# Publications

Fremier A, DeClerck F, Bosque-Perez N, Carmona NE, Hill R, Joyal T, Keesecker L, Klos PZ, Martinez-Salinas A, Niemeyer R, et al. Understanding Spatiotemporal Lags in Ecosystem Services to Improve Incentives. BioScience [Internet]. 2013;63 :472-482. Publisher's VersionAbstract

Ecosystem-service production is strongly influenced by the landscape configuration of natural and human systems. Ecosystem services are not only produced and consumed locally but can be transferred within and among ecosystems. The time and distance between the producer and the consumer of ecosystem services can be considered lags in ecosystem-service provisioning. Incorporation of heterogeneity and lag effects into conservation incentives helps identify appropriate governance systems and incentive mechanisms for effective ecosystem-service management. These spatiotemporal dimensions are particularly apparent in river–riparian systems, which provide a suite of important ecosystem services and promote biodiversity conservation at multiple scales, including habitat protection and functional connectivity. Management of ecosystem services with spatiotemporal lags requires an interdisciplinary consideration of both the biophysical landscape features that produce services and the human actors that control and benefit from the creation of those services.

Dallimer M, Irvine KN, Skinner AMJ, Davies ZG, Rouquette JR, Maltby LL, Warren PH, Armsworth PR, Gaston KJ. Biodiversity and the Feel-Good Factor: Understanding Associations between Self-Reported Human Well-being and Species Richness. BioScience [Internet]. 2012;62 (1) :47-55. Publisher's VersionAbstract

Over half of the world’s human population lives in cities, and for many, urban greenspaces are the only places where they encounter biodiversity. This is of particular concern because there is growing evidence that human well-being is enhanced by exposure to nature. However, the specific qualities of greenspaces that offer the greatest benefits remain poorly understood. One possibility is that humans respond positively to increased levels of biodiversity. Here, we demonstrate the lack of a consistent relationship between actual plant, butterfly, and bird species richness and the psychological well-being of urban greenspace visitors. Instead, well-being shows a positive relationship with the richness that the greenspace users perceived to be present. One plausible explanation for this discrepancy, which we investigate, is that people generally have poor biodiversity- identification skills. The apparent importance of perceived species richness and the mismatch between reality and perception pose a serious chal- lenge for aligning conservation and human well-being agendas.

Garaway CJ, Photitay C, Roger K, Khamsivilay L, Halwart M. Biodiversity and Nutrition in Rice-Based Ecosystems; the Case of Lao PDR. Hum Ecol [Internet]. 2013;41 :547-562. Publisher's VersionAbstract

This paper presents results from a year-long household survey in which the aquatic resource collection and consumption activities of 240 households across Lao PDR were studied to assess the diversity of species used, their role in household food security and the overall impor- tance of ricefield habitats in this respect. Results show that aquatic biodiversity, under threat in rice-based ecosystems, plays a larger role in household consumption than previous estimates. More than 90 % of these resources are collected by households themselves and the greatest quantities from ricefield habitats. This seasonal aquatic environment is there- fore the principal habitat from which households acquire aquatic animals, both to eat fresh and to process and store for use during nutritionally vulnerable times of year. The importance of these habitats therefore goes far beyond their use for rice production and this multi-functionality needs to be understood and addressed in agricultural, conservation and food security policy.

Johns T, Sthapit BR. Biocultural Diversity in the Sustainability of Developing-country Food Systems. Food and Nutrition Bulletin [Internet]. 2004;25 :143-155. Publisher's VersionAbstract

