Linking Biodiversity with Health and Well-being: Consequences of Scientific Pluralism for Ethics, Values and Responsibilities

Abstract

This paper investigates the ethical implications of research at the interface between biodiversity and both human and animal health. Health and sanitary crises often lead to ethical debates, especially when it comes to disruptive interventions such as forced vaccinations, quarantine, or mass culling of domestic or wild animals. In such debates, the emergence of a “Planetary health ethics” can be highlighted. Ethics and accountability principles apply to all aspects of scientific research including its technological and engineering applications, regardless of whether they are considered “hard sciences”, such as state-of-the-art technology in the fields of medicine, veterinary medicine, agronomy, or environment, or “soft”, such as local or global governance, health, socio-ecosystems, and the environment. Ethical reflection in the interdisciplinary field of biodiversity and health requires the examination of relevant scientific domains, such as biology, ecology, evolution, human medicine, animal medicine, anthropology, and law, and their epistemology and representation as well as scientific pluralism, which is crucial to establish genuine interdisciplinarity. Navigating the ethics-scape necessitates going beyond the hierarchy of science by recognising that scientific knowledge has implications for both scientific and non-scientific perspectives on the study of nature. The example of a Nipah virus outbreak is used to illustrate how the so-called “modern epidemiological” approach often focuses on risk factors associated with individual behavioural characteristics or collective practices, whereas the so-called “eco-social” approach focuses on global, socio-economic, and environmental factors that are the contextual causes of the health problem affecting the community. “Modern epidemiologists” aim to “correct” individual or practice factors using a “minimal set” of ethics, whereas “eco-social” scientists have to act systemically, which requires integrated research that acknowledges scientific pluralism, avoids the hierarchy of sciences, but accepts the pluralism of ethics and values.

Introduction

Major health crises, such as the last Ebola epidemic in West Africa or the ongoing epidemic in Central Africa, often lead to ethical debates regarding public health interventions in times of crisis. These debates are particularly heated when these interventions rely on forced quarantine or the use of new vaccines that have not yet been registered or, for veterinary sanitary crises, when these interventions result in the mass slaughter of infected as well as non-infected domestic or wild animals, promulgated as a measure to eradicate infectious diseases. Ethical responses to these public health crises have been assigned different labels, including “One Bioethics” (Thompson and List 2015), “One Health ethics”, and “Global Health ethics” (Goldberg and Patz 2015), but there is no consensus among bioethicists as to what they mean (Verweij and Bovenkerk 2016).

These major crises are related to zoonotic diseases often involving wildlife reservoirs, which questions the scientific practices and attitudes in conservation biology (as applied to endangered and/or protected species or pristine habitats), the rise of conservation medicine (Aguirre et al. 2012), and more broadly, biodiversity. We refer here to Norton (2006, quoted by Maier 2012, at 9) who stated that biodiversity:

must … capture all that we mean by, and value in, nature, [which should also comprise the] highly managed and manipulated landscapes or the products of genetic manipulation, [which] might plausibly contribute to the plus column of the biodiversity ledger.

Ethical principles apply to all aspects of scientific research including its technological and engineering applications, regardless of whether they are considered “hard science”, such as state-of-the-art technology in the fields of medicine, veterinary medicine, agronomy, or environment, or “soft science”, such as local or global governance of health, socio-ecosystems, and the environment. For instance, the development of new technologies, such as gene editing (CRISPR-Cas9) and the creation of hyper-virulent pathogens (through “gain-of-function” mutation) raise ethical issues and responsible research challenges regarding the consequences of these new technologies for society and the environment (Courtier-Orgogozo et al. 2017; Lipsitch and Galvani 2014).

Ethical reflection in the field of biodiversity and health requires examining the relevant scientific domains (i.e. biology, ecology, evolution, human medicine, animal medicine, anthropology, and juridical science), their epistemology, and the need for scientific pluralism already advocated in several specific scientific domains such as evolutionary biology or health ecology (Dieckmann and Doebeli 2005; Morand and Lajaunie 2017). Scientific pluralism is essential to establish genuine interdisciplinarity and requires the values, practices, and impact of each constituent field to be evaluated.

Here, we do not pretend to be exhaustive, but only to present an overview of how such ethical frameworks could be considered in interdisciplinary research and their implications in the daily work of a researcher. We emphasise that linking biodiversity and health commands the recognition of scientific pluralism, which implies the acceptance of a pluralism of values and ethical approaches.

