Conservation medicine: combining the best of all worlds - Focus

Environmental Health Perspectives, August, 2003 by Bob Weinhold

A third-grader can figure out the easy labels: someone who practices biology is a biologist; ecology, an ecologist. But what do you call a practitioner in the fledgling field of conservation medicine? "I don't know," says Peter Daszak, executive director of the Palisades, New York-based Consortium for Conservation Medicine, laughing at yet another small hurdle for his new field. "A conservation medic?"

Creating nomenclature for the field is just one of many challenges facing conservation medicine, which is attempting to pull together human health, animal health, and ecosystem health--three fields that are tough enough on their own in terms of complexity, lack of data, and other factors. Conservation medicine--or ecological medicine, or medical geology, or whatever it may be called by various advocates--is rushing headlong against a decades-long trend of specialization in medicine and the sciences. And many of the essential data needed to rigorously establish the links between environmental factors, sick wildlife, and sick people just don't exist yet.

However, in the past few decades, a growing number of professionals have been noticing the links between illness--in both humans and wildlife--and ecosystem impacts including toxic emissions, land clearing, international travel, and climate changes. One result of these impacts, say conservation medicine advocates, has been the spate of emerging diseases associated with now-familiar names such as Lyme, Ebola, Marburg, Pfiesteria, and Cryptosporidium.

Emerging diseases such as Rift Valley fever, hantavirus pulmonary syndrome, Nipah virus encephalitis, severe acute respiratory syndrome (SARS), HIV, and West Nile virus infection have become notorious. Also of concern are lesser-known emerging diseases such as fibropapillomatosis, a marine turtle disease associated with heavily polluted coastal areas that many suspect could be an indicator portending human health problems. Other researchers are just as concerned about the pervasive effects of endocrine disruptors, the international airborne spread of dust, bacteria, and viruses, and the environmental consequences of throngs of well-intentioned ecotourists visiting the wild.

All the evidence suggesting strong connections between human health, wildlife health, and ecosystem health has whetted the appetite for hundreds of people to edge into conservation medicine. And with more than 30 emerging diseases in humans making headlines in the past three decades, advocates say even more people are becoming interested in the field, particularly the human health angle. "Everybody understands [human health]," says Mary Pearl, president of the nonprofit conservation organization Wildlife Trust and a primary catalyst behind the consortium, which is housed in Wildlife Trust offices, "You don't want to get sick, or have your family get sick."

What's in a Name?

The general concept of looking at the links between sickness in the environment, wildlife, and people is centuries old. As recently as the 19th Century, health care practitioners were expected to have training in both the medical and natural sciences. But as 20th century science unveiled an increasingly complex world and specialization became the norm, those connections have become murky. "Some physicians look at you with a blank stare when you mention mercury and other environmental issues," says Ted Schettler, a physician and science director for the Science and Environmental Health Network (SEHN), an Ames, Iowa-based advocacy organization.

But individual disease, pollution, and environmental disruption scenarios have begun to merge in the minds of a few people. To begin to capture the concepts behind the potential linkages, the term "conservation medicine" was first floated in a 1996 article, "Wildlife, People, and Development," in the journal Tropical Animal Health and Production. Picking up on that and other threads, Pearl, along with Tufts University's David Sherman (then an associate professor of environmental and population health) and Mark Pokras (director of the Center for Conservation Medicine at the Tufts School of Veterinary Medicine), pushed for an organization that would cover the fields of both animal and ecosystem health. The human health element was added later, says Pokras.

The end result was the Consortium for Conservation Medicine. Consortium partners include Wildlife Trust, the Tufts Center for Conservation Medicine, the U.S. Geological Survey (USGS) National Wildlife Health Center, the Harvard Medical School Center for Health and the Global Environment, and the Bloomberg School of Public Health of The Johns Hopkins University. The nonprofit consortium advocates for and conducts research, develops interdisciplinary education and training programs, informs policy makers, and is trying to formulate pragmatic solutions to conservation medicine-related problems identified to date. Individuals can join, and about 25 have done so.

After much pondering over what to call this new field, the consortium adopted the term "conservation medicine." But it isn't married to the term, says Alonso Aguirre, director for conservation medicine at Wildlife Trust and senior editor of the first book covering the issue, Conservation Medicine: Ecological Health in Practice, published in October 2002.