The policy implications of a model of contemporary food systems for developing countries that integrates nutri- tion, reduction of disease risk, culture, income genera- tion, and biodiversity are reviewed within a theoretical and empirical examination of the relevance of nutrition to the priorities put forward at the World Summit on Sustainable Development in Johannesburg, South Africa, 2002. Agricultural, health, economic, and social policies with local reach are necessary responses to the increase in noncommunicable disease associated with the globali- zation of food systems. Nutrition offers a nexus for the changes in individual behavior and motivation essential for fundamental shifts in production and consumption patterns. Mutual consideration of biocultural diversity and nutrition can guide policy, research, promotion, and applied action in developing countries. Benefits from enhanced use of biodiversity must legitimately flow to the undernourished poor, while potential negative conse- quences must be minimized and mitigated. Quality and quantity of food need not be mutually exclusive. Func- tions related to energy density, glycemic control, oxidative stress, and immunostimulation define important research priorities. Tests of the hypothesis that biodiversity equates with dietary diversity and health might combine quanti- tative indicators of dietary and biological diversity with nutrition and health outcomes. Biodiversity, where it is part of traditional agricultural and food systems, can be best conserved and enhanced through rational use within a broad-based developmental focus on small-scale and low-input production. The fact that traditional systems, once lost, are hard to recreate underlines the imperative for timely documentation, compilation, and dissemina- tion of eroding knowledge of biodiversity and the use of food culture for promoting positive behaviors.

Keesing F, Young TP. Cascading Consequences of the Loss of Large Mammals in an African Savanna. BioScience [Internet]. 2014;20 (10) :1-9. Publisher's VersionAbstract

African savannas are home to an abundant and diverse assemblage of wild herbivores, but the very grasses that sustain these wild herds also make savannas attractive to humans and their livestock. We used the Kenya Long-term Exclosure Experiment to investigate the ecological effects of different combinations of native and domestic grazers. The experimental removal of large grazing mammals set into motion a cascade of consequences, beginning with the doubling in abundance of a small grazing mammal, the pouched mouse (Saccostomus mearnsi). The presence of abundant mice attracted venomous snakes such as the olive hissing snake (Psammophis mossambicus); devastated seedlings of the dominant tree (Acacia drepanolobium); and doubled the abundance of fleas, which potentially increased the risk of transmission of flea-borne pathogens. Together, these results show the potential for the loss of large mammals to have cryptic consequences for African savannas, with important and often undesirable repercussions for humans.

Calderone NW. Insect Pollinated Crops, Insect Polliantors and US Agriculture: Trend Analysis of Aggregate Data for the Period 1992-2009. PLoS ONE. 2012;7 (5) :e37235.Abstract

In the US, the cultivated area (hectares) and production (tonnes) of crops that require or benefit from insect pollination (directly dependent crops: apples, almonds, blueberries, cucurbits, etc.) increased from 1992, the first year in this study, through 1999 and continued near those levels through 2009; aggregate yield (tonnes/hectare) remained unchanged. The value of directly dependent crops attributed to all insect pollination (2009 USD) decreased from $14.29 billion in 1996, the first year for value data in this study, to$10.69 billion in 2001, but increased thereafter, reaching $15.12 billion by 2009. The values attributed to honey bees and non-Apis pollinators followed similar patterns, reaching$11.68 billion and $3.44 billion, respectively, by 2009. The cultivated area of crops grown from seeds resulting from insect pollination (indirectly dependent crops: legume hays, carrots, onions, etc.) was stable from 1992 through 1999, but has since declined. Production of those crops also declined, albeit not as rapidly as the decline in cultivated area; this asymmetry was due to increases in aggregate yield. The value of indirectly dependent crops attributed to insect pollination declined from$15.45 billion in 1996 to $12.00 billion in 2004, but has since trended upward. The value of indirectly dependent crops attributed to honey bees and non- Apis pollinators, exclusive of alfalfa leafcutter bees, has declined since 1996 to$5.39 billion and $1.15 billion, respectively in 2009. The value of alfalfa hay attributed to alfalfa leafcutter bees ranged between$4.99 and \$7.04 billion. Trend analysis demonstrates that US producers have a continued and significant need for insect pollinators and that a diminution in managed or wild pollinator populations could seriously threaten the continued production of insect pollinated crops and crops grown from seeds resulting from insect pollination.

