.jpg)
Because nature's contributions to health are not being valued
Read the Thesis
Why we need to invest in jointly improving Health and Nature
Every person deserves to live in an environment that supports their health and wellbeing. Yet, many people don’t.
The World Health Organization estimates that about one-in-four deaths — and the loss of approximately 596 million healthy life years annually — are due to modifiable environmental risks. These include zoonotic and vector-borne diseases, heat stress, air pollution, malnutrition, and even impacts on mental health. Beyond human health, livestock, an important form of wealth and savings in many countries, are also severely affected by environmental risks.
Bitter lessons from the past (like COVID) tell us that preventing disease is more effective, and often cheaper, than treating it. But, efforts to prevent these risks — by combatting climate change, restoring ecosystems, and thereby protecting health — are critically underfinanced and fragmented. To make matters worse, funding that has long underpinned health, climate and biodiversity programs in LMICs is retrenching. Official development assistance to sub-Saharan Africa fell by a quarter in 2025.
This underinvestment is not just a failure to safeguard human wellbeing, it is an increasingly material financial risk.
Health damages stemming from climate change and environmental degradation ultimately translate into economic costs borne by governments, businesses, and communities. Heat stress, for instance, is estimated to reduce agricultural labor productivity in Africa by 20%, costing approximately 4% of the continent’s GDP. Lassa fever alone causes about 8 million infections a year in West Africa, at a cost of approximately USD 923 million. Cholera costs the public and private sectors in Africa an estimated USD 1 billion every year.
Because wealthier countries depend on these regions, disruptions to farming, labor, migration and supply chains in LMICs transmit health-related shocks across borders, affecting trade, sovereign debt stability, and investment portfolios at a global scale. During the 2014–2015 West African Ebola outbreak, Guinea, Liberia, and Sierra Leone lost an estimated USD 38.6 billion in GDP, with agriculture, transportation, trade, and tourism particularly affected. The outbreak indirectly cost the United States ~ USD 2 billion and more than 10,000 jobs tied to exports.
High-income countries are directly impacted too. Conservative estimates suggest that a single catastrophic wildfire in California costs the public and private sectors ~ USD 3.55 billion in economic output from respiratory disease alone.
Investments in climate and nature do more than protect the environment. They prevent disease and ease pressure on health systems - improving people’s lives, and delivering cost savings for governments and businesses.
Capturing the resulting improvements to people’s lives, alongside health-related cost savings, and reduced exposure to financial, reputational, and political risks, could unlock powerful new incentives to invest in climate and nature, while freeing up resources that would otherwise be spent on responding to health crises. This could help close large, well-documented financing gaps across all three sectors.
Our work, for instance, shows that Forest Resilience Bonds — which fund forest restoration to reduce catastrophic wildfire risk in California — can generate ~ USD 300 million in avoided health costs for households, firms and public services. This is roughly four times the environmental benefits these instruments are currently valued for.
This opportunity is increasingly recognized at the highest levels of global and national policy. The Quadripartite One Health Joint Plan of Action, CBD Global Action Plan on Biodiversity and Health, Intergovernmental Panel on Climate Change (IPCC), IPBES Nexus report, and regional development plans (like Africa Vision 2063) are calling for the public and private sectors to promote investment in climate, biodiversity and health linkages.
Yet the USD 8.2 trillion sustainability finance market does not see nature's role in securing health as an investment opportunity.
This is because investors will only commit resources to effective stewardship of nature or prevention of human and animal disease when they can capture tangible benefits. But, there is no guidance on how environmentally-derived health benefits are supposed to be measured and captured, and what financial architecture would be required to achieve that goal.
As a result, nature finance (including biodiversity, conservation and some forms of climate finance) and public health finance are developing independently despite strong complementarities.
A Case in Point: The Yuba Forest Resilience Bond
In 2021, a coalition of public agencies, philanthropies, and private investors raised $25 million to restore 48,000 acres of fire-prone forest in California's North Yuba River watershed. The deal was structured around two clear beneficiaries — the local water agency, which saved an estimated USD 36.5 million in water management costs, and the State of California, which avoided nearly USD 40 million in fire-fighting and damage expenditure. By its own terms, the transaction worked.
What it did not account for was an estimated $300 million in avoided health costs accruing to households, firms, and public health services in the surrounding region — through reduced smoke exposure, fewer hospital admissions, and lower healthcare expenditure — over the same five-year period. That figure is approximately four times the environmental value the bond was priced for, and it flowed entirely to beneficiaries — employers, insurers, hospitals, and families — who had no formal role in the transaction and made no contribution to the investment that generated it.
This is the gap EFH's work seeks to close. By developing the tools to identify, measure, and capture health value in nature-positive investments, we aim to make transactions like this one attractive to a broader range of investors — and to begin addressing the costly redundancy between how we finance nature and how we finance health.
