EcoHealth 5, 519–527, 2008 DOI: 10.1007/s10393-008-0208-7 Ó 2009 International Association for Ecology and Health Forum Designing Graduate Training Programs in Conservation Medicine—Producing the Right Professionals with the Right Tools Gretchen E. Kaufman,1 Jonathan H. Epstein,2 Joanne Paul-Murphy,3 and Jennifer D. Modrall1 1Tufts Center for Conservation Medicine, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA 01536 2The Consortium for Conservation Medicine, 460 West 34th Street, 17th Floor, New York, NY 10001 3Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California at Davis, 2108 Tupper Hall, Davis, CA 95616 Abstract: New challenges to human, animal, and ecosystem health demand novel solutions: New diseases are emerging from new configurations of humans, their domestic animals and wildlife; new pressures on once robust and resilient ecosystems are compromising their integrity; synthetic compounds and engineered organisms, new to the natural world, are spreading unpredictably around the globe. Globalization provides opportunities for infectious organisms to gain access to new hosts, changing in distribution and virulence. What type of training should be developed to provide professionals with the right tools to meet these chal- lenges? In this article, we offer recommendations for developing academic programs in conservation medicine. We discuss the need for, and the advantages to, using a conservation medicine approach to address real world situations and present illustrations of how this is applied today. We suggest a core set of skills that are needed in a conservation medicine practitioner, and recommend key considerations for designing new conservation medicine training programs. We review existing programs that offer conservation medicine content, and provide examples of where opportunities exist for those interested in pursuing a conservation medicine career. Keywords: conservation medicine, training, academic program, interdisciplinary INTRODUCTION all of which recognize the clear relationship between human and animal health; however, conservation medicine Conservation medicine is the study of health relationships is also closely allied with the values of conservation biology, occurring at the interface of humans, animals, and eco- and recognizes that health and disease are fundamentally systems. It may be considered a meta-discipline: a field of related to the integrity of ecosystems. Thus, understanding study that incorporates the tools and perspectives of as the importance of ecosystem functionality in the context of many different scientific disciplines as necessary in order to health is essential to conservation medicine, and it draws address challenges or test hypotheses related to global on the principles of both ecology and applied medicine as health issues. Conservation medicine shares a similar phi- an approach to human and animal disease issues. losophy with EcoHealth, One Health, and Global Health, A conservation medicine professional is someone with expertise in one or more scientific disciplines, who uses their Published online: February 11, 2009 expertise to collaborate with other scientists (physicians, Correspondence to: Gretchen E. Kaufman, e-mail: [email protected] 520 Gretchen E. Kaufman et al. biologists, virologists, geologists, anthropologists, veteri- (Chua et al. 2000). Following the initial outbreak investi- narians, etc.) to comprehensively address a health-related gation, a large-scale multi-year collaborative study was issue within an ecological context. The result is more than a launched by the Henipavirus Ecology Research Group collection of individual disciplinary perspectives; it aims to (HERG—http://www.henipavirus.net). This group used a produce a fully integrated interdisciplinary analysis of a conservation medicine approach to test two major complex problem informing a practical applied conclusion hypotheses for Nipah virus’ emergence. The first postulated (i.e., the whole is more than the sum of its parts). Many that Nipah virus emerged due to climatic effects from El scientists have naturally cultivated a broad-based view of Nin˜o-caused forest fires that created tremendous atmo- science throughout their careers, and some have worked as spheric haze, driving Nipah virus-infected bats from part of large-scale, multi-dimensional teams. Professionals Sumatra to Malaysia (Chua et al. 2002). The second from different fields that are practicing in a conservation hypothesis was that the size, structure, and management of medicine setting have generally developed their careers the pig farm where Nipah emerged had allowed the virus, through perseverance, experience, and sometimes through once introduced to pigs by fruit bats, to