Civitello DJ, Cohen J, Fatima H, Halstead NT, Liriano J, McMahon TA, Ortega CN, Sauer EL, Sehgal T, Young S, et al. Biodiversity Inhibits Parasites: Broad Evidence for the Dilution Effect. PNAS [Internet]. 2015;112 (28) :8667-8671. Publisher's VersionAbstract

Infectious diseases of humans, wildlife, and domesticated species are increasing worldwide, driving the need to understand the mechanisms that shape outbreaks. Simultaneously, human activ- ities are drastically reducing biodiversity. These concurrent pat- terns have prompted repeated suggestions that biodiversity and disease are linked. For example, the dilution effect hypothesis posits that these patterns are causally related; diverse host communities inhibit the spread of parasites via several mecha- nisms, such as by regulating populations of susceptible hosts or interfering with parasite transmission. However, the generality of the dilution effect hypothesis remains controversial, especially for zoonotic diseases of humans. Here we provide broad evidence that host diversity inhibits parasite abundance using a meta- analysis of 202 effect sizes on 61 parasite species. The magnitude of these effects was independent of host density, study design, and type and specialization of parasites, indicating that dilution was robust across all ecological contexts examined. However, the magnitude of dilution was more closely related to the frequency, rather than density, of focal host species. Importantly, observa- tional studies overwhelmingly documented dilution effects, and there was also significant evidence for dilution effects of zoonotic parasites of humans. Thus, dilution effects occur commonly in nature, and they may modulate human disease risk. A second analysis identified similar effects of diversity in plantherbivore systems. Thus, although there can be exceptions, our results in- dicate that biodiversity generally decreases parasitism and herbiv- ory. Consequently, anthropogenic declines in biodiversity could increase human and wildlife diseases and decrease crop and forest production.

Rwego IB, Isabirye-Basuta G, Gillespie TR, Goldberg TL. Gastrointestinal Bacterial Transmission among Humans, Mountain Gorillas, and Livestock in Bwindi Impenetrable National Park, Uganda. Conservation Biology [Internet]. 2008;22 (6) :1600-1607. Publisher's VersionAbstract

Habitat overlap can increase the risks of anthroponotic and zoonotic pathogen transmission be- tween humans, livestock, and wild apes. We collected Escherichia coli bacteria from humans, livestock, and mountain gorillas (Gorilla gorilla beringei) in Bwindi Impenetrable National Park, Uganda, from May to Au- gust 2005 to examine whether habitat overlap influences rates and patterns of pathogen transmission between humans and apes and whether livestock might facilitate transmission. We genotyped 496 E. coli isolates with repetitive extragenic palindromic polymerase chain reaction fingerprinting and measured susceptibility to 11 antibiotics with the disc-diffusion method. We conducted population genetic analyses to examine genetic differ- ences among populations of bacteria from different hosts and locations. Gorilla populations that overlapped in their use of habitat at high rates with people and livestock harbored E. coli that were genetically similar to E. coli from those people and livestock, whereas E. coli from gorillas that did not overlap in their use of habitats with people and livestock were more distantly related to human or livestock bacteria. Thirty-five percent of isolates from humans, 27% of isolates from livestock, and 17% of isolates from gorillas were clinically resistant to at least one antibiotic used by local people, and the proportion of individual gorillas harboring resistant isolates declined across populations in proportion to decreasing degrees of habitat overlap with humans. These patterns of genetic similarity and antibiotic resistance among E. coli from populations of apes, humans, and livestock indicate that habitat overlap between species affects the dynamics of gastrointestinal bacterial transmission, perhaps through domestic animal intermediates and the physical environment. Limiting such transmission would benefit human and domestic animal health and ape conservation.

Wood CL, Lafferty KD, DeLeo G, Young HS, Hudson PJ, Kuris AM. Does Biodiversity Protect Humans Against Infectious Disease. Ecology [Internet]. 2014;95 (4) :817-832. Publisher's VersionAbstract

Control of human infectious disease has been promoted as a valuable ecosystem service arising from the conservation of biodiversity. There are two commonly discussed mechanisms by which biodiversity loss could increase rates of infectious disease in a landscape. First, loss of competitors or predators could facilitate an increase in the abundance of competent reservoir hosts. Second, biodiversity loss could disproportionately affect non- competent, or less competent reservoir hosts, which would otherwise interfere with pathogen transmission to human populations by, for example, wasting the bites of infected vectors. A negative association between biodiversity and disease risk, sometimes called the ‘‘dilution effect hypothesis,’’ has been supported for a few disease agents, suggests an exciting win–win outcome for the environment and society, and has become a pervasive topic in the disease ecology literature. Case studies have been assembled to argue that the dilution effect is general across disease agents. Less touted are examples in which elevated biodiversity does not affect or increases infectious disease risk for pathogens of public health concern. In order to assess the likely generality of the dilution effect, we review the association between biodiversity and public health across a broad variety of human disease agents. Overall, we hypothesize that conditions for the dilution effect are unlikely to be met for most important diseases of humans. Biodiversity probably has little net effect on most human infectious diseases but, when it does have an effect, observation and basic logic suggest that biodiversity will be more likely to increase than to decrease infectious disease risk.

