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Tuesday, May 21, 2024

Stop the Next Pandemic: Conservation as Public Health Policy

The legacy of the ongoing COVID-19 pandemic leaves behind an urgent question: How do we prevent history from repeating itself? Far from a doomsday conjecture, our shared history with pathogens shows that outbreaks will happen again. Soon. But to forestall the next pandemic, we must first understand how outbreaks begin.  

“Zoonosis”— a disease that can be passed from animals to humans. That clinical definition belies the tragedy and familiarity of outbreaks in human history, including the Black Death, HIV/AIDS crisis, and COVID-19 pandemic, to name a few. For the public, the narrative around zoonosis is largely distorted by fear, and it fixates on the horrifying outcomes of transmission. There is, after all, something horrifyingly enthralling about macabre diseases. Consider the trending pandemic thriller, “Contagion,” in which viewers witness the skin-crawling outbreak of an invisible contagion that knows no boundaries. The sensationalization of infectious diseases obscures our understanding of the far less insidious root cause of zoonosis: human interactions with the natural world. 

One interaction could be as simple and commonplace as a farmer clearing land. Combined, though, these inane interactions have formed an ecological footprint significant enough to launch a new geological epoch — the Anthropocene — characterized by humanity’s influence on Earth’s ecological foundation. What are the implications for zoonotic disease transmission? When the actions of that farmer clearing land is multiplied a thousand-fold by those like him, how many animals are displaced? Where do they go as the wilderness thins? The increased frequency of contact with human population complements the increased risk of spillover infection. It’s a game of chance, and we are tipping the odds, as of now, against our species. 

As humans increasingly encroach upon natural habitats, destroying upwards of half the Earth’s total biomass, it is hardly surprising that upwards of 60% of emerging infectious diseases are zoonotic. The grim future forecasted by these statistics, though, obscures the fact that change is possible. Instead of  accepting pandemics as an inevitability, we must redefine the unchallenged narrative of the anthropocene by setting new norms for interactions between humans and nature. 

Lessons from the Past

For the most part, humanity’s approach to zoonotic diseases has been reactive rather than preventative. As illustrated by the recent crisis, governments have scrambled to contain — often unsuccessfully — rather than prevent an outbreak. According to Ellen Carlin, an assistant professor at the Center for Global Health Science and Security at Georgetown University, the “vast majority of [the U.S. federal budget] goes into response or preparedness for response,” with little investment in preventative methods involving “multi-sectoral” teams of environmental health and public health specialists. Despite the catastrophic failures of the COVID-19 response, there is still no change in sight. As Colin Chapman, a conservation scientist and professor at George Washington University put it, habit trumps rationality: Governments will “respond to the immediate human factors… rather than dealing with the original cause, which is basically zoonotic disease transmission.” If a disruptive global pandemic is not enough to change public health policy by integrating it with environmental health, what is? 

Without a change in outlook and mindset, reactionary responses are virtually useless. The Ebola epidemic is just one cautionary example. Aaron Berstein, the interim director of the Center of Climate, Health, and the Global Environment for the Harvard School of Public Health, identified rampant deforestation as a major culprit. One factor was that the destruction of the natural habitats of bats — Ebola virus carriers — pushed them towards human populations. Still, after the Ebola crisis there was no effort to strengthen regulations on deforestation, said Berstein. In fact, the exact opposite has occurred. 

Granted, there are a few exceptions, like China, where strict enforcement by the government, aided by its authoritarian reach, supports proactive environmental regulations — most recently, a ban on the wildlife trade. Overall, significant progress is largely curbed due to the attitude that “a lack of compliance [with environmental law] is fine” at the highest level of governance in countries including Brazil and the United States, according to Eric Lambin, a professor at the Woods Institute for the Environment at Stanford University. 

Complacency and indifference can undermine the potential of any good policy. As a result, regulation is not equivalent to enforcement. When we rely too much on policy to drive change, we forget the human factor. Consider the recent backlash against bushmeat in wet markets — places that sell produce and fresh meat — for potentially spreading COVID-19. Outrage over the recklessness of wet markets, which has captured popular imagination as breeding grounds of disease, fuels the call for bans: If this “backwards” system were outlawed, wouldn’t tragedies be prevented? Our disgust at bushmeat — implicitly thinking of wet markets as “backwards”— disrespects and throws aside the communities that participate in and rely on the bushmeat trade. 

