The Planetary Health Alliance
Background: Anticipated dietary transitions—including shifts toward greater animal production consumption—coupled with an increasing population, will place greater pressure on the global land system for food production. These changes have the potential to create harm to both the environmental and human heath, and thus impact planetary health. For example, achieving food security through agricultural expansion and intensification threatens global biodiversity and the functioning of natural ecosystems. Global transitions to diets lower in meat could reduce agricultural land and the associated inputs required, but to date, the potential impact of dietary changes on biodiversity have not been quantified.
Methods: To investigate potential land use change, a model system has been developed that couples a biologically-representative global vegetation model (LPJ-GUESS) with a land use model (PLUMv2). LPJ-GUESS simulates yield potentials globally at 0.5° resolution for crops and pasture under a range of management intensities, and for a time-dependent atmospheric CO2 level and climatic forcing. PLUMv2 uses these yields, in conjunction with other socio-economic parameters, to simulate future land use and management inputs (fertilizer and irrigation water) for given dietary assumptions.
The simulation results are used to explore the potential impact of land use resulting from alternative dietary scenarios on regional and global biodiversity for different taxa. Furthermore, the extent to which global protected areas—as recorded by the World Database of Protected Areas (WDPA)—help to reduce land use change impacts is modelled and considered.
Findings: Results show the importance of dietary choice and protected areas for biodiversity conservation in terrestrial ecosystems. We find that current projected dietary demand, with increasing meat consumption, causes both the expansion of agricultural areas as well as increased intensity of production in global biodiversity hotspots. However, global transitions to diets lower in meat (in addition to maintaining existing WDPA protection) substantially reduces the loss of natural land in areas of high biodiversity.
Interpretation: The links between global meat consumption and agricultural expansion and intensification in biodiversity hotspots are demonstrated and quantified by the results. They suggest the potential and need to help safeguard natural ecosystems and associated biodiversity through alterations in food demand.
Background: Environmental trade-offs associated with land use, for example between food security and biodiversity conservation, represent critical dimensions of planetary health. Land use-driven biodiversity losses may predictably affect disease risk if reservoir host species are consistently more likely to persist under human disturbance (i.e. if ecological communities in modified habitats generally have a higher zoonotic potential). Such a phenomenon has been observed in specific disease systems, but with high rates of global land use change projected for this century, assessing its global and taxonomic generality would shed light on an important hypothesised driver of environmental synergies or trade-offs between conservation and public health.
Methods: We combine data on hosts of human-shared parasites and pathogens (‘hosts’) with a global database of local ecological communities and associated land use data (originally collated from published studies). We analyse the effects of land use on host diversity metrics across over 9000 sites globally, controlling for disease-related research effort and differences in survey methods.
Findings: Ecological communities in anthropogenic land uses (managed ecosystems and urban) contain a consistently higher richness and abundance of host species than communities in nearby primary land sites. However, among mammal hosts of zoonotic pathogens, we find considerable taxonomic variation in host responses to land use, with rodent and bat host abundances generally increasing and primate and carnivore hosts declining in modified landscapes.
Interpretation: Our results suggest that future global land use change has potential to drive increasing contact between people and ecological communities with increased shared pathogen potential (i.e. more potential hosts and possible opportunities for transmission). However, the variability among mammals, for example with rodent hosts most abundant in modified habitats and primate hosts most abundant in intact communities, highlights that these changes are unlikely to affect all zoonotic diseases consistently. This result supports arguments that, rather than expecting a consistent biodiversity-disease relationship, in practice policies aiming to both conserve biodiversity and reduce human disease (for example through establishment of protected areas) must be disease- and context-specific.
Understanding the global environmental context of human health is of key current concern (e.g. The Rockefeller Foundation–Lancet Commission on planetary health, The Wellcome Trusts’ priority area Our Planet, Our Health). While there is an increasing discussion regarding the need to consider the interplay between poverty, human health, land-use conversion and climate change, there are few tools available to undertake system dynamic analyses of disease burden. Improving the understanding of how zoonotic diseases will respond, as a whole, to global change represents a vital component of setting future, sustainable global development policies.