Fiorella KJ, Camlin CS, Salmen CR, Omondi R, Hickey MD, Omollo DO, Milner EM, Bukusi EA, Fernald LCH, Brashares JS. Transactional Fish-for-Sex Relationships Amid Declining Fish Access in Kenya. World Development [Internet]. 2015;74 :323-332. Publisher's VersionAbstract

Women’s access to natural resources for food and livelihoods is shaped by resource availability, income, and the gender dynamics that mediate access. In fisheries, where men often fish but women comprise 90% of traders, transactional sex is among the strategies women use to access resources. Using the case of Lake Victoria, we employed mixed methods (in-depth interviews, n = 30; cross-sectional survey, n = 303) to analyze the influence of fish declines on fish-for-sex relationships. We found that fish declines affect relationship duration and women’s bargaining power. Our results have broad implications for the dynamics of economies dependent on increasingly scarce resources throughout the world.

Jones TG, Ratsimba HR, Ravaoarinorotsihoarana L, Cripps G, Bey A. Ecological Variability and Carbon Stock Estimates of Mangrove Ecosystems in Northwestern Madagascar. Forests [Internet]. 2014;5 :177-205. Publisher's VersionAbstract

Mangroves are found throughout the tropics, providing critical ecosystem goods and services to coastal communities and supporting rich biodiversity. Despite their value, world-wide, mangroves are being rapidly degraded and deforested. Madagascar contains approximately 2% of the world’s mangroves, >20% of which has been deforested since 1990 from increased extraction for charcoal and timber and conversion to small to large-scale agriculture and aquaculture. Loss is particularly prominent in the northwestern Ambaro and Ambanja bays. Here, we focus on Ambaro and Ambanja bays, presenting dynamics calculated using United States Geological Survey (USGS) national-level mangrove maps and the first localized satellite imagery derived map of dominant land-cover types. The analysis of USGS data indicated a loss of 7659 ha (23.7%) and a gain of 995 ha (3.1%) from 1990–2010. Contemporary mapping results were 93.4% accurate overall (Kappa 0.9), with producer’s and user’s accuracies 85%. Classification results allowed partitioning mangroves in to ecologically meaningful, spectrally distinct strata, wherein field measurements facilitated estimating the first total carbon stocks for mangroves in Madagascar. Estimates suggest that higher stature closed-canopy mangroves have average total vegetation carbon values of 146.8 Mg/ha (±10.2) and soil organic carbon of 446.2 (±36.9), supporting a growing body of studies that mangroves are amongst the most carbon-dense tropical forests.

Gallai N, Salles JM, Settele J, Vaissiere BE. Economic Valuation of the Vulnerability of World Agriculture Confronted with Pollinator Decline. Ecological Economics [Internet]. 2009;68 :810-821. Publisher's VersionAbstract

There is mounting evidence of pollinator decline all over the world and consequences in many agricultural areas could be significant. We assessed these consequences by measuring 1) the contribution of insect pollination to the world agricultural output economic value, and 2) the vulnerability of world agriculture in the face of pollinator decline. We used a bioeconomic approach, which integrated the production dependence ratio on pollinators, for the 100 crops used directly for human food worldwide as listed by FAO. The total economic value of pollination worldwide amounted to 153 billion, which represented 9.5% of the value of the world agricultural production used for human food in 2005. In terms of welfare, the consumer surplus loss was estimated between 190 and 310 billion based upon average price elasticities of 1.5 to 0.8, respectively. Vegetables and fruits were the leading crop categories in value of insect pollination with about 50 billion each, followed by edible oil crops, stimulants, nuts and spices. The production value of a ton of the crop categories that do not depend on insect pollination averaged 151 while that of those that are pollinator-dependent averaged 761. The vulnerability ratio was calculated for each crop category at the regional and world scales as the ratio between the economic value of pollination and the current total crop value. This ratio varied considerably among crop categories and there was a positive correlation between the rate of vulnerability to pollinators decline of a crop category and its value per production unit. Looking at the capacity to nourish the world population after pollinator loss, the production of 3 crop categories namely fruits, vegetables, and stimulants - will clearly be below the current consumption level at the world scale and even more so for certain regions like Europe. Yet, although our valuation clearly demonstrates the economic importance of insect pollinators, it cannot be considered as a scenario since it does not take into account the strategic responses of the markets.