Knowledge Creation: Beyond the “Hierarchy of Sciences”

Auguste Comte described that the scientific progress passes through successive development stages, from astronomy followed by physics, chemistry, biology, and lastly, sociology, presenting a “hierarchy of sciences”. Kuhn (1970) developed a different view and classified the sciences according to the state of development of their paradigm and the sharing of theoretical structures and methodological approaches knowing a high level of consensus among researchers. Cole (1992) explained that the “hierarchy of sciences” of Comte describes not only the complexity of the phenomena studied by different sciences but also their stage of “intellectual development”, leading to the distinction between “hard” natural sciences and “soft” social sciences. Cole (1992) provided a more critical approach to the hierarchy of science. The sciences do not differ on the reality of different fields and forms of their scientific practices, but on the subjective perceptions of their domains and of their forms of practice (Table 1).

Table 1.

Characteristics of the different types of sciences (adapted from Cole 1992) and their links to the positivism of Auguste Comte and his “hierarchy of sciences”

Characteristics	“Top” of the hierarchy	“Bottom” of the hierarchy
1. Development of theory	Highly developed theory; paradigm-driven research; high levels of codification	No theory or weak generalisation; pre-paradigmatic phase; low levels of codification
2. Quantification	Ideas expressed in mathematical language	Ideas expressed in words
3. Cognitive consensus	High levels of consensus on theory, methods; importance of problems; importance of individual contribution	Low levels of consensus on theory, methods; importance of problems; importance of individual contribution
4. Prediction	Possibility of using theory to make verifiable predictions	Inability to make verifiable predictions
5. Obsolescence rate	High proportion of references to recent work; rapid obsolescence of previous work; significant accumulation of knowledge	Low proportion of references to recent work; old works remain as important as new ones; low knowledge accumulation
6. Rate of growth	High rate of increase of new knowledge	Low rate of increase of new knowledge

The “hierarchy of sciences” leads to the problem of scientific monism, which is defined by Kellert et al. (2006, at 15) as

the ultimate goal of a science, which is to establish a single and complete account of the natural world (or part of the world studied by this science) on the basis of a single set of fundamental principles; the existence of investigative methods which, if properly pursued, will produce such a report and that these methods of investigation must be accepted on the basis of their ability to produce such a report.

Kellert et al. (2006) further defined scientific pluralism as the multiplicity of approaches that is characterised by many fields of scientific enquiry. As a more holistic approach that borrows from different fields, scientific pluralism defies the scientific hierarchy and reinforces interdisciplinarity. Miller et al. (2008) also emphasised that scientific pluralism supports a more integrative approach to research. Pluralism in studies on the management of socio-ecological systems may avoid the predominance of a scientific domain, or the emergence of a “hierarchy of sciences”, which obstructs integrated research. But to achieve this, scientific pluralism necessitates an understanding of the epistemology and representations of the disciplines that are being integrated (Table 2).

Table 2.

The metaphors of scientific knowledge and their implications for studying nature (adapted from Miller et al. 2008)

Knowledge as the study of mechanisms	Knowledge as contingent	Knowledge as narrative
Belief in objectivity, replicability. Knowledge acquired through the scientific method seeks to demonstrate causality and allow prediction.	Importance of agent and context. Knowledge seeks causality; it is based on behaviour, variability in relation to social norms.	Interpretive and critical knowledge. Knowledge is inherent to the object and represents values that can be shared or held individually.
Nature is a mechanism	Nature is a complex adaptive system	Nature is built

Scientific pluralism recognises the plurality of scientific representations and narratives. However, to avoid relativism, some authors have proposed that the principle of scientific impartiality (Lacey 1999) be introduced. Impartiality is constitutive of science and must be reflected in the cognitive or epistemic criteria of acceptance or rejection of a scientific theory, and not on social, ethical, or aesthetic values. Lechopier (2011), revisiting Lacey, pointed out that

the concept of impartiality analysed forms the basis of a realistic epistemology of scientific knowledge: it is possible, by guiding the inquiry into cognitive values, to know the reality, it is independent of any other value judgement.

However, it is highly questionable if these social, ethical, and aesthetic values should always be left out in the interest of “impartiality”. The impartiality in science was stated in opposition to post-modern philosophers who emphasise the impossibility of developing scientific activity without drawing on the values-based representations that circulate in societies.