Here, we use recently developed techniques, at a continental scale, to understand the expected responses of a wide set of zoonotic diseases to major drivers of change. Using a novel, grid-cell based, environmental-mechanistic model, we combine a correlative distribution model of host niche suitability, with a mathematical model of pathogen spill-over and a compartment model of zoonotic disease infections in humans. These models are parameterised across space using remote-sensed input data, while also incorporating poverty-health relationships and simulating human behaviour across empirically-based human contact and transportation networks. We apply these models to historical, present day and future conditions, validate against case data, and, finally, combine burden estimates across all diseases to calculate a net response for each time period in each grid cell.
Zoonotic diseases display a varied response to different drivers of environmental change. Some animal-borne diseases show a low sensitivity e.g. to climate change (Rabies), while others show a stronger response e.g. to land-use change, with both increases in prevalence (Lassa) and some reductions (e.g. Ebola). The patterns are spatially heterogeneous, with many disease seeing both increases and decreases across their endemic areas.
Recent outbreaks of Zika, Ebola and SARS have cause widespread public concern by emerging into novel geographic areas. Our results allow a better understanding of the conditions that precipitated such changes and then allow us to predict, in the future, how ongoing climate, land-use and socio-economic changes will likely alter these risks.
Introduction and Background
This study was conducted on Bonga forest which represents one of the remaining afromontane forest tracts of Ethiopia. The study area was located at the head water of the Omo-Gibe Basin harbors the highest biodiversity. The main objective of the research was to assess on the role of participatory forest management and integration of population and health issues in forest conservation and sustainable use.
The study has employed 1) forest inventory for vegetative data collection on forest structure, 2) land use and land cover change analysis using satellite image to see land use and land cover in forests under participatory forest management practice and non-participatory forests management practice, and 3) questionnaire survey for understanding population issues and management practices. The vegetative data was collected from 70 plots. Assessment was done on the social and demographic aspects of the forest management practices through the questionnaire survey involving 120 households.
The total plant density was found to be 3976 individuals/ha for PFM forests and 2834 individuals/ha for non-PFM forests where Coffea Arabica L. has the highest density to both forest blocks. The total forest basal area was calculated and found to be 110.189 and 104.725 m2/ha for the PFM and non-PFM forests. The questionnaire survey has demonstrated that there was better forest management practices in the PFM forests. The trends of deforestation through the periods 1985 to 2015 were analyzed using the satellite images. The forest cover has deceased at a rate of 4.9%, 4.5% and 15% for the period of 1985 to 1995, 1995 to 2005 and 2005 to 2015 respectively. On the other hand, the forest cover has decreased at a rate of 5%, 7% and 20% for the period of 1985 to 1995, 1995 to 2005 and 2005 to 2015 respectively. It was found that there was limitation of integrating population issues including reproductive health activities. On the other hand the results of the study has showed that, there is strong practices of allocating land to new youths which is strong threat to the previous biodiversity resources of the area.
The study has revealed the positive role of PFM in forest conservation and sustainable use. PFM has played strong role in creating ownership and stewardship towards the forest resources. Moreover, the Participatory Forest Management Cooperatives are better involved in integrating population and heath issues in the forest management plan implementation. The comparison of the assessment results on the different parameter has showed that a relatively better forest conservation and sustainable use put in place in the PFM forests than the non-PFM forests. In general the study has showed community participation and engagement in management forests has better contribution for conserving the resources and enhancing the benefits.
Background: The Aedes albopictus mosquito is a vector of arboviruses associated with high rates of global morbidity and mortality. The northern extent of Ae. albopictus in the United States runs through the southern counties of New York State (NYS). During 2016, there were 1,499 imported cases of human Dengue, Zika, and Chikungunya in NYS. Given the geographic overlap of a potentially competent vector and infectious human hosts, the NYS Department of Health (NYSDOH) enhanced Ae. albopictus trapping and testing during the 2016–2017 summer seasons. The objective of this research is to understand the landscape and climate determinants of the spatiotemporal variation in Ae. albopictus abundance at the northern limit of the species’ range.
Methods: Here we present a landscape-level analysis of mosquito abundance as measured by daily counts of Ae. albopictus across 53 trap sites in three counties during 2016–2017. Using a negative binomial model, we evaluate the effect of variables such as land cover classification, elevation, distance to roads, precipitation, and temperature on Ae. albopictus abundance.
