Harnessing Medical-Bioethics Mediation to Advance One Health Governance

One Health (OH) envisions integrated governance across human, animal, and envi-ronmental systems to prevent and respond to complex health threats. Despite its global endorsement, OH implementation often falters due to institutional fragmentation, power asymmetries, and ethical tensions that erode trust and cooperation. This paper proposes the integration of medical-bioethics mediation within OH governance as a structured, relational mechanism to manage conflict, foster ethical deliberation, and strengthen trust among sectors and communities. We develop a conceptual framework to apply the me-diation principles of neutrality, confidentiality, respect, and shared problem-solving- beyond clinical ethics toward multisectoral OH contexts. The framework is illustrated through domain-specific examples from zoonotic disease control, antimicrobial resistance, and environmental health. Medical-bioethics mediation can advance conflict transfor-mation, ethical reflection, participatory decision-making, and policy alignment, thereby supporting transparent negotiation of values and institutionalized dialogue of different OH actors. Future research should pilot mediation-based governance models and assess their effects on intersectoral trust, collaborative capacity, and integrated health outcomes.