A renewed scientific pluralism should better acknowledge the importance of the social, ethical, and aesthetic values that are mostly outside of the current scientific practices. One way is to promote values-based evaluation together with scientific-based evaluation. Both evaluations may help researchers whose activities are at the interface between biodiversity, animal health and public health, and those who investigate and navigate at the interface of communities, animals, nature, and various knowledge practices. Therefore, a renewed scientific pluralism will also require questioning the ethics and the values of the contributing sciences.

The “Ethics-scape” and the Diversity of Ethical Approaches

Kernohan (2012) explains that ethical evaluation could be directed at the moral agent concerned, the principles that have guided the action, or on the consequences of the action in terms of benefits and harms. In addition, different ethical approaches could be applied.

For instance, virtue ethics focuses on the character of the moral agent and has been related to the ethics of “care” for human or animal welfare (Jeangène Vilmer 2008). An ethical approach in deontology focuses on principles that guide and evaluate an action based on its compliance with universal moral obligation rules that the action must respect (Jeangène Vilmer 2008). Such an approach has some similarities to the attribution of moral responsibilities by drawing reference to divine entities, or religious doctrines, or to an entity like “Mother Nature” (Roach 2003), which appears to be the case for certain approaches in environmental ethics (Peterson 2001) or biodiversity ethics (O’Brien 2010).

This may be contrasted with an ethical approach in consequentialism, which emphasises the consequences of an action and more specifically as to whether the best possible consequences are produced (Jeangène Vilmer 2008; Kraut 2009). For a utilitarian like Jeremy Bentham or John Stuart Mill, these consequences are assessed on the extent that the happiness or well-being of individuals are maximised (Kraut 2009). By this approach, harm may be inflicted if a greater good is achieved. An example is animal experimentation, where the suffering and death of the animal experimented upon is tolerated if the result contributes to the improvement of human health. Applied to public health crises, the culling of some animals is acceptable for the protection of the health of other ones or of human health.

Kernohan (2012) pointed out that each case involves a moral questioning of the consequences of an action on the recipient(s), which raises specific ethical considerations when it comes to livestock and wild animals, habitat, or ecosystems because of the intimate interrelationships and interdependence between human beings, their domesticated animals and nature. Any action on human beings, animal, or elements of nature may have a predictable and unpredictable impact. Such consequences in complex sociological and natural systems have specific implications on notions of responsibility towards nature, as described by Passmore (1980; Hooker 1992).

Humanism and Human Health Ethics

Ethical principles that guide medical practice and research (Beauchamp and Childress 1994; Gillon 1994) imply a common morality for all of humankind that embodies responsibilities for all. This universalism implies a consensus on the moral principle and some general norms while recognising that responsibilities have a global scope (Boyle 2006). This moral universalism may come up against the recognition of cultural diversity, as Engelhardt (2006) underlined in the Declaration on Bioethics and Human Rights (UNESCO 2005). Article 10 of the declaration states that “The fundamental equality of all human beings in dignity and rights is to be respected so that they are treated justly and equitably”, and Article 12 stipulates that

The importance of cultural diversity and pluralism should be given due regard. However, such considerations are not to be invoked to infringe upon human dignity, human rights, and fundamental freedoms nor upon the principles set out in this declaration, nor to limit their scope.

According to Engelhardt (2006), the UNESCO declaration reflects the false assumption of a consensus from morality experts, which should be similar to that of a scientists’ consensus. Bioethics is therefore a “field of controversy”, a consequence of the existence of moral pluralism. There are significant moral disagreements on substantive issues, which are not resolved through rational arguments as in the case of scientific controversies (Engelhardt 2006).

The principle of respect for persons is an example of moral universalism. Persons must be treated with dignity, as well as with the authenticity and honesty of the action, through the notion of “informed consent”, which is based on the moral principles set out above (Faden 1986). Obtaining the informed consent of individuals presupposes that they have the knowledge to understand the objectives of the research being conducted and the benefits and potential harms, which will be withdrawn individually or collectively. However, informed consent may question the ethics of anthropological research, not only on how we can be sure that any individual has clearly understood the potential benefits and harms caused by the research (epidemiological surveys or clinical trial) but also on how the collective consent, where applicable, can be effectively assumed.

