In this study, we introduced an evaluation tool, GOHI-FS, as a part of the global One Health index to evaluate the performance of food security across countries/territories. GOHI-FS integrated multiple indicators related to food security and developed the evaluation framework from a holistic perspective of One Health. Our pilot analysis showed the global food security performance are far from optimal.

There have been several existing indicators developed by academic institutions, national governments, and international agencies to measure or monitor the sustainable development, overall performance, or progress of food security. The GHI aims to measure “hunger” using four equally weighted indicator framework with a purpose of “highlight successes and failures in hunger reduction” and “raise awareness and understanding of regional and country differences in hunger” [18]. Designed by the Economist Intelligence Unit, the GFSI is another multi-dimensional tool for assessing country-level trends in food security with four dimension about availability, access, utilization and stability [19]. FSI aims to evaluate food security based on the three dimensions of food loss and waste, sustainable agriculture, and nutrition challenges [20]. Cleveland et al. discussed food security indicators should be specific to spatial scale and be adapted to the local natural, social, and economic environment [21]. Although several indicator frameworks have been investigated, further refinements on the healthy and sustainable food security should embrace the concept of One Health, since it is necessary to solve the more complex food security problems effectively from a more comprehensive and integrated perspective [4].

The GOHI-FS index framework was developed with the identification the complexed interaction across human, animal, plant, ecosystem, and social environment and a possible solution via One Health practice in the food security field. The conceptual framework of the first-level indicators was in line with the definition of food security by FAO as “Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe, and nutritious food which meets their dietary needs and food preference for an active and health life” [22] and the extended concept of food security. Availability, access, utilization and stability are four pillars proposed by the United Nations Committee on World Food Security (CFS) and FAO, and has been widely recognized as the key pillars since the 2007–08 food crisis [23]. With the in-depth understanding of food security, the HLPE-FSN proposed additional pillars: agency and sustainability, into the food security framework in 2020 [13]. The GOHI-FS framework was based on the extension of the six-dimensional framework. Agency refers to the capacity of individuals or groups to make their decision of food and their involvement in food policies and governance, which relied on the agency capacity to provide policy, finical, and technical supports for food security. Sustainability refers to Natural & Social Circumstance which evaluates the natural, social, and economic long-term sustainability for food generation and adaption. The second-level indicators were organized based on the SPO model proposed by Donabedian [14]. The structures refer to nature, social resources and communities, that provide services, resources, and facilities to support the food systems. Processes refer to attributes (such as interventions, policies) of activities to ensure the functioning well of food security. Outcomes refer to related outcomes of food security. This design facilitates to trace specific structural and process weaknesses when identifying problems in a results-oriented manner, and to inform decisions by the relevant stakeholders. And our third-level indicator focus on perspectives on the One Health spotlight related to human, animal, plant, ecosystem, and social environments for food security.

The One Health concept has gained increased attention and progress from policymakers and scientists in food security [6, 24]. FAO is actively working with partners to develop and implement effective One Health strategies. Priorities for improving the capacity against food insecurity include developing early warning systems on animal and plant diseases, biosecurity for animals and plants disease management, AMR risk management and enhancing One Health systems [9]. In the report of global strategy for food safety 2022–2030, WHO proposed the One Health approach for emerging diseases and hazards detection and control for food safety improvement [25]. The Quadripartite (FAO, UNEP, WHO, and WOAH) released its first One Health Joint Plan of Action (2022–2026), which emphasizes specific One Health actions to address risks in food safety, including strengthening food control systems and food safety coordination, enhancing foodborne disease surveillance, and improving data surveillance and analysis for risk management in the food systems [26]. The methodology in developing GOHI-FS followed the process of well-known assessment tools, such as GFSI, FSI, SDG Index and HDI. GOHI-FS, which broadly collected data from authoritative sources, constructed according to the latest conceptual framework, and assessed by the standard process with agreement by expert advisory committee, can be used to identify gaps and weaknesses in the food systems for countries, and promote the implementation of One Health approaches for achieving food security. It can also be a supplementary tool for the Quadripartite to track the progress of achieving proposed One Health actions, facilitating evidence-based policy and practice of One Health.