Findings: During 2016–2017 the number of Ae. albopictus caught per night of trapping ranged from zero to 98 across all sites, with an average of three Ae. albopictus mosquitoes per night of trapping. Preliminary analyses demonstrated that the percent of low-intensity and medium-intensity development within a 200 meter buffer of mosquito traps were associated with higher abundance, while controlling for other climatic and landscape factors. The percent of high-intensity development was associated with lower mosquito abundance when controlling for other factors. Daily mean temperature was positively associated with mosquito abundance, while elevation and distance to highway were negatively associated.
Interpretation: Findings are supported by previous evidence that Ae. albopictus experience lower growth and survival rates within urban sites compared to non-urban sites. Additionally, heterogeneities may be explained by differential accumulation of artificial breeding containers and pesticide treatment across land development gradients. Continued investigation over a broader geographic area is required. However, in collaboration with the NYSDOH, this project will aid in implementing and evaluating mosquito surveillance and control. In the long-term, information from this study can be used to mitigate the northward invasion of Ae. albopictus, and in turn risk of disease introduction, under changing landscape and climate conditions.
Human consumption of endangered sea turtles remains prevalent throughout Mexico even though laws restricting trade in threatened and endangered species have been in place for several decades. Our prior research has found that the majority of sea turtle mortality in Baja California is due to human consumption. While demand for sea turtle meat has reportedly decreased in some regions, turtle trafficking and illegal harvesting continue to threaten environmental security in the region. Besides being a threat to animal and ecological health, poaching may be a threat to human health. People who consume turtle meat may be exposed to bacteria, parasites, and other pathogens as well as organochlorine compounds and heavy metals such as cadmium and mercury.
In 2017, we conducted a knowledge, attitudes, and practices (KAP) survey with a convenience sample of more than 200 residents of 14 fishing communities in northwestern Mexico. We asked participants about their nutritional and health status, dietary and risk behaviors, and perceptions of local ecological issues, and we collected hair samples that could be tested for heavy metals.
About one-quarter of the participants reported consuming sea turtle in the past month. Laboratory tests showed a high prevalence of elevated levels of arsenic, lead, and mercury. Preliminary analyses show that people who eat sea turtle meat are more likely than their neighbors to have high levels of mercury in their hair.
Conservation efforts may be more successful when they appeal to people’s self-interest rather than merely focusing on ecological benefits. Concerns about toxins in sharks, tuna, and other types of deep-sea fish have reduced human consumption of some species. Sea turtle conservation efforts may benefit from awareness campaigns that emphasize the adverse health outcomes associated with eating turtle meat while continuing to affirm the economic benefits of healthy ecosystems. Transdisciplinary research that draws on diverse fields such as ecology, epidemiology, toxicology, environmental law, and public policy provides a valuable foundation for solving planetary health issues. Creative reframing of biodiversity concerns in countries around the globe will be necessary for promoting environmental health and public health in a time of accelerating environmental change.
Background: Despite the abundance of edible biodiversity, both wild and cultivated, malnutrition and food insecurity persist in Busia, Kenya, where poverty indices range from 63% to 74% and 1 in 4 children under five are stunted, 11% are underweight and 4% are thin for age. Much of this diversity, used in traditional food preparations, has potential to provide access to key micronutrients for healthy and balanced diets as well as act as an important source of community resilience to climate change and economic turbulence. Yet, lack of consumer awareness of the value of local biodiversity, poorly developed value chains and negative perceptions associated with traditional foods have led to the disappearance of many nutrient-rich species and the shift to unhealthy diets. The study shows that heightened knowledge of the value of biodiversity and improved value chain efficiencies can help to conserve biodiversity and improve local food systems.
Methods: A farmer business school model was developed and training provided to 25 farmer groups across 7 sub-counties on the sustainable production of traditional vegetables, post-harvest handling, contract farming, nutrition and value addition. At the same time, select species were analyzed for nutritional content, a food procurement model was tested supporting market linkages between farmers and local institutions and nutrition education activities carried out to improve the capacity of schools and clinics to incorporate traditional foods in institutional meals.
Findings: Traditional vegetables are rich in iron, with cowpea leaves, for example, found to contain 17 times more iron than kales. Since the data was made available to all value chain actors and the food procurement model was implemented, a 12% increase was recorded in the number of households cultivating local biodiversity both for household consumption and off-farm sales, along with an increase in the plot size devoted to traditional vegetable cultivation. Furthermore, household incomes rose by 47% as a result of direct links with institutional markets.
