By Alice Ruhweza; Jeff Worden; Peter Scheren; and Lydia Franklinos
On 21st May, members of the G20 and leaders of international and regional organizations including the United Nations and the International Monetary Fund congregated in Rome to share lessons learned from the COVID-19 pandemic and identify opportunities for collective action to prevent future global health catastrophes. A key output of this meeting will be a ‘Rome Declaration’ of principles to guide the world’s future battle against pandemics.
While attention understandably focussed on practical steps to reduce the spread and mitigate the impact of emerging diseases — such as strengthening healthcare systems and ensuring the equitable production and distribution of vaccines — this summit also provides an excellent opportunity to reflect on the role that nature plays in protecting us from a wide range of global health challenges.
The last two centuries of human history have seen unparalleled achievements in human health, wealth, and wellbeing. Broadly, declines in poverty, increases in food security, and the reduction and eradication of many diseases have transformed the lives of millions around the globe. But these advances are not always equitable or without cost. Much of recent human development has come at the expense of nature — undermining ecosystems, fragmenting habitats, reducing biodiversity, and increasing our exposure and vulnerability to emerging diseases. For example, as we push deeper into tropical forests, and convert more land to agriculture and human settlements, the rate at which people encounter new pathogens that may trigger the next public health, social and economic crisis, will continue to increase. In this regard, pandemics such as COVID are just one of a growing number of health challenges that humanity is facing as a result of our one-sided and destructive relationship with nature
Expanding and strengthening our understanding of the links between nature and human health is especially important in Africa, where nature brings economic prosperity and wellbeing to more than a billion people on the continent. In response, WWF Africa and the Smithsonian’s Global Health Program have been carrying out a scoping study to identify the most pressing challenges that must be overcome to shift this narrative and ensure that nature is appropriately valued for the role it plays in supporting health, with a specific focus on Africa.
A first take home from our analysis is that the collapse of ecosystems and the services they provide that support health represent a much more pervasive threat to our well-being than just emerging diseases such as COVID-19. This is because once degraded, ecosystems not only lose their ability to regulate burdens of infectious and non-infectious disease, but also their ability to remove pollutants, provide food and water security and the ingredients for pharmaceutical products, and support spiritual and mental health. We also found evidence that extensive environmental degradation stemming from rapid urbanization, increased expansion, and intensification of agriculture, and ongoing economic transformation, pose an increasingly severe threat to public health on the continent.
Efforts to promote the protection and more sustainable use of lands and waters should therefore be treated as a form of preventative medicine. In much the same way that reducing air pollution is seen as a public health priority for preventing respiratory disease, measures such as halting deforestation, restoring degraded habitats, and promoting biodiversity and alternative livelihoods, represent a set of frontline tools that can be used to prevent future global health crises.
While the importance of health to human wellbeing and sustainable development is clear, the critical role of nature in human health, especially in developing country contexts, is still underappreciated. Robust evidence for the health benefits that resilient ecosystems and biodiversity provide is critical to shifting this narrative and transforming our appreciation of the importance of nature to human health. Alarmingly, however, we found major gaps in understanding of the mechanisms by which environmental degradation endangers human health. For example, the social and cultural drivers of the bushmeat trade in Africa, particularly in major cities where people are at the highest risk, are poorly understood. And, despite the World Health Organization recognizing that biodiversity loss endangers human health, very few studies are dedicated to measuring this relationship. This stems from a lack of coordinated efforts to study human health at the scale of land and seascapes. There is therefore a great need for small-scale initiatives to be connected and integrated into inter-sectoral One Health research initiatives. Without sound scientific evidence and real-world success stories, communicating the importance of integrating the protection of the natural world into global health policies to decision-makers, remains a significant challenge.
Making an economic case for prevention rather than remediation is also crucial. While the economics of pandemic prevention have been laid out by scientists, our analysis indicates that nature’s broader role in supporting health remains undervalued in economic terms. We conclude that an important factor in this is due to the fact that the economic losses that ecosystem degradation causes through infectious disease, nutritional disorders, and mental illness are not being measured. To address this, we need new metrics that reliably quantify the benefits of healthy ecosystems to human health — similar to those that have been developed for ecosystem service valuation and “natural capital” accounting. For example, strong links between environmental degradation and human health support the need for disease risk to be incorporated into sustainability standards for infrastructure development and the extractives industry. If linked to global benchmarks for human health (such as Disability Adjusted Life Years) these metrics would allow the economic value of preventative measures that avert global health crises to be properly assessed and considered by policymakers.
Our scoping study concludes that to effectively make the case for the economic and health benefits of nature, and galvanize action around One Health in Africa experts we must come together around the following critical issues: 1) address evidence gaps, 2) connect and integrate small-scale initiatives as part of an inter-sectoral One Health initiative on the continent, 3) establish cross-sectoral partnerships, 4) engage and inform policymakers, 5) enhance public awareness on the importance of nature to human health and wellbeing. In addition to these challenges and opportunities, it is crucial for leaders to signal their support for the environment and nature to be at the heart of global health policy moving forward. Through establishing a One Health High-Level Expert Council to “collect, distribute and publicize reliable scientific information on the links between human, animal and environmental health” international organizations have already signaled their intent to support these efforts. In this context, and in partnership with governments, academic, non-governmental organizations, and civil society must form broad partnerships to address evidence gaps, deliver evidence to policymakers, and engage with and educate the public on the importance of the natural world to health.
While last week’s Global Health Summit was a time for multilateral cooperation and strengthening of existing global health systems, it also presents a critical opportunity to signal our intention to address the root cause of the problem by strengthening the environmental component of One Health and thereby shifting from a program of remediation to prevention. Because measures that are taken to protect ecosystem services that underpin human health will simultaneously boost the economy and contribute to climate change efforts — representing a win-win scenario for people and the planet.
This summary is part of an ongoing analysis of the connections between human health and nature conservation, from a One Health perspective, the full results of which are intended to be released at a later stage.
