries in this region during the last decade, together with the mass displacement of people seeking refuge, have resulted in serious epidemiological and social impacts. Zoonoses and related food-borne diseases are, indeed, a worldwide challenge, whose prevention and control mainly depend on the actions of national authorities. Once peace has been established in this region, authorities need to address the burden of these diseases through resource mobilisation, the implementation of international agencies’ technical guidance, and inter-country collaboration.

The concept of 'one medicine' and its evolution are discussed and some considerations on the relationship between 'one medicine' and veterinary profession are made, with particular reference to Italy. The concept of 'one medicine' is mainly associated with public health and has its roots in the Italian tradition and health organisation. In a future which is already with us, the veterinary profession will be called upon to deal with many problems at worldwide level (e.g. the emergence/re-emergence of new/old zoonotic pathogens, biological and chemical contaminants in food, bacterial resistance to antibiotics, non-epidemic emergencies associated with natural or man-made disasters, animal well-being, etc.), integrating with other professions. In Italy, most of these problems find the Veterinary Services prepared, but not homogeneously throughout the country. At the present time, doubts are expressed on maintaining and improving these services, mainly due to the lack of students interested in veterinary public health (VPH) training. The globalisation of the veterinary profession imposes changes, in both culture and training. The expertise required for 'one medicine' must be considered and aspects of veterinary training should be changed to promote sharing expertise with other professionals, mainly within the Italian Health Service. The public should be informed about professional competence and activities of veterinarians, in both the private and public sectors, in order to offer a true picture of the profession, one that is not limited to the conventional model which the public generally has of veterinary medicine.

The significance of zoonoses varies depending on many socio-economic factors and on the specific situation that prevails in a specific area. The role of the media often determines the importance given to a disease. In resource-rich countries, a zoonosis may be perceived as being important due to inaccurate information that has been circulated by mass media on the risk of infection for animals and humans and on the possible use of the agent for terrorist actions. Images of sick or dead people and animals, drastic methods of control and others, can contribute to an overestimation of the significance of a disease. Information can be lacking or absent in regard to socio-economic factors that clarify occurrence and also on geographic distribution. Therefore, the sensitivity of people can be influenced rapidly and negative socio-economic consequences can occur. These zoonoses can be named 'media-oriented (emphasised) zoonoses'. On the contrary, some zoonoses are scarcely considered for several reasons, for instance: occurrence in poverty-stricken areas and populations, risks of infection for people not considered important enough to deserve medical care, little interest from the media, decision-makers and health services, lack of information and official reports. These zoonoses can be named 'neglected zoonoses'. Some examples of zoonoses included in the above categories are described.

Zoonoses are discussed as occupational diseases, with special reference to animal husbandry and related activities. After quoting some historical references, occupational zoonoses are examined in relation to the evolution of the concept of occupational zoonosis, the involvement of the World Health Organization in this field, their socio-economic significance, the principal working activities, zoonoses of greatest importance (with special reference to the Mediterranean region), the evaluation of damage and risks. An outline is made of the transmission of zoonoses from farm workers to animals and the biological hazards from the environment. The present situation of occupational zoonoses and related risks in industrialised and traditional farming activities are presented and the importance of some emerging and re-emerging zoonoses for the health of workers is highlighted. The author concludes by stressing that the prevention of occupational zoonoses must be implemented jointly by both veterinary and medical services through preventive measures and epidemiological surveillance of human and animal health, risk evaluation, diagnosis of infections and prompt reporting. It is hoped that the future will offer better interdisciplinary collaboration and that legislation will be timely and better tailored to safeguard working health and safety.