Animals and Animal Health Ethics

The ethics of animal health is different from that of human health in the fact that an animal is not regarded as a “moral being” but as a “sentient being” (Broom 2014) to which utilitarian principles apply. These principles date back to Jeremy Bentham and prior to him, Jean-Jacques Rousseau, who both stressed the duties of humans towards animals, as Jeangène Vilmer (2008) reminded us. Animal ethics considers animal suffering and death as harm that must be avoided or minimised (in breeding as well as in research) and is generally concerned with promoting animal welfare. Research in ethology and stress physiology have helped to inform animal ethics and have contributed to the setting up of ethics committees for research involving laboratory and wild animals. The guiding principles of using animals in scientific research refer to the three “Rs”, i.e. Replacement, Reduction, and Refinement, as originally described by Russell and Burch (1959). These principles have been formalised in animal law, which deals with the legal status of domestic and wild animals and affirmed in animal ethics, animal welfare, and humanistic ethics (Smulewicz-Zucker 2012).

Veterinary ethics is different from animal ethics due to the fact that the veterinarian interacts not only with the animal but also with the client (farmer, private individual, and more often company) and with society (public health, agriculture, and trade). A veterinarian can thus find himself or herself in situations where he or she does not provide care but where he or she advocates quarantine or mass slaughter, as in the management of infectious epidemics and sanitary crises affecting livestock or poultry farms. The development of informed consent in veterinary ethics is thus more concerned with the interactions of veterinary researchers with breeders or any other group of people than with the animals themselves, which are the movable property of owners.

In contrast, animal ethics concerns sentient living beings and makes animal suffering its main concern (Singer 1975). It poses the question of specism and therefore of anthropocentrism, of animals as a moral subject (as in the case of chimpanzee or gorilla) or as individuals “subject of a life” (Regan 2003). Animal ethics questions not only on the basis of animal welfare principles (animal bioethics) or environmental safety (the precautionary principle) but also on the basis of recognition of the status of a moral subject or animal subject to its own life, which may lead to giving rights to animals (Regan 2003; Donaldson and Kymlicka 2011).

Environmental Ethics

International law has evolved to recognise the right of humans to a decent, healthy, and sustainable environment. Thus, a charter adopted in 2007 highlighted that (Paris Appeal 2007, quoted by Taylor 2008, at 96)

To promote environmental ethics, we are calling for the adoption of a Universal Declaration of Environmental Rights and Duties. This common charter will ensure that present and future generations have a new human right to a sound and well-preserved environment.

The charter raises the question of a balance that must be found between rights, duties, and responsibilities. It also questions the place of anthropocentrism, which is inherent in human rights, in the environment. For some commentators, the very existence of human rights in the environment reinforces the idea that the environment and natural resources only exist for human purposes and have no intrinsic value and ultimately create a hierarchy where humanity holds a superior position over other members of the natural community (Taylor 2008; Maris 2010). This vision is present in many of the studies in which the state of the environment is determined by human needs (living standards, natural resources, and health) and not by the needs of other species or the importance and ecological significance of complex interactions between species and the environment. These contradictions of needs reflect the contradictions of scientific and non-scientific representations and perceptions of nature.

The development of environmental ethics addresses new questions about non-sensitive living entities, such as plants or complex entities such as ecosystems. Rolston (1992) defined environmental ethics based on the principles of respect for plants and animals, endangered species, and ecosystems. Thus, contrary to humanistic ethics, which consider ecosystems based on their contributions to human well-being, environmental ethics consider ecosystems to have a broader value by contributing to human well-being, animal experience, and plant life. Thus, the task of environmental ethics is to “preserve the integrity, stability, and beauty of the biotic community” (Rolston 1992).

It is not possible to cover the entire history of philosophy and environmental ethics (Leopold 1949; Nash 1989; Foster 1997; Perterson 2001; Kernohan 2012), which would include cultural diversity (Maffi 2005), the rights of indigenous people (Low 1999), ecofeminism and the ethics of care (Warren 1997), deep ecology (Naess 1989), Marxist ecology (Foster 2007; Foster et al. 2010; Moore 2015), evolutionary ethics (Scott 2011), biophilia (Wilson 1984), bioregionalism (McGinnis 1999; Berg, in Glotfelty and Quesnel 2015), and up to the most recent debates (Rolston 2012; Maier 2012; Callicott 2013). Rather, we want to emphasise that the most important aspect is the point of view, whether this be individual or collective/community (Table 3).

Table 3.

The categories of environmental ethics (adapted from Hooker 1992). These categories and points of view must be linked to the representations of nature (Table 2)

Point of view	Anthropocentrism	Ecocentrism
Individual	Liberal ecologism (market economy) (see Foster et al. 2010), rights of nature (see Nash 1989)	Animal rights* (Regan 2003; Donaldson and Kymlicka 2011)
Community	Cultural diversity (Maffi 2005), ecofeminism (Warren 1997), Marxist ecology (Foster et al. 2010), justice (Low and Gleeson 1998), rights of indigenous peoples (Low 1999)	Earth ethics (Leopold 1949; Callicott 2013), biophilia (Wilson 1984), deep ecology (Naess 1989), bioregionalism (Berg, in Glotfelty and Quesnel 2015)

*Some of them could refer to antispecism

Animal ethicists often take the individual animal as a point of view for their moral status, whereas environmental ethicists emphasise the moral status of living groups or ecosystems as the basis of ethical obligations towards individuals (Verweij and Bovenkerk 2016) (Table 3). Fundamentally, environmental ethics is anthropocentric because it emphasises that only a flourishing biodiversity may sustain human societies. On the reasoning that biodiversity contributes to health and well-being of humans, human health ethics and animal health ethics are both contained within the broad framework of environmental ethics.

Considering Global and Applied Environmental Ethics

The different perceptions of nature are envisioned in environmental engineering, particularly, in the control of agricultural “pests” and the control of vectors and reservoirs of infectious diseases (such as bats). In “The Control of Nature”, John McPhee (quoted by Roach 2003) mentioned a documentary on the United States Army Corps of Engineers in which they presented their fight against “Mother Nature” for flood control along the Mississippi River through management of the river’s course, as (Roach 2003, 117),

This nation has a large and powerful adversary. Our opponent could cause the United States to lose nearly all her seaborne commerce, to lose her standing as first among trading nations ... We are fighting Mother Nature ... It’s a battle we have to fight day by day, year by year; the health of our economy depends on victory.

Environmental action is confronted with ambivalence towards nature and this image of Mother Nature in the form of three representations, as summarised by Roach (2003), “Nature is our sweet mother; she loves us, and we her. Nature is our treacherous enemy; she needs taming, now. Nature is our wounded victim; we must heal her who has given us life”.

Environmental ethicists advocate the need for change in consciousness, attitudes, thoughts, models, beliefs, and world view. Their environmental ideas are often borrowed from Asian or Native American philosophical and religious traditions and can be adopted as a therapy for the global crisis (Callicott and Ames 1989). The ethics of the planet as a “medicine” for the planet was already present in land ethics of Leopold (1949). However, neither individual change nor a purely scientific approach is enough to guide human actions in the face of the environmental crisis (Paavola and Lowe 2005). Hence, the concept of stewardship emerged from environmental ethics as a principle for managing the care of the environment as opposed to its selfish exploitation (Attfield 1999). Stewardship postulates that humans are a sort of shop steward, tenant, conservator, or tutor, which implies to possess a prominent level of concern for the present and for the future. Good stewardship requires justice, truth, sensitivity, and compassion.

Planetary stewardship, or Earth stewardship, requires integrating scientific and traditional ecological knowledge, emphasising that biocultural diversity is not a collection of biological, physical, or cultural objects (Maffi 2005). Incorporating scientific knowledge and traditional ecological knowledge is a dynamic process, sometimes a source of conflict, but requires intercultural dialogue and negotiation (Rozzi et al. 2015a, b) and to learn from ecologies of the others (Descola 2005, 2011). This view of the environmental ethics of planetary stewardship explicitly refers to non-Western philosophies, and Amerindian ones in this case, for the conceptual framework of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (Díaz et al. 2015a, b). Earth stewardship needs to integrate intercultural, interdisciplinary, interinstitutional, and international processes that generate forms of co-management of ecosystems, ultimately avoiding the “tragedy of the commons” (Ostrom 1990). The maintenance of the integrity of ecological systems is envisioned as emerging ecological processes of a complex system (Crabbé and Manno 2008).

The concept of “ecological solidarity” (Mathevet 2012), which falls between an ecocentric and an anthropocentric worldview, recognises that humans are tied up by an ecological solidarity regarding their dependencies on their environment (Thompson et al. 2011). According to its promotors, the concept of ecological solidarity may help to consolidate ecological and social interdependence in biodiversity policy. In a way, ecological solidarity is a “local” (perhaps more modest) application of the Earth stewardship.