It is rarely broadcasted, but spillover often occurs in communities that interact with the environment extensively out of necessity, and regulations will not fix that. Chapman points out that in countries like Uganda, bushmeat transactions are mainly neighbor to neighbor, and hunting is part of the social, cultural, and economic structure. It is not that regulations do not exist, but as Hongying Li, a research scientist at EcoHealth Alliance, aptly remarked, “we have to change the culture, change human behavior” around interactions with the ecosystem. Change starts small, and change begins locally. Catherine Machalaba, a policy advisor with EcoHealth Alliance, expressed surprise that “communities are often overlooked in global health” when they are in fact critical to the global conservation effort. There is no global policy and no “simple fix,” added Bernstein. “Success lies in a real understanding of the needs of the people who live in these communities and figuring out how that can be.” 

A Question of Money?

There’s no doubt that one of these needs is economic. To make a living, people hunt and clear land, whether to raise livestock or for timber. If conservation is contrary to basic monetary needs, then conservation is not possible. As a result, many successful conservation strategies look for ways to meet economic needs while promoting safe and sustainable practices. Payments for ecosystem services, which subsidize farmers for conservation services, are one example, and ecotourism, where revenue from sustainable nature tourism goes towards both conservation and supporting local communities, is another. But are monetary benefits alone enough to stop unsafe and unsustainable interactions between humans and the environment?

There is an unspoken agreement that increasing individual and communal wealth will eliminate the need for unsafe practices. But this assumes that everyone resorts to unsafe and unsustainable practices only out of need or desperation. Chapman inadvertently put this to the test by running a mobile clinic that provides free health care services communities living near the Kibale National Park in Uganda. He noticed that, surprisingly, “as we increase the wealth of our particular community, poaching goes up.” Locals he questioned have told him, “why do you have more money? [So] you can buy bushmeat.” Choice, which is shaped by culture, attitudes, and behaviour beyond direct economic motivations, plays an important and often underrated role. 

Still doubtful? Consider bushmeat hunting in the United States. If this is new or surprising, it may be because bushmeat is commonly referred to as a “third world problem.” It’s not: bushmeat is not exclusive to the meat of exotic animals. Common wildlife, like deer, also fits under the umbrella term. Bushmeat hunting in the U.S. is, for the most part, recreational and determined by personal choice. As illustrated above, soft features and other qualitative factors like culture and behavior are, unlike economic incentives, unquantifiable. Regardless, these are the critical considerations that must shape conservation. If conservation aims can be neatly divided into three components, they would be education, incentives, and capacity building, according to Lambin. For each of these categories, economic considerations are only a piece of the puzzle. 

Changing the Story

What are the intangibles that motivate conservation? Let’s examine a conservation experiment  to answer this question. Lambin recounts a study on local, eco-certified coffee plantations in Colombia where the direct economic benefits were almost negligible: to meet the eco-certification standards, local farmers “had to comply to more than 90 criteria” but were only “paid about two percent above market price.” There are long term benefits like improved drought resilience due to increased tree coverage, explained Lambin, but in the absence of a direct economic incentive, he wondered what could be motivating them to stay or become eco-certified. From interviewing the farmers, Lambin sensed that a key motivator was their “pride [in] having a sustainable farming system.” Their pride came from being able to “[do]the right thing” after “hearing about climate change” and being pushed by their children to be eco-certified. The key takeaway is that providing the practical means through which communities can change lifestyle or behavior must be supplemented by a change in attitude first. Here, moral pride cemented a shift in perception of what Berstein calls the value of the environment “beyond the commodities that can be extracted from it.” Simply put, people both want and choose practices that break from familiar habits and even culture. 

Looking back at different conservation projects, a pattern emerges where the aim is really to change how communities and individuals perceive the environment rather than simply conserving it. To Chapman, the value in the mobile clinic, which is sponsored by the nearby Kibale national park, is that it “show[s] that [the park] cares for [the local’s] needs, […] respects them and respects what they want” so that they ideally “will respect the forest more” and act accordingly. Similarly the real value of ecotourism, Chapman continues, is not necessarily the revenue it generates for local communities, but how it compounds the value of the local environment to individuals as an unmatched national and international beauty to be treasured. 

