Bridging the implementation gap in One Health diagnostics: from point-of-care technologies to integrated diagnostic ecosystems

Recent advances in molecular diagnostics and portable sequencing technologies have significantly expanded the technical capabilities of decentralized diagnostic platforms. Point-of-care (POC) diagnostics have emerged as essential tools for improving the surveillance and control of zoonotic diseases within the One Health framework. Despite this, the translation of these innovations into systematic implementation in routine field applications remains limited. This review argues that the primary barriers are no longer technological performance but rather the complex challenges associated with large-scale implementation. These challenges include fragmented governance, regulatory heterogeneity, economic constraints, logistical challenges, workforce capacity, and insufficient integration among human, animal, and environmental health systems. Through a critical analysis of current evidence, this manuscript identifies a gap between technological innovation and operational implementation and advocates a transition from device-centric innovation to integrated diagnostic ecosystems that support coordinated One Health surveillance. Strategic directions are discussed, including adaptable diagnostic platforms, interoperable diagnostic networks, digital integration of surveillance systems, operational decentralization, and unified regulatory pathways. Collectively, these strategies could accelerate the translation of emerging diagnostic technologies into sustainable field applications, maximizing their potential to strengthen early detection, integrated surveillance, and preparedness for current and future zoonotic threats.