Table 2.

Examples of ongoing biodiversity and sustainability initiatives that could potentially incorporate spillover prevention.

Initiative	Year founded	Description	Biodiversity goals	Potential health goals?	Potential extensions for preventing spillover	Generality	References
The Bonn Challenge	2011	Launched by the Government of Germany and the International Union for Conservation of Nature to reduce deforestation and promote ecosystem restoration	Obtain pledges for 150 million hectares of degraded and deforested landscapes globally on which to begin restoration by 2020 (which was successfully reached in 2017) and 350 million hectares by 2030	Improve human health, wellbeing, and livelihood by conserving and restoring degraded or deforested landscapes (no mention of infectious disease burden or spillover per se)	Landscape restoration of wildlife habitat, especially for large-bodied predators and consumers, could potentially help reduce spillover risk driven by increase in rodent abundance due to competitor and predator release related to agriculture and deforestation	1–3	175
Convention on Biological Diversity	1992	A list of goals (2020–2050) for sustainable nature-based solutions for improving planetary health and human well-being, set by the United Nations	Address mitigation of biodiversity loss and anthropogenic disturbances	Improve human health and well-being (no mention of infectious disease burden or spillover per se)	The Convention on Biological Diversity handbooks, including in 2020, do not mention actionable next steps for implementing nature-based solutions. How nature-based solutions may target spillover prevention merits further investigation	1–3	195,221
Convention on International Trade in Endangered Species (CITES) of Wild Fauna and Flora	1973	A global agreement (182 countries) to regulate the international wildlife trade and ban trade of endangered species	Support surveillance efforts to track species under threat in the international wildlife trade and control illegal wildlife trade activity	Mission statement does not include the prevention of spillover (or improving human health or well-being)	CITES could adopt a pathogen screening regulation scheme to be implemented by all of its member countries to prevent the global spread of emerging diseases that may also hurt endangered wild populations	2,4	189,158
Thirty-By-Thirty Resolution to Save Nature	2020	Part of a global effort, spearheaded by the Wyss Campaign for Nature, National Geographic Society, and over 100 organizations	The Natural Resources Defense Council proposed a ‘commitment to protect nature and life on Earth’ urging the US federal government to conserve at least 30% of US lands and 30% of ocean regions by the year 2030	Mission statement does not recognize the additional human health benefits of reduced spillover risk via the proposed conservation efforts (e.g. conservation of wildlife habitat and corridors for safe passage of wildlife between intact habitats)	Wildlife corridors would aid conservation of natural predators and large consumers, which could help reduce spillover risk of zoonotic disease where predators keep reservoir populations in check (e.g. rodents) or where corridors help migrations of large herbivores (e.g. caribou) reducing brucellosis risk	1–3	176,177,222,223
Payments for Ecosystem Services (PES) Program in Costa Rica	1997	PES requires those who benefit from ecosystem services to compensate stewards of these services (e.g. landowners keeping forests intact should be compensated for the services their forests provide, such as carbon sequestration, clean air, and clean rivers)	Forest conservation and restoration aimed to improve biodiversity conservation and other recognized ecosystem services (e.g. watershed services, carbon sequestration, and landscape beauty)	PES programs do not explicitly include infectious disease or spillover prevention	Spillover prevention could be embedded in existing efforts (or be introduced as its own ecosystem service). PES schemes that conserve contiguous and diverse forests could potentially benefit spillover prevention by reducing density of small-bodied mammal reservoir hosts, and intact forests serve as carbon sinks (thereby mitigating climate change effects on spillover)	1–3	178,179
Project Finance for Permanence (PFP)	2010	A model that includes restoring and conserving contiguous intact ecosystems. PFP programs, e.g. Amazon Region Protected Areas (ARPA), are funded by foundations, NGOs (e.g. WWF), and government agencies	Aims to improve the abundance and management of intact ecosystems. ARPA intends to create, consolidate, and maintain a 60-million-hectare network of protected areas in the Brazilian Amazon	Although not a specific PFP objective, ARPA has likely reduced cases of malaria transmission in the Inner Amazon by slowing the rate of deforestation. This example highlights the potential joint benefits of the PFP model for conservation and public health	Spillover prevention is not yet incorporated in PFP programs, although they could be extended to zoonotic spillover prevention via similar mechanisms to PES programs	1–3	182,183,224

Several initiatives are listed along with the four generalities discussed in the main text section ‘Incorporating concepts of ecological diversity to mitigate spillover risk’ that may be considered applicable. Generality numbers in the tables refer to: 1) Large, intact habitat reduces overlap among host species and promotes wildlife health; 2) Loss of predators and competitors reduces regulation of reservoir host and vector populations; 3) Reservoir hosts are better adapted to human-modified systems; and 4) Human activity may increase opportunities for novel interspecies contacts.