By changing perceptions and attitudes towards our relationship with the environment, we are changing the narrative of the anthropocene. Attitudes are the building blocks for lasting change. It will not happen quickly, but it will happen. The presentation of environmental issues in popular media makes it easy to adopt a fatalistic perspective — climate change fatigue. But forecasts aside, we are far from the end of the story. The good news is that there are already so many successful conservation methods and stories. The hope is that the individual contributions will cascade over time to create lasting change — a new direction for the anthropogenic narrative. Twenty years ago in Kibale, Chapman recalls a woman doing educational outreach, teaching children slogans about conservation and the forest. Twenty years later when Chapman returned, he saw the children — now adults — again and asked their children about their views of the forest. They earnestly “gave [him] back [the same] slogans.” 

Role of Institutions

The much-needed change in attitudes is not exclusive to local communities. This also needs to happen at an institutional level before policies can truly be effective. The first step is recognizing that public health, environmental health, and animal health are inseparable — this is what the concept of One Health advocates for, the integration of conservation as part of public health. In most countries including the U.S., Carlin says, “politically, there is no connection between animal, environment, and human health.” Even now during the pandemic, OneHealth is still not a priority. Although we have seen effective conservation efforts juxtaposed against policy failures, “it’s not local conservation effort or regulation,” emphasizes Lambin, “we need local, regional, national or international efforts also to reinforce each other.” Successful conservation projects exist, but most are small-scale. From providing funds to giving direction to these projects, institutional involvement, whether with private or public entities, is required. According to Lambin, “It’s only when there’s some minimum level of alignment between [public, private, local, national, and international] that we could achieve long term a transition to sustainability.” 

On the national front, it may come as a surprise that smaller countries are setting the example. Machalaba gives the example of Liberia, a severely “resource limited” country that was at the epicenter of the Ebola epidemic. The disadvantage in resources did not discourage them from committing to a “One Health coordination platform [that is] chaired by the vice president of the country.” To Machalaba, Liberia’s commitment far outshines that of most other countries, and she is “always inspired” by their effort. What sets Liberia apart from other countries? Machalaba thinks that it is largely attitude which drives their “genuine interest and genuine commitment.” Although Liberia has made significant progress in a short time, they still face massive challenges. The question is, will they, and other countries, ever meet their conservation target?

The answer is yes, they can. It is a monumental challenge that should not invite intimidation, but rather encourage creativity in the solution. And it has been done before. Lambin recalls that before the 1980s, “Costa Rica was always identified as the worst country in terms of deforestation.” In just a few decades, “they lost about 80% of their forest covers,” and the “beautiful national capital of Costa Rica was completely destroyed by deforestation.” This “created a kind of mental shock” that permeated the entire population. Fortunately, “at the highest level of the political power, with the president, they turn things around in a matter of a couple of years” through massive conservation programs. Now, the rainforests of Costa Rica are a national treasure, and the complementary “economic payoff came very quickly” with a booming ecotourism industry. Most importantly, though, these changes have continued to this day. 

The Human Parasite

When pandemics are discussed, they are spoken of in fear and horror. Outbreaks as described in Richard Preston’s popular science book, “The Hot Zone,” which traces the emergence of Ebola, represent “the earth […] attempting to rid itself of an infection by the human parasite.” This antagonistic view of our relationship with nature not only distorts the facts, but also promotes the destructive narrative of the anthropocene, where humans only do harm. Nature is not launching an offensive; rather, these outbreaks occur because of human actions. We are so used to viewing the environment as a resource to be fully exploited that we even consider ourselves to be the “parasite.” But it does not have to be that way, and in reality, it has never been that way. The anthropocene simply describes the profound ability of mankind to shape and direct the natural world through our combined actions, for better or for worse. 

As conservation experiments have shown, human-nature relations are not limited to one of extraction and destruction: They can be one of coexistence and mutual respect. Look at the successful conservation projects mentioned in Uganda, Colombia, Costa Rica; weren’t they all trying to change how humans understand and view the natural world? We do not even know the full value of nature, so discovering that value is the first step towards a safer future. Moving forward, we must be honest with ourselves and first recognize that our fate is linked with that of the planet. In the age of COVID-19, there is no better time to address the root cause of pandemics — the way in which human interact with the environment — and change our legacy from that of “parasite” to nature’s advocate. 

Image Credit: Photograph by Jason Houston for USAID is in the public domain.

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