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This report synthesizes the findings from the Millennium Ecosystem Assessment (MA) global and sub-global assessments of how ecosystem changes do or could affect human health and well-being. Over the past 50 years humans have changed natural ecosystems more rapidly and extensively than any comparable period in human history. The findings provide the strongest evidence so far of the ways in which pressures on ecosystems have resulted in the loss of vital ecosystem services which purify and replenish water soil and air resources essential to health and also keep many diseases in check. Loss of these ecosystem services in turn affect patterns of communicable and non-communicable disease distribution and transmission. In the future, still-increasing pressures on ecosystems could impact public health in a variety of ways that are unpredictable and potentially severe. Human exploitation of ecosystem services has indeed contributed to substantial net gains in well-being and development across much of the planet. Still not all regions and groups of people have benefited from this process and many have been harmed. Moreover the full costs associated with these gains are only now becoming apparent. Approximately 60% of the ecosystem services examined, from regulation of air quality to purification of water, are being degraded or used unsustainably. The Millennium Ecosystem Assessment has worked to assess the consequences of ecosystem change for human well-being and establish the scientific basis for actions needed to enhance the conservation and sustainable use of those systems so that they can continue to supply the services that underpin all aspects of human life. The assessment exercise has involved more than 1 300 experts worldwide and started in 2001.
Ecosystem services are necessary, yet not sufficient for human well-being (however defined). Insufficient access to the ecosystem provisioning service of food is a particularly important factor in the loss of human well-being, but all ecosystem services contribute in some way to well-being. Although perhaps long obvious to ecologists, the links between ecosystems and aspects of human well-being, including health, have been less well understood among the social science community. This situation may now be starting to change, thanks in part to the Millennium Ecosystem Assessment (MA). Causality between ecosystem services and well-being is bidirectional; it is increasingly clear that functioning societies can protect or enhance ecosystem services, and accordingly, that societies with impaired well-being (best documented in the case of chronic diseases such as malaria and HIV/AIDS) can also experience a related decline in ecosystem services. The future state of human well-being and of ecosystem services is more than the co-evolution of these two fundamental elements. Human well-being also depends, critically, upon the human institutions that govern relationships between human individuals and groups, and also between humans and ecosystem services. The scenarios working group of the MA found that human well-being is highest in the Global Orchestration scenario, which assumes the fastest evolution of beneficial institutions, and is lowest in the Order from Strength scenario. Human well-being was found to be intermediate in the other two scenarios (Adapting Mosaic and Techno-Garden) even though these scenarios share a much greater recognition of the importance of ecosystem services to human well-being.