Interpretation: The project has positively impacted the abundance, composition and distribution of species and revived interest in local food biodiversity, in addition to producing benefits around diverse diets. Experience in implementing the Busia model was used to inform global policy mechanisms that aim to mainstream biodiversity into sustainable food systems using public procurement, particularly schools, as a platform for improving nutrition. Nationally, a Biodiversity Policy is being developed for Busia that recognizes the importance of local biodiversity, including for improved livelihoods, community resilience and health and nutrition.
Program Background, Context and Aim:
Gunung Palung National Park (GPNP), a 90,000-hectare protected area in Indonesian Borneo, is home to spectacular biodiversity and covers a vital watershed that supports more than 60,000 people from 23 villages. More than 70% of lowland forests within the park’s buffer zone were deforested between 1988-2002 (Curran et al, 2004); forest cover inside GPNP decreased by 18.7% from 1992 to 2004, accelerated by illegal logging after decentralization in 1999 (Zamzani et al, 2009).
Health In Harmony’s (HIH) pilot program, Alam Sehat Lestari (ASRI), offers a disruptive model that combines access to affordable, high quality healthcare, opportunities for alternative livelihoods, and conservation programs to restore GPNP. In 2007, HIH and ASRI initiated a process of radical listening to identify drivers of deforestation and help the communities design and execute solutions. After more than 400 hours of community meetings, villages unanimously agreed they could stop logging if they had access to high-quality, affordable healthcare and training in alternative livelihoods. Today, ASRI’s integrated programs: monitor logging activity through community meetings and satellite imagery; provide healthcare in ASRI’s hospital, which offers non-cash payment options and discounts to villages that stop logging; make alternative livelihood opportunities available; and reforest the park to restore critical habitat.
A 2007 baseline, followed by a 2012 and 2017 quantitative survey were conducted in 25 villages surrounding GPNP to understand the health and conservation changes in these communities. Pairs of trained nurses systematically interviewed 1,300 households in the region.
The baseline survey found the communities bordering GPNP were extremely poor, with an average income of $13USD per month. Healthcare services were unavailable or of extremely low quality, and the nearest hospital was 2-12 hours away. Poverty and a lack of access to affordable healthcare left people with few choices of livelihoods, and many turned to logging. Follow-up quantitative surveys described a positive change: an estimated 1,350 logging households (HH) in 2007 declined to 450 HH in 2012, and to 150 HH in 2017 (an 89% decline from baseline). GIS data revealed a stabilization in primary forest loss and an increase in secondary forest growth. Additionally, the 2012 survey found 52% of previous loggers were farming. Health indicators also improved: from 2007 to 2012, infant mortality declined from 3.4 to 1.2 deaths per 100 households. To date, ASRI has treated nearly 30,000 patients and maintained a patient dropout rate of <1% for tuberculosis treatment.
Programming improved the health of the people and forest in the GPNP region. This integrated approach to conservation, healthcare, and livelihoods protects ecosystems while empowering individuals to improve community well-being.
Conserving the most threatened ecosystems and biodiversity is vital to human health and wellbeing and to planetary health but is proving increasingly challenging. Natural ecosystems continue to lose resilience and function under increasing pressures driven by human demographics, unsustainable food production patterns and global overconsumption trends. Increased awareness and efforts to mitigate against such trends now occur as the overuse of our finite planet’s resources translates into new health challenges associated with climate change and the emergence of novel diseases. Addressing these new challenges with the novel One Health approach which recognizes the interconnectedness between human health, animal health and environmental health is increasingly proving to be effective.
In biodiverse areas and natural ecosystems, maintaining environmental health has traditionally been based on increasing or establishing new protected areas (PAs). New targets are regularly being established, such as in the recent Agenda 2030 for Sustainable Development. However, local and indigenous communities living in such areas constitute the poorest and most marginalized segments of the population in their countries. Through their traditional environmental knowledge and resource management systems, they are the custodians of unique biocultural heritages on which Planetary Health relies. Biodiversity conservation efforts will not be sustainable unless the issues of health, poverty and livelihoods are addressed in these communities.