Hanski I, Hertzen L, Fyhrquist N, Koskinen K, Torppa K, Laatikainen T, Karisola P, Auvinen P, Paulin L, Makela MJ, et al. Environmental Biodiversity, Human Microbiota, and Allergy are Interrelated. PNAS, Early Edition [Internet]. 2012. Publisher's VersionAbstract

Rapidly declining biodiversity may be a contributing factor to another global megatrendthe rapidly increasing prevalence of allergies and other chronic inflammatory diseases among urban populations worldwide. According to the biodiversity hypothesis,reduced contact of people with natural environmental features and biodiversity may adversely affect the human commensal microbiota and its immunomodulatory capacity. Analyzing atopic sensitization (i.e., allergic disposition) in a random sample of adolescents living in a heterogeneous region of 100 × 150 km, we show that environ- mental biodiversity in the surroundings of the study subjectshomes influenced the composition of the bacterial classes on their skin. Compared with healthy individuals, atopic individuals had lower environmental biodiversity in the surroundings of their homes and significantly lower generic diversity of gammaproteobacteria on their skin. The functional role of the Gram-negative gammaproteobacteria is supported by in vitro measurements of expression of IL-10, a key anti-inflammatory cytokine in immunologic tolerance, in peripheral blood mononuclear cells. In healthy, but not in atopic, individuals, IL-10 expression was positively correlated with the abundance of the gammaproteobacterial genus Acinetobacter on the skin. These results raise fundamental questions about the consequences of biodiversity loss for both allergic conditions and public health in general.

Hough RL. Biodiversity and Human Health: Evidence for Causality. Biodivers Conserv [Internet]. 2014;23 :267-288. Publisher's VersionAbstract

The Millennium Ecosystem Assessment and other commentators have warned about the impacts that biodiversity decline will have on human health. There is no doubting that the natural world provides mankind with the majority of the resources required to sustain life and health. Many species provide food, fuel, medicines; with the potential for many more (as of yet) undiscovered uses for various species. Despite this, there have been very few attempts to actually investigate relationships between biodiversity (i.e. number of species, rather than the ability of specific species to provide health benefits) and human health. This paper reviews the available evidence and demonstrates that while the links between biodiversity and health seem intuitive, they are very difficult to prove. Socio- economics has a huge influence on health status and the exploitation of natural resources (leading to eventual biodiversity loss) tends to have a positive economic effects. More direct effects of biodiversity on health include the diversity of the internal microbiome, the effect of natural diversity on our mental health and well-being (although this has large social aspects with many people feeling fearful in very diverse environments). Still to be elucidated are the tipping points where the level of global biodiversity loss is such that human health can no longer be sustained.

Salkeld DJ, Padgett KA, Jones JH. A Meta-analysis Suggesting that the Relationship Between Biodiversity and Risk of Zoonotic Pathogen Transmission is Idiosyncratic. Ecology Letters [Internet]. 2013. Publisher's VersionAbstract

Zoonotic pathogens are significant burdens on global public health. Because they are transmitted to humans from non-human animals, the transmission dynamics of zoonoses are necessarily influenced by the ecology of their animal hosts and vectors. The ‘dilution effect’ proposes that increased species diversity reduces disease risk, suggesting that conservation and public health initiatives can work synergistically to improve human health and wildlife biodiversity. However, the meta-analysis that we present here indicates a weak and highly heterogeneous relationship between host biodiversity and disease. Our results suggest that disease risk is more likely a local phenomenon that relies on the specific composition of reservoir hosts and vectors, and their ecology, rather than patterns of species biodiversity.