The vision of global governance raises other ethical and legal conflicts. The United Nations Sustainable Development Goals (2015) constitute global objectives, including health, the environment, and biodiversity, but universal multilateralism can be rejected by nation states (Mackey 2008). Rozzi et al. (2015a, b) stressed that the integration of ethics and ecological sciences must occur through environmental citizenship, but cosmopolitan environmental ethics with the notion of environmental citizenship may prove to be contradictory with the loyalty that citizens owe to their nation state (Dower 1998; Mackey 2008).

Incorporating biodiversity together with poverty reduction and health, the sustainable development goals highlight the different conceptions and values of good, nature, justice, public policy, and priorities regarding sustainable development, environmental justice, and ethics (Table 4) (Kandil 2012, 2017). Whether for scientific knowledge creation or governance, the ethical and other values-based landscapes should be considered. Health crises involving zoonotic agents (i.e. the pathogens that circulate between animals), wild or domestic, and humans offer matter for reflection. The urgency of the public health and political responses to the threats often leads to what we may consider to be a “minimal set” of ethics: human health ethics and veterinary ethics. Scientific knowledge gained from the study of health crises and their management may help improve governance through better compliance with a broader set of ethical values. However, this incremental approach to better “ethical” governance necessitates that scientists first acquire the competence to navigate in the normative landscape.

Table 4.

Typology of the conceptions of sustainable environment (after Kandil 2017)

	Sustainable development	Environmental justice	Environmental ethics
Idea of good	Good is well-being (material conditions)	Good is good life in society (demands for social justice)	Good is the newfound harmony of human being with nature
Idea of nature	Nature is a capital (with possible substitution between natural capital and technological capital)	Nature is a capital, but some resources are neither renewable nor substitutable	Nature has an intrinsic value (nature is sacred)
Idea of distributive justice	Equality must relate to satisfactions of human needs	Equality concerns the respect for rights and freedoms	Justice concerns the equal respect due to all that emanate or are constitutive of nature
Community of justice	Humans of present and future generations	The human and non-human beings of the present generations	The human and non-human beings of past, present, and future generations
Purpose of a just (fair) public action	Promote intergenerational well-being	Fight against inequalities in the face of environmental risks and nuisances	Fulfilling our duties towards nature
Priorities for sustainable public action	Ensure a sustainable growth	Develop environmental rights	Protect nature

Necessity of Pluralism of Ethics: An illustrative Example

As Hooker (1992) noted, every aspect of life is filled with tensions and these tensions also concern ethics. How scientific results are communicated and how they are interpreted and used by public health authorities can have important consequences. For example, saying that wild birds (in the case of H5N8 avian influenza outbreaks) or bats (in the case of Ebola and Nipah outbreaks) are the “key” players for these epidemics that can lead to policy decisions with negative consequences on wildlife (such as the promotion of culling measures). If wildlife is the effective reservoirs of viral diversity and therefore the biological origin of pathogens, the transmission of viruses to livestock or humans should be envisioned by the socio-ecosystem approach (including management practices and governance) and the origin of a health crisis through the socio-politics responses.

The Nipah virus outbreak in Malaysia in 1998 is relevant to our discussion as it illustrates the impact of globalisation on intricate relationship between global health and ecology. The health crisis caused by the Nipah virus resulted from changes in the farming and ecological systems in Southeast Asia. In September 1998, a strange epidemic broke out in pig farms in peninsular Malaysia. Many animals showed signs of infection, and soon thereafter, breeders contracted severe haemorrhagic fevers. The epidemic then spread to slaughterhouses in Singapore, where the infected pigs were imported from Malaysia. Epidemiological investigations demonstrated the role of frugivorous bats as reservoirs of the infectious agent, the Nipah virus. This health crisis resulted in the deaths of 106 out of 205 people infected with the virus and the slaughter of 1.1 million pigs was considered necessary by health authorities to stop the epidemic (Looi and Chua 2007). The epidemic was declared under control in March 1999. Retrospective epidemiological analyses explained how a virus hosted by fruit bats has been able to infect pigs in a country where a majority of its population does not consume this animal due to religious precepts, cross the species-barrier to infect pig farmers, and move on to slaughterhouse staff in another country (Chua 2003).