By examining the roles and responsibilities of local and indigenous women in supporting functional ecosystems, we show their pivotal role at the interface and their vulnerability to a wide range of global priority health concerns, including infections and non-communicable illnesses. The drivers of such vulnerability include social and geographical marginalization, poor access to health services and reproductive and sexual information, restricted access to resources, malnutrition, air and water quality, human and animal conflict. We suggest that a One Health approach with a gender perspective can contribute to the Agenda 2030 for Sustainable Development and specifically to the objectives of biodiversity conservation and poverty reduction in threatened ecosystems.
The Good of the Hive is an artistic initiative founded by Matthew Willey on a personal commitment to hand-paint 50,000 honeybees – the number necessary for a healthy, thriving hive – in murals around the world. Through art and imagination, The Good of the Hive raises awareness about the importance of honeybees and other pollinators while celebrating the beauty and power of human connection.
2700 bees in thirteen mural projects have been completed across the US since 2015 and we are taking the initiative international in 2018.
The work starts with the issues surrounding honeybees, but it also views the hive as a metaphor for communities of people. The immune system of the honeybee is based on the health of the hive, not the individual bee. Humans are the same way- although we rarely operate in a manner that recognizes this. Whether it is a honeybee hive or a community of kids in a school, military veterans, women with cancer, refugees, or the entire global human population, the health and success of the individual relies heavily on information and connections within the group.
An average mural takes 6 weeks to complete. We use that time to engage people through social events, panel discussions and film screenings. The initiative, in essence, is a unique marketing tool that is traveling the world and engaging people through art, multi media platforms, press, and social interaction. By creating an emotional connection based in truth, we inspire lasting change.
Artists have long had social duties to communicate. But for their teachings to create effective change for the general population, those teachings must be comprehensible.
Murals have the power to bridge the world of information with the emotional centers of the general public. When people come together and feel something collectively, they remember it.
The initiative has participated in round table discussions, panels and projects including the USDA, US Forest Service, the FAO at the UN, Endangered Species Coalition, Humanitas Global, Burt’s Bees, Pollinator Partnership, The World Council of Peoples for the UN, Bee City USA and many local city officials and school systems.
There is a cavernous (and widening) gap between the overwhelming details of environmental issues like honeybee health or pollination, and having that information understood by people at a local level. Communicating in a way that is effective long term is crucial. This work is a proven vehicle for this type of sustainable awareness.
Vibrio parahaemolyticus disease emergence in the Northeast, US reflects a wider trend of water-borne infectious disease dynamics that are changing globally. V. parahaemolyticus is most associated with seafood-borne illness and the widespread impacts of changing disease dynamics pose major costs to public health, fisheries and aquaculture that disproportional affect local and developing economies. One of the key characteristics of V. parahaemolyticus is that it is a natural part of the microbial community in most marine and estuarine ecosystems, so it is intrinsically linked to the environment it inhabits. As such, preventing human disease relies on managing seafood and public exposure to conditions in the environment that enrich for pathogenic strains. Currently, these conditions are not well understood, so public health methods apply general and easily measured characteristics, such as elevated water temperatures and total V. parahaemolyticus concentration to predict V. parahaemolyticus disease risk. However, these approaches can inaccurately predict risk and it is clear that improved approaches are needed to differentiate high-risk conditions from low-risk conditions for V. parahaemolyticus disease outbreak. At the University of New Hampshire, US, long-term surveillance of the Great Bay Estuary (GBE), and effective multidisciplinary collaboration between aquaculture and environmental and public health agencies provides a powerful resource to address many of the currently unresolved questions surrounding V. parahaemolyticus ecology. Using improved methods for environmental modeling and comparative genomics, including multivariate, seasonal analysis and a custom pipeline for functional genome annotation, a clearer, more comprehensive picture is emerging of the interactions that drive V. parahaemolyticus size and population structure in temperate water ecosystems. Preliminary results of this work have identified previously unrecognized seasonal, water quality and microbial community interactions and will ultimately contribute to the development of more effective public health tools. The challenge of these emerging disease dynamics requires approaches that integrate human and environmental health. This in-depth characterization is focused on the environmental conditions that shape V. parahaemolyticus populations and will provide the new directions to better characterize the conditions that lead to human health risk.