Sep 29, 2019 — This report in the form of a PDF can be viewed and downloaded at ecohealthalliance. Page 3. Activity Start Date And End Date:.
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INFECTIOUS DISEASE EMERGENCE AND ECONOMICS OF ALTERED LANDSCAPES (IDEEAL) FINAL REPORT This document was produced for review by the United States Agency for International Development Regional Development Mission for Asia (USAID/RDMA). Suggested Citation: EcoHealth Alliance (2019). Infectious disease emergence and economics of altered landscapes – IDEEAL. P. Daszak, T. Hughes, C. Zambrana-Torrelio, J. H. Epstein, H. E. Field, A. H. White, D. Finno˜, K. D. Lee, Y. Feferholtz, S. Dattaray, S. M. L. Maher, J. Lee, E. E. Johnson, S. E. Elwood, E. H. Loh, K. A. Murray, M. H. Lee, F. Kamarol-Zaman, H. Lasimbang, A. Lasimbang, V. S. Sathianarayanan, V. Kumar, A. Kamruddin, J. R. A. Sukor, C. Rundi, J. Jelip, N. Arsad, M. Hamid, R. Jaudin, P. Duengkae, R. Maude, P. Sudathip, and S. Kitchakarn (Editors). Published by EcoHealth Alliance, New York, New York, U.S.A. 88 pages. This report in the form of a PDF can be viewed and downloaded at

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Activity Start Date And End Date: October 15, 2013 – February 28, 2019 Name of Prime Implementing Partner: EcoHealth Alliance [Contract/Agreement] Number: AID-486-A-13-00005 Major Counterpart Organizations Faculty of Medicine and Health Sciences Universiti Malaysia Sabah, Sabah Wildlife Department, Sabah State Health Department, Ministry of Public Health Thailand, Faculty of Forestry Kasetsart University, Mahidol – Oxford Tropical Medicine Research Unit Geographic Coverage (cities and or countries) Malaysia, Thailand, Indonesia Reporting Period: October 15, 2013 – February 28, 2019 [COR/AOR] Name: Daniel Schar Submitted by: Peter Daszak, Chief of Party EcoHealth Alliance 460 W. 34th St., 17th Fl., NY, NY 10001 Tel: 212-380-4460 Email: Print ISBN: 978-1-7334388-0-3

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Page 2 | Table of Contents LIST OF ACRONYMS 4EXECUTIVE SUMMARY 6BACKGROUND AND CONTEXT 8Emerging Infectious Diseases and Land Use Change 9Area of Focus: Southeast Asia 10TASK 1: QUANTITATIVE MODELS: INFECTIOUS DISEASES AND LAND USE CHANGE 12 Modeling Overview 13Data Acquisition 14Lessons Learned: Data Acquisition 14Part A: Analysis of Link Between Malaria and Land Use Change and Quantifying Ecosystem Services in the Region 16Results: Land use Change and Malaria 16Graduate Student Training 18Results: INVEST Ecosystem Service Modeling 20Part B: Dynamic Optimization Modeling 20Results: Sabah and Thailand Economic Models 20Results: Spatially Explicit Modeling 22Results: Global Economic Model 23TABLE OF CONTENTS

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Table of Contents | Page 3 TASK 2: POLICY & OUTREACH 26 Part A: Stakeholders and Development Health Research Unit (DHRU) 27Stakeholder Engagement 27Part B: Policy and Scienti˜c Outreach 29 Policy 29 Baseline and Ongoing Surveys 31DHRU Graduate Students 33Amy Lim Research Summary 35Part C: Capacity Building, Toolkit Development, and Knowledge Communication 36Capacity Building Trainings 36Toolkit Development 39Success Story 40IDEEAL App 42Scienti˜c Outreach 42Collaborations 45MONITORING & EVALUATION 46 PROJECT MILESTONES 60 REFERENCES 68 APPENDICES 71

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Page 4 | List of Acronyms BOE DDC MPH Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health Thailand BCI BC Initiative BMHRC Borneo Medical and Health Research Centre BVD Bureau of Vector Borne Diseases, Ministry of Public Health Thailand CBD – COP13 Convention on Biological Diversity- Conference of the Parties CEