Galapagueños have among the highest rates of diabetes, obesity and related diseases in the country. At the same time, 99% of food is now imported, even though available agricultural lands lie fallow. In urban areas, waste treatment is in a terrible state, and raw sewage is routinely pumped into the ocean on the four inhabited islands. The marine life is further threatened, as worrying levels of antibiotic resistance genes can be found in the ocean water near the pier. These circumstances present an opportunity to pursue the One Health approach on these Islands, drawing expertise from Public Health and Veterinary Medicine.