Findings from our pilot analysis suggested clear gaps across countries/territories and regions, including disparities in food supply and demand, lack of clear actions for guiding food safety, lack of sustainability environment on natural and social resources, and lack of sufficient capacity building from government or agency. Specifically, for Food Supply and Demand, although some countries/territories in Europe and North America, such as the US, Greece and Turkey showed better performance of this domain than other countries, they also showed significant worse performance on food loss and waste (P < 0.05 by ANOVA). It highlights the urgency for those countries/territories to reduce food waste that can further minimize the burden of agriculture on climate, soils, water, atmosphere, and biodiversity and facilitate a sustainable food system. Political and legislative interventions should be enhanced to control food loss and waste [27]. Sub-Saharan Africa and South Asia showed low performance on food safety with a high burden of foodborne illness burden. In contrast, Europe and Central Asia and East Asia and Pacific had higher scores on foodborne illness burden. The reason may be those countries/territories have relatively mature food safety surveillance and recall systems than less-developed regions [28]. In addition, although most of countries/territories have their own governance systems to control or monitor food safety, it still lacks unified and assessable criteria to distinguish country performance with high granularity through publicly available sources. Data used in our indicators were limited to the use of binary (Yes/No) or five-level ordered data (i.e., food safety score reported by WHO), which might not sufficiently reveal the real performance. Similar problems also occurred in some indicators such as nutrition promotion. Further efforts are warranted to detail and refine the evaluation criteria with a multiple-level categorical measurement.

Our results found an overall low performance in Government Support and Response globally. For one reason, data for understanding the national differences on agriculture education programme were largely absent in many countries/territories. For another, it may indeed reflect the lack of agency support. Agriculture training programme is important to facilitate food systems transformation, which requires scientific technology and well-educated human resources in response to food insecurity risks [29]. The indicator was measured by the percentage of tertiary graduates from agriculture programmes. However, relevant data was largely absent and out of date, so we removed the score from the final total score. The absence of data also reflects inadequate capacity building from agency level in response to food insecurity.

Overall, North American showed on average better performance in all five dimensions of GOHI-FS, while sub-Saharan Africa had overall low performance of these dimensions. The regional heterogeneity of GOHI-FS might be attributed to notable heterogeneity of nature resources and socioeconomic developments. The score of GOHI-FS showed high correlations with economic indicators such as GPD per capita, social development indicators such as SDI, health indictors such as health expenditure and life expectancy, suggesting the importance of double down on catch-up development. Appropriate policies or strategies for stimulating economic growth, ensuring education attainment, and improving the status of women can be set as priorities not only for the country’s development, but important pathways to achieve food security. In addition, more financial, human resources, and technology investments are needed to reinforce the top-level design, promote digital agriculture and the transformation of the food system, which can lead to increased effectiveness and adaption on healthy food systems, and improve regional food security.

Some limitations should be noted for GOHI-FS. First, to ensure the quality of global data, most of the data were retrieved from international authoritative agencies. However, the overall data missing rate is 19.4% and commonly occurred in some developing countries/territories, which may pose a challenge to precisely evaluate the performance of food security in those countries/territories. To minimize the impact of missing data, we adopted composited factors (health and social development data) to interpolate the missing data. We also tried interpolation by single variable (i.e., GDP, EXP), and the results did not change our main conclusions. It should be noted the data we retrieved in 2020 that reflected the situations in 2019 or earlier since part of data had a long updating interval. Thus, the index didn’t reflect the negative impact of COVID-19 pandemic on food security [30]. Second, the weighting scheme was mainly determined by our expert committee the FAHP approach. According to previous experience of other evaluation tools, it may be hard to achieve a broader consensus about the weights. Thus, some of them also adopted equal weights for each level indicator [31]. Further efforts should provide alternative weighting scheme with more objective approaches and investigate the robustness of the results by different weighting schemes. Third, GOHI provides an evaluation tool for One Health performance across countries/territories. To ensure the independence of indicators and avoid overlap across different aspects, GOHI has been constructed with a coordinated indicator framework that evaluates each aspect once although such an aspect may be a common problem in the One Health interface. For example, health, zoonotic diseases and antimicrobial resistance in livestock were measured in the GOHI sub-index Intrinsic Drivers Index [32], zoonoses [33] and AMR [34], respectively. Those issues are also associated with food security while we did not repeatedly include them in the GOHI-FS framework. Further efforts should focus on the optimization of the calculation and indicator framework to balance conceptual completeness and model applicability between the whole GOHI framework and its sub-index framework. Last, due to the data availability, GOHI-FS temporarily applies to national levels only. Further studies are warranted to extend its application at subregional levels and make appropriate modifications based on local context.