The detailed evidence for the importance of biodiversity to health and well-being is highlighted in the rest of the Key Issues section of this website. It is widely acknowledged across multiple sectors - including economics, finance, food production, tourism, social protection, emergency response, marine and coastal management, forestries and fisheries, and private enterprise - that biodiversity loss is at the centre of the numerous intersecting crises of the modern age.  It is also acknowledged that the conservation and sustainable use of biodiversity present important opportunities for increasing prosperity, promoting peace and security, and sustaining lives and livelihoods.

This is reflected in the growing attention given to biodiversity in decision making at all levels and across all sectors.  Since its announcement in 1992, the UN Convention on Biological Diversity has called for biodiversity to be mainstreamed across all areas of decision making to help to ensure that those sectors and communities who depend or impact upon biodiversity can develop into the future in a way which does not jeopardise the ability of future generations to meet their own needs.

However, biodiversity has yet to be effectively mainstreamed widely within the health sector. Whilst the number and scope of initiatives taking ecosystem approaches to health  continues to grow (such as ecohealth, One Health and related approaches) the conservation, restoration and sustainable use of biodiversity do not feature substantively in the plans, programmes and development of the health sector.

There are several reasons why the health sector represents a key area for mainstreaming biodiversity. Firstly, the varied and intricate relationships between nature and health are increasingly well understood and have been explored in detail in scientific literature, and have become of increasing concern to governments and citizens worldwide. Recent experience of the Covid-19 pandemic has provided clear examples of the connections between the health of the environment, human health and the health of other species. Second, investments in health and healthcare account for a significant amount of public expenditure at regional, national and local levels; for example, in the EU health systems require an average investment equivalent to approximately 11% of GDP and 20% of gross national budgets, as well as being a key area of household expenditure for individuals and families. Furthermore, the health sector directly or indirectly encompasses a broad diversity of scientific disciplines, policy sectors and areas of economic activity; as such, the health sector may be seen as an important instrument of economic policy which has many dependencies and impacts on the environment. Third, health is recognised as a significant component of well-being, influencing individual and societal metrics on quality of life, lived experience, personal development and social interaction, and therefore should factor explicitly in assessments of nature’s contribution to people.

It is important to note also that the health sector can, through various policies, programmes and practices, have negative impacts on biodiversity. Where these impacts threaten the sustainability or functions of ecosystems which contribute positively to health or other elements of well-being, or potentially increase negative externalities, it is important that they are recognised, understood, and appropriately addressed.

There are numerous barriers to effective integration between the health sector and the biodiversity conservation sector. Historically, one difficulty has been a perception within the health sector, or in government agencies in various countries, that biodiversity and ecosystems are a source of health threats and therefore options for the management of those risks should include ecosystem degradation or culling of wild species. Examples include policies on the destruction of wetlands in many countries as a means of combating malaria and calls for the widespread culling of wild birds and removal of their preferred habitats as a means of preventing the spread of avian influenza. If such strategies in turn pose a threat to the sustainability of the ecosystems which positively support health and well-being, then the ultimate impacts on human health and well-being may be negative – in addition to the fact that these actions may often be counter-productive.

Although the relationships between elements of biodiversity or certain ecosystems and health are in some cases clearly identified, the exact mechanisms and pathways through which ecosystems influence health outcomes are sometimes poorly understood, or are highly case specific, depending upon, for example, climate, geography, and cultural perspectives and behaviours. For communities, business and decision makers it is important that these pathways (linking biodiversity health, and related social and economic implications) are carefully examined. This is particularly important for complex systems where a full understanding of which aspects of biodiversity or ecosystem functioning can or should be managed to address health issues requires careful consideration of the interaction between ecosystem health and the health of animals, plants and humans, as well as of the past, present or future role of human activity and behaviour in driving those health issues. This requires collaboration between the nature conservation and health communities, and many other sectors.

The health sector has a vitally important role to play in highlighting and addressing the risks associated with biodiversity loss and ecosystem degradation, and in helping to reverse the trends of overconsumption and biodiversity loss.