Rationale, experience and ethical considerations underpinning integrated actions to further global goals for health and land biodiversity in Papua New Guinea

The SURFACES project is integrating action on good health and wellbeing [Sustainable Development Goal (SDG) 3] and conservation of life on land (SDG 15) in the threatened rainforests of Papua New Guinea (PNG), and mapping evidence of similar projects worldwide. Our approach is framed by Planetary Health, aiming to safeguard both human health and the natural systems that underpin it. Our rationale is demonstrated through a summary of health needs and forest conservation issues across PNG, and how these play out locally. We outline differing types of integrated conservation and health interventions worldwide, providing examples from Borneo, Uganda, India and elsewhere. We then describe what we are doing on-the-ground in PNG, which includes expansion of a rainforest conservation area alongside the establishment of a nurse-staffed aid post, and an educational intervention conceptually linking forest conservation and health. Importantly, we explore some ethical considerations on the conditionality of medical provision and identify key challenges to the successful implementation of such projects. The latter include: avoiding cross-sectoral blindness and achieving genuine interdisciplinary working; the weak evidence base justifying projects; and temporal-spatial issues. We conclude by suggesting how projects integrating actions on health and conservation SDGs can benefit from (and contribute to) the energy of the emerging Planetary Health movement.