Imagine that Conservation Biology ran a restaurant. Rather than listing salads and entrées, the menu would include intervention options for achieving conservation goals, like setting fish harvesting limits and restoring degraded wetlands. Conversely, if Public Health ran a restaurant, the menu would probably have different fare, like increasing vaccination coverage, controlling vector populations, and treating sick patients. But what menu should practitioners and policy makers consider when they want to simultaneously advance conservation goals and improve human health? For this, we need to imagine a “Planetary Health” fusion restaurant. To find potential recipes for Planetary Health, we collected suggested examples of win–win interventions that both reduce human infectious disease and improve ecosystem integrity using a systematic literature review and expert surveys. To our surprise, we found 48 such examples, which led to new questions: which of these interventions should go on the menu, and how would one choose an intervention from such a diverse menu? To answer these question, we critically evaluated each example and then developed a decision hierarchy to facilitate evaluating and comparing amongst potential Planetary Health interventions.
Results/Conclusions
We found that two sequential questions could determine whether proposed interventions should be placed on the Planetary Health menu: (Tier 1) is it likely that the intervention would negatively impact people or nature (no=move to Tier 2, yes=find alternative), and (Tier 2) is the intervention feasible at the necessary spatial and temporal scales (yes=move to Tier 3, no=find alternative)? Feasibility was determined by several viability criteria: practicality, social acceptability, affordability, scalability, and sustainability. Many interventions passed these first two filters, creating a surprisingly diverse menu. From these choices, practitioners and policy makers must then decide which interventions are most compatible with their priorities, resources, and risk aversion strategies. To do this, they must consider the probability that potential interventions will succeed in delivering the desired outcomes for conservation and human health (Tier 3: Evidence Quality). Based on our synthesis of currently available evidence, most interventions among these 48 examples were either hypothetical or supported by limited evidence, and thus organizations with low risk aversion would be most likely to order from this menu. Therefore, experimentation with enticing but untried recipes through academic research and/or implementation via adaptive-management frameworks has potential to increase the popularity of the Planetary Health menu.