persist and cause a the pursuit of multiple academic degrees. However, most wide-spread epidemic (Daszak et al. 2006). Epidemiology, will admit that experience and determination alone may not veterinary medicine, and ecology were involved in exam- provide the necessary tools and skills that could be better ining the health data and management practices of the pigs developed through a focused academic training program. on the index farm. These data were incorporated into a Since the advent of conservation medicine (ca. 1997), mathematical model which simulated the introduction and few formalized graduate training programs have been spe- spread of the virus in pigs on the farm (Pulliam et al. 2007). cifically designed to train people in the field of conservation Wildlife biology and ecology were used to study the pop- medicine. We contend that such a program could provide the ulation demographics and dynamics of the pteropid fruit scientific cross-training and interdisciplinary approaches that bat and better understand the risk of future outbreaks are missing from traditional academic programs. A training (Epstein et al. 2007). Molecular biology, epidemiology, and program that concentrates specifically on fundamental con- classical virology were used to study Nipah virus in wild bat servation medicine skills could accelerate achievement and populations and peri-domestic animals using population- more effectively provide the versatility that is needed to based studies and laboratory-based experimental infections. adequately address the challenges in conservation medicine. These studies gave the team a better understanding of the Just as conservation biology struggled to establish itself in the dynamics of the virus in wild populations, as well as the 1980s as a new interdisciplinary field, beginning with 16 pathogenesis of Nipah virus in bats and its ability to survive programs in 1990 and growing to more than 108 programs in in the environment under various experimental conditions 99 colleges and universities (Meine et al. 2006), conservation (Epstein et al. 2007; Halpin and Mungall 2007; Fogarty medicine is now facing similar academic scrutiny and needs a et al. 2008). Ultimately, all aspects of the study were nec- place in the scholarly arena to support its legitimacy. essary to understand the factors that caused Nipah virus to emerge and also the risks associated with future outbreaks [Pulliam et al., submitted for publication]. CONSERVATION MEDICINE IN ACTION Here we present three examples of applied conservation Linking Bushmeat Hunting and Zoonotic Disease medicine projects to illustrate the value of this approach Emergence and demonstrate some of the skills required in a conser- Bushmeat hunting is widely considered a socially, eco- vation medicine practitioner: (1) uncovering the emergence nomically, and nutritionally significant activity throughout of Nipah virus, (2) linking bushmeat hunting and zoonotic much of the developing world (Asibey et al. 1974; Juste disease emergence, and (3) using seabirds as sentinels for et al. 1995; Davies 2002). The practice of hunting and ecological health. consuming wild animals potentially places hunters or market workers at particularly high risk of exposure to Uncovering the Emergence of Nipah Virus animal pathogens (Wolfe et al. 2005a), in addition to Nipah virus was first discovered during an outbreak of threatening the health of endangered animal populations encephalitis among pig-farmers in Peninsular Malaysia (Milner-Gulland and Akcakaya, 2001; Brashares et al. Training Programs in Conservation Medicine 521 2004). Transmission of pathogens such as HIV-1 (Hahn marine mammals and birds (Bogomolni et al. 2008); (2) et al. 2000), HTLV (Wolfe et al. 2005b), Simian Foamy obstruction and starvation of seabirds associated with plastic virus (Wolfe et al. 2004), SARS coronavirus (Li et al. 2005), ingestion (Pierce et al. 2004); (3) the first published report of and Ebola (Leroy et al. 2004) have been linked to bushmeat a fungal aneurism in a wild bird (Courchesne and Garner, in hunting and the wild animal trade. press); (4) a microbial source tracking study that suggested Investigation of zoonotic viral transmission from non- that gulls obtain fecal bacteria from waste water (Nelson et al. human primates to bushmeat hunters in Cameroon provides 2008); and (5) potential discovery of new pathogens involved a second example of a trans-disciplinary study that combined in Common Eider die-offs [Courchesne and Ellis, under epidemiology, molecular biology, and virology with medical investigation]. anthropology. The research included sampling both hunters and nonhuman primates and testing them for novel patho- gens, conducting extensive surveys