Thread by @parasiteecology

You probably know that ecosystem degradation can cause spillover and disease outbreaks (lose–lose scenarios). In our new paper, we evaluate 46 potential ✨win–win solutions✨ for conservation and human infectious disease control. Here’s what we learned👇🏼 thelancet.com/journals/lanpl…

Let’s start with an example of a win–win solution: in western Borneo, programs that improve health care access and sustainable livelihood options for people living near protected rainforests reduce illegal logging and improve human health. @planet_indo @HIHngo

Another example: educating people about how to live safely with bats (like placing bamboo skirts around collection pots for edible sap to reduce bat contamination of food) can reduce spillover of bat viruses to people and hopefully reduce conflicts between bats and people.

Not fun fact: in 2003, #monkeypox was accidentally imported to the United States on some pet pouched rats and 47 people were infected. Wildlife trade regulations might be a win-win solution to protect wildlife threatened by trade and reduce the spread of human pathogens.

Our team – the Ecological Levers for Health Working Group @ucsb_nceas – knew about a few examples before starting this project. We wanted to know how many MORE potential solutions exist, what they have in common, and where solutions are needed but missing

First, we had to find a common definition for “win–win solution”. It turns out that different people assume that means different things! You can read more about that in a previous paper published in Nature Sustainability. nature.com/articles/s4189…

Armed with a definition, how does one find every potential win–win solution that advances any kind of conservation goal and controls any kind of human infectious disease?! Back then, you couldn’t just Google a list. (I tried). So we used a subject-wide evidence synthesis.

In Phase 1, we did a massive, systematic literature review to find every paper that MIGHT contain a potential win–win solution. Then we had to go through all those papers (with the help of machine learning) to decide which ones really were relevant. This took YEARS of our lives.

Amid all those papers, we found 46 unique potential solutions; here they are summarized in <12 words each. Sometimes a potential solution was mentioned in many papers and sometimes it was only mentioned once. We’ll come back to that when we talk about “evidence”.

In Phase 2, we did targeted reviews, or “deep dives” into the 46 potential win–win solutions. We wrote a one-page summary on each one (using standardized info categories), which we sent to experts for friendly review, and then revised over and over and over.

I bet you want to read those summaries, right? Good news! You can read and sort through all 46 evidence summaries on our website. (And thank you again, so much, to all of the experts who reviewed the summaries!) jvr782.wixsite.com/leversforhealth

And now for some results!! Potential win–win solutions are EVERYWHERE. High income countries. Low income countries. Tiny islands. Huge multi-country regions. (Technically NOT in Antarctica, but toxoplasma-related solutions in other countries probably protect polar wildlife, too.)

Potential win–win solutions aim to solve many conservation problems, including most of the “threat classes” defined by the @IUCN. Solutions related to land use change (e.g., agriculture, urbanization) were especially common.

BUT we couldn’t find a solution where climate change was the major threat addressed. Climate change IS degrading ecosystems AND exacerbating human infectious disease burdens, so finding and implementing solutions to reduce these related issues is critical. @ProjectDrawdown

The potential solutions also aimed to reduce burdens of diverse infectious diseases, including those with huge global burdens (e.g., HIV/AIDS, schistosomiasis) and those that are relatively rare but deadly or that could become more problematic (e.g., Hendra virus, Anthrax).

The potential solutions also came in three “flavors”: conservation interventions that have knock on health benefits (#naturebasedsolutions), health interventions that have knock on conservation benefits, and “other” interventions that benefit both health and conservation.

You might have noticed that we call them “potential solutions”. That’s because many are still at the hypothesis or anecdote stage (“no evidence”) or the evidence for their success is limited and correlational (“low evidence”). (See our evidence scoring rubric below!

Is it “bad” that evidence is so limited for many of the potential solutions? Not necessarily! Those might be great opportunities for future funding and research. It’s only a problem if evidence quality is low because there’s a lot of conflicting evidence for success.

One solution already had high evidence quality for both disease control and conservation outcomes: vaccinating domestic dogs and wild canids to reduce rabies transmission to wildlife and people.

Actually, several of the potential solutions were about infectious diseases spread by domestic dogs and cats. Pet owners of Twitter, YOU can play a role in win–win solutions!

Is evidence for success the only thing that funders, researchers, and decisionmakers need to consider when deciding to implement a potential solution? No! We used 11 “viability criteria'' to classify potential solutions.

The first criteria are about collateral impacts. HARMLESS, CONTAINED, and CONSISTENT interventions don’t harm some people or ecosystem components while trying to help others. And they *do* consistently improve their targets (rather than backfiring unexpectedly).

The next two criteria (FEASIBLE and SOCIALLY ACCEPTABLE) are about whether a potential solution can really be done given existing social and technological contexts. Some interventions are socially acceptable in some locations but not in others.

We already talked about the EFFECTIVE criterion, which we evaluated with an evidence rubric. The last four criteria are very important, but we couldn’t evaluate them, because different people would rate them differently.

For example, a small conservation impact might not be worth it for a conservation organization, but a health organization might be happy to do an intervention with a small conservation impact (and a big health impact). There’s more about these criteria in the paper!

To recap: we found that proposed solutions address diverse and context-dependent threats with cross-sector interventions that are equally diverse. Numerous solutions had the potential to be safe and feasible and some were supported by medium and high quality evidence of success.

But all proposed solutions had evidence gaps and collectively they did not cover all health and conservation threats (e.g., climate change). Info on impacts (quantitative outcomes), cost-effectiveness, and affordability were especially scarce–priorities for future research!

More evidence will accumulate when stakeholders invest in research, adaptive implementation, monitoring, and evaluation for existing approaches. New solutions will also be created, filling in existing gaps or addressing new problems.

Our website can help with that! We like to think of it as a bespoke menu with a taste of the universe of possibilities. You can use it to find an existing potential solution and decide if it works for you OR use it to brainstorm a new potential solution that doesn’t exist yet.

There were 28 (!!) of us who made this project work, including @NicoleNovaBio, @andjanlund, @leboa_chris, @DeLeoLab, @izzybeljones, @DrChelseaLWood, @Buckette84, @tobeR0tobe, @ali_bat, @_tarasite_, @Justin_Remais, and @LisaAMandle

You can find the paper at Lancet Planetary Health, where it is free for everyone to access!

thelancet.com/journals/lanpl…