Integration of medical service provision and nature conservation worldwide 1980–2022: collaborative evidence mapping of 43 projects across 22 countries

Background Biodiversity protection is fundamental to human wellbeing, and, in turn, serving human health in medically underserved areas can sometimes strengthen conservation. We aimed to collaboratively map the evidence on projects worldwide that are, or have been, providing health services with the intention of producing conservation outcomes in addition to health improvements. Methods Scoping indicated many NGO projects are never published in the academic literature. To avoid missing such interventions we asked conservation staff worldwide to contribute data online or through zoom calls. Advertising to join the collaboration was through formal networks (International Union for Conservation of Nature, Planetary Health Alliance, etc.), professional contacts, funders, and a call in The Lancet Planetary Health. Additionally, data and literature were synthesised from libraries and datasets of collaborators at Population Reference Bureau, Sussex Sustainability Research Programme, and Ecological Levers for Health. Findings Forty-three projects from 22 countries fitted inclusion criteria. Around half had not been published in the collected literature, with data only available through direct submission. Tropical wet forest was by far the most common habitat, followed by tropical dry forest, coral reefs, and tropical grasslands. The most represented region was Sub-Saharan Africa with 27 projects, followed by South-East Asia (five), South Asia (five), Oceania (two), South America (two), Central America (one), Europe (one). Projects ranged from basic health interventions bolted on to pre-existing conservation programmes to generate goodwill (e.g., vaccination rounds bordering national parks) to complex schemes jointly acting on health and biodiversity driven (and funded) by concerns for human welfare as much as conservation. Interpretation Synergistic action on biodiversity conservation and health service provision is very often effective and the approach is more widespread than literature would indicate. However, funding was usually provided on a siloed basis for either health or conservation, and this remains a barrier to wider adoption.