The world is changing rapidly and humans are at the forefront of this change. Not only are people being affected by global alterations, we are contributing to the transition. Some geologists now believe that human activity has irrevocably altered our planet to the extent that we have entered a new geological age – the Anthropocene age. This is more than just about understanding our place in the history of the planet; it is about the future and our involvement in it. There is no part of the Earth now left unaffected by the human footprint and consequential health risks are emerging unevenly all over the world, with a re-emergence of infectious diseases and an increase in life-style related diseases. We face a contradiction: economic and social development is needed to alleviate poverty and improve human lives, but ecosystems are still deteriorating because of past and present patterns of development, with major implications for human health.
EcoHealth as a concept is designed to meet the challenges of the future in this dynamic and complex world.
What is EcoHealth?
EcoHealth is both a science and a culture. As a science, it is about recognising that the social, cultural, and economic activities of people are occurring within ecosystems, from local household decisions, to national policies and international treaties and systems. Human activities not only affect the conditions of ecosystems within which we live, but also influence human health and well-being, thereby shaping the relationships people have with their environment. As a culture, EcoHealth aims to be inclusive, to involve local communities, researchers, policy makers, to build bridges between disparate disciplines, and to integrate methodologies from natural and social sciences.
EcoHealth is (quotes from speakers at the Kunming 2012 conference):
…‘the elephant’. The reason every one of you is telling it differently is because each one of you touched the different part of the elephant. So, actually the elephant has all these features, we must stop talking, start listening and collaborate to ‘see’ the full elephant.
….. a team sport.
…… a collage, not a jigsaw. A jigsaw is a collection of predictable pieces of an already known picture.
… a synthesis of ideas to develop a transformational tapestry.
The mission of the International Association for Ecology and Health (EcoHealth) is ‘to strive for sustainable health of people, wildlife and ecosystems by promoting discovery, understanding and transdisciplinarity’.
There are six guiding principles to EcoHealth used to conceptually frame an effective research process for complex problems and to aid in the application of the results:
1. Systems thinking
2. Transdisciplinary Research
5. Gender and Social Equity
These principles are interrelated, but expressing them explicitly aims to emphasise the scientific and cultural elements of the EcoHealth agenda.
Lessons from the EcoHealth conference in Kunming
The conference was divided into cross-cutting imperatives:
(ii) Vulnerable populations, vulnerable ecosystems, and health
(iii) Capacity building and action.
Tackling the whole of complex problems, incorporating change and uncertainty, taking account of the context of an issue were the underlying themes from the conference speakers.
Vulnerable populations, vulnerable people and health: During the conference, there was a particular focus on vulnerable people who live on the critical ecological and socio-economic margins of globalisation. Maria Carlota Monroy gave an inspiring example of how EcoHealth can improve the lives of vulnerable people in a sustainable and participatory way when describing a local solution to Chagas disease in Guatemala. Chagas is an important vector-borne disease in Central America, infecting more than ten million people and killing more than 10,000 per year (WHO, 2010). In Guatemala, conventional insecticide house spraying has little lasting effect on human disease and new solutions were required. A team of scientists from different disciplines (medical entomology, anthropology, microbiology, architecture and civil engineering) worked together to understand the different facets of the problem with the aim to devise practical interventions to reduce Chagas risk and improve community well-being. The resulting intervention was based on the research of local risk factors and incorporated local knowledge and practices.
Capacity building success stories: Álvaro Fernández spoke about ‘teaching teachers to teach EcoHealth’ in Costa Rica. By the end of 2012, 1,000 teachers from 400 public elementary and secondary schools will have received a one-year modular course on educational innovation for integrated management of health and the environment. The course is acknowledged by the Ministry of Education as part of their continuing education requirements. The course includes modules on extracurricular and curricular planning, pollution, and biodiversity, with facilitators and joint field-supervision from the Ministry and local universities.
There were many conference papers from the EcoZD group (Ecosystem Approaches to the Better Management of Zoonotic Emerging Infectious Diseases in the Southeast Asia Region) which is building capacity within multi-disciplinary research groups in six pilot countries: Cambodia, Indonesia, Lao PDR, Thailand, Viet Nam and China (Yunnan Province). The International Livestock Research Institute, in Kenya, is coordinating the set of pilot research projects in these countries, facilitating learning across the projects, and helping translate the knowledge gained into feasible policies and actions.
One of the biggest challenges for the conference organisers was overcoming the barriers to equitable participation, a core EcoHealth principle: including cost, time and distance. EcoHealth 2012 responded to some of these challenges with innovations that encouraged engagement in a range of new ways. Off-site participation in selected symposia and workshops were available throughout via the Web-based and Distance-Engagement (WEB-ADE) initiative. This continues to be active with key plenary sessions, poster and oral presentations available on the website.
EcoHealth contributions to Millennium Development Goals: Sustainable development is composed of three dimensions: economic, social and environmental. In his plenary address, Jakobo Finkelman recognised that health is both a pre-condition and an outcome of all three dimensions, as well as a measurable indicator of development. The achievement of health as expressed in the MDGs is dependent on creating and maintaining health environments and societies. He called for engagement from the EcoHealth community in the push towards the 2015 MDG targets and beyond (read more). The challenge is developing a global understanding of (i) the dependence of health on ecosystem services; (ii) the centrality of social and political determinants of health and (iii) the necessary involvement of communities in the solution of local problems. EcoHealth 2012 accepted this challenge and developed a conference position statement on the MDGs, creating recommendations for current and future strategies for success.
Conference take-home messages: Many of the well-known contradictions relating to health and development were reiterated. There were conflicting priorities: those who believed infectious disease should be prioritised over non-communicable diseases and those who believe the opposite; others saw emerging diseases as more of a threat than neglected infectious diseases. Paradoxes that were hotly debated included: livestock are a way out of poverty BUT increased livestock numbers are unsustainable due to pasture degradation. Mining and logging can increase local job opportunities BUT destroy local ecosystems, cause pollution and affect water supply. And this is exactly where EcoHealth, as a science and as an approach to ‘action for change’, stands: explicitly acknowledging these conflicting interactions to find solutions on how policy development could be cognizant of the trade-offs between ecosystem services and human health and well-being and animal health and their resolution according to the principles of sustainability and equity.
In her plenary session, Valerie Brown purported that if our physical and social environments are changing, so are we, personally, professionally and as a community, the future is about transformation. She concluded that EcoHealth as a transformation science asks that we change our way of thinking from a pre-determined path and pre-existing tools to make use of what went before in new ways, and using our creativity to develop even newer ways that allow us to take account of the change. While the EcoHealth approach embraces the tools of core domains such as public health, ecology, and ecosystem management, its emphasis on interdisciplinarity and cross-sectoral collaboration enables it to transcend the limitations of individual fields of expertise. As a culture it enables us to utilise skill sets such as humour, patience, tolerance, a willingness to reciprocate; and as an association it seeks to have the development of these skills included as part of national curricula.
Additional resources on EcoHealth
EcoHealth Research in Practice is an easily readable book that demonstrates how EcoHealth research works and how it has led to lasting changes for the betterment of peoples’ lives and the ecosystems that support them.
The London EcoHealth Forum is a platform that provides a venue for researchers in London from various fields to exchange ideas and discuss problems using an ecosystem approach to health. If you are interested in participating then please contact us.
Contributed by Mieghan Bruce, PhD student with the Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), with Silvia Alonso Alvarez, Lecturer in Veterinary Public Health at the Royal Veterinary College (RVC).