Olivier Lareyre

Achieving ambitious goals in Global Health first requires an integrative understanding of how individuals and organizations adapt in a living ecosystem. The absence of a unified framework limits the consideration of the issues in their complexity, which further complicates the planning of Global Health programs aimed at articulating population-based prevention and individual-level (clinical) interventions. The aim of the conceptual contribution is to propose such a model. It introduces the Dynamic Ecosystem of Adaptation through Allostasis (DEA-A) theoretical framework, emphasizing the functional adaptation of individuals and organizations in symbiosis with their living ecosystem. The DEA-A framework articulates two central components to grasp the complexity of adaptation: the internal dynamics (intrasystem level) and the environmental dynamics (ecosystem level). It bridges diverse conceptual approaches, including stress and adaptation models, behavior-change models, and ecosystem-based perspectives. Epistemological considerations raised in the conceptual article prompt a reconsideration of methods and tools for the planning of intervention. Further contributions will present a suitable methodology for the application of the DEA-A framework along with practical recommendations.