Let us consider the context. In 1998, the island of Borneo suffered from many forest fires of anthropic origin. These fires were worsened by an exceptional drought due to a strong El Niño, an event of climatic variability that disrupted the normal regime of the tropical monsoon. The island of Borneo has been heavily deforested to make way for oil palm plantations. Fires were also voluntarily maintained to increase land that could be subsequently used for plantation. Faced with the reduction of their territories, the fruit bats went in search of new areas, such as rural areas repurposed as pig farms for the Asian market. The conversion of Borneo’s tropical forests to oil palm plantations for the international market has brought bats into contact with pigs, also destined for the international market. Bats transmitted their viruses to humans due to the alteration of their original habitats and their new cohabitation with agricultural and animal productions. This unexpected transmission of a virus from bats to pigs and ultimately to humans is indicative of the effects of globalisation on biodiversity and, in turn, on the occurrence of major health crises. The Nipah virus outbreak is one of those health crises that is the result of changes in agronomic and ecological systems brought about by international trade (Morand 2018).

A health crisis is a disease made visible to the public and to the health actors, independent of the number of people or animals infected. Recognising a health crisis generates a political response. In the case of the Nipah virus outbreak of 1988, the response involved the slaughter of hundreds of thousands of animals to control the epidemic and also the establishment of quarantine to limit the movement of animals and people (Lo Presti et al. 2016)1. It may call for culling of wild animals in order to control the disease, as the Australian government proposed in response to outbreaks of another bat-borne disease, the Hendra virus (Olival 2016). Disease ecologists have instead advocated for other prevention measures, such as changing agricultural practices and behaviour in the more recent Nipah virus outbreak in Bangladesh (Gurley et al. 2017). Integrated measures at the interface between human health, animal health and environment are examples of the One Health approach. Other environmental scientists advocate to tackle the origins of outbreaks by recognising that the modifications of the socio-ecosystem may have led to critical boundary limits beyond the ability of healthy functioning ecosystem to regulate disease transmission (Living with Resistance project 2018). In this connection, the Planetary health approach represents a scientific initiative to pinpoint responsibilities in managing the socio-ecosystems.

The Nipah virus example demonstrates the importance of different values of various factors that could come into conflict. The fields of public, animal, and environmental health research, and in particular, epidemiology (and its various branches), determine the choice of variables, parameters, and factors that are considered to be relevant enough to study and select those of strategic choices (Lacey 1999). The so-called “modern epidemiological” approach often focuses on risk factors associated with individual behavioural characteristics or collective practices. This approach makes it possible to apply targeted action to “correct” individual or practice factors. The so-called “eco-social” approach focuses on global, socio-economic, and environmental factors, which are the contextual causes of the considered health problem that affects a community. Whereas “modern epidemiology” will base their activities on a “minimal set” of ethics (i.e. human health ethics and veterinary ethics), the “eco-social” scientists should act at the systemic level, which requires ethical pluralism (and framed in the environmental ethics).

Conclusion

The quality of goods and services that ecosystems provide to human societies depends on their good condition and functioning. This implies an analogy of “good health” in ecosystems. Proper functioning of the planet’s ecosystems requires continuous “adaptation” of modern societies through governance and stewardship, and in a way that maximises both the levels of well-being and health and biodiversity. Such an objective requires taking into account values that are conferred by Global Health ethics.

Such ethics cannot be limited to human interests and concerns, but must include non-human animals and the environment. It must reflect the needs of justice for populations and societies that are most exposed to environmental and health crises in a world that has been globalised by a liberal economy. It must consider individualist and collectivist values. It must be adaptive, while being pragmatic and normative, integrating the needs for development and well-being as well as the conservation of biological diversity.

The cultural diversity of representations of nature and health calls into question the “ecosystem services” that scientists seek to predict and implement in governance tools (Callicott 2013). A well-established “Global Health ethics” is more essential than to build a “One Bioethics”, as proposed by the “One Health” approach, or a “Planetary health ethics”. As Verweij and Bovenkerk (2016) pointed out, such “One Bioethics” or “Planetary health ethics” are more the domain of meta-ethics that correspond to a moral belief in “health” and “Planetary health”. The crucial point is the scientific posture adopted in the face of health crises originating from ecological crises, and its implications for studying nature (broadly conceptualised as ranging from a simple mechanism that can be easily fixed to a complex adaptive system that requires care). The recognition that crises are systemic must lead to the development of systemic actions for better earth stewardship and better common health and well-being. To meet this goal, scientific research will need to embrace pluralism, avoid the hierarchy of sciences, and be better integrated with ethical and other normative values.

Funding

Agence Nationale de la Recherche project FutureHealthSEA ANR-17-CE35-0003-01

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.