Morand S, Jittapalapong S, Suputtamongkol Y, Abdullah MT, Huan TB. Infectious Diseases and Their Outbreaks in Asia-Pacific: Biodiversity and Its Regulation Loss Matter. PLoS ONE [Internet]. 2014;9 (2) :e900932. Publisher's VersionAbstract

Despite increasing control measures, numerous parasitic and infectious diseases are emerging, re-emerging or causing recurrent outbreaks particularly in Asia and the Pacific region, a hot spot of both infectious disease emergence and biodiversity at risk. We investigate how biodiversity affects the distribution of infectious diseases and their outbreaks in this region, taking into account socio-economics (population size, GDP, public health expenditure), geography (latitude and nation size), climate (precipitation, temperature) and biodiversity (bird and mammal species richness, forest cover, mammal and bird species at threat). We show, among countries, that the overall richness of infectious diseases is positively correlated with the richness of birds and mammals, but the number of zoonotic disease outbreaks is positively correlated with the number of threatened mammal and bird species and the number of vector-borne disease outbreaks is negatively correlated with forest cover. These results suggest that, among countries, biodiversity is a source of pathogens, but also that the loss of biodiversity or its regulation, as measured by forest cover or threatened species, seems to be associated with an increase in zoonotic and vector-borne disease outbreaks.

Johnson PTJ, Preston DL, Hoverman JT, Richgels KLD. Biodiversity Decreases Disease through Predictable Changes in Host Community Competence. Nature [Internet]. 2013;494 :230-234. Publisher's VersionAbstract

Accelerating rates of species extinctions and disease emergence underscore the importance of understanding how changes in bio- diversity affect disease outcomes. Over the past decade, a growing number of studies have reported negative correlations between host biodiversity and disease risk, prompting suggestions that biodiversity conservation could promote human and wildlife health. Yet the generality of the diversity–disease linkage remains conjectural, in part because empirical evidence of a relationship between host competence (the ability to maintain and transmit infections) and the order in which communities assemble has proven elusive. Here we integrate high-resolution field data with multi-scale experiments to show that host diversity inhibits transmission of the virulent pathogen Ribeiroia ondatrae and reduces amphibian disease as a result of consistent linkages among species richness, host composition and community competence. Surveys of 345 wetlands indi- cated that community composition changed nonrandomly with species richness, such that highly competent hosts dominated in species-poor assemblages whereas more resistant species became progressively more common in diverse assemblages. As a result, amphibian species richness strongly moderated pathogen transmission and disease pathology among 24,215 examined hosts, with a 78.4% decline in realized transmission in richer assemblages. Laboratory and mesocosm manipulations revealed an approxi- mately 50% decrease in pathogen transmission and host pathology across a realistic diversity gradient while controlling for host density, helping to establish mechanisms underlying the diversity–disease relationship and their consequences for host fitness. By revealing a consistent link between species richness and community competence, these findings highlight the influence of biodiversity on infection risk and emphasize the benefit of a community-based approach to understanding infectious diseases.

Keune H, Kretsch C, Blust DG, Gilbert M, Flandroy L, Berge KVD, Versteirt V, Hartig T, Keersmaecker LD, Eggermont H, et al. Science-policy Challenges for Biodiversity, Public Health, and Urbanization: Examples from Belgium. Environ Res Lett [Internet]. 2013;8. Publisher's VersionAbstract

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human–nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem–human/public health–urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed.

Zaghi D, Calaciura B, Spinelli O, Basili M, Romi R. Literature Study on the Impact of Biodiversity Changes on Human Health. Comunita Ambiente; 2010. Publisher's VersionAbstract

Maintaining biodiversity underpins the stability of ecosystems and the services that they supply to the community, such as food, drinking water, clean air, control of disease and raw materials for the development of medicinal drugs. These are essential to human health.

The objective of this literature study is to provide an overview of existing information concerning the impacts of changes in biodiversity and ecosystems on two services related to human health: regulation of infectious diseases and provision of medicines.