Central Asia has made much progress in public health and animal health in the last 20 years but was as unprepared as other regions in the world to respond to the COVID-19 pandemic. The region also faces challenges from other emerging diseases, re-emerging diseases, and climate change. Since 2020, the Central Asian regional economies, as the rest of the world, have faced two shocks - the COVID-19 pandemic and the war in Ukraine. Animal diseases do not respect borders and remain a public health concern because of the possible transmission of pathogens to humans. They can spread quickly from one country to another, with impact on animal health, trade, food security, food safety and possibly creating public health emergencies. One Health is an approach that allows for addressing human, animal, and ecosystem health issues through intersectoral action, to prevent, detect, respond to, and recover from infectious diseases, with an endpoint of improving global health security and achieving gains in development. The World Bank has been actively engaged in Central Asia for over two decades and is well-placed to act as a convener able to provide regional program-design expertise and implementation support for a One Health program. The findings of this report will support the preparation of the Central Asia One Health Framework for Action by providing recommendations for activities which can be further supported through public spending, private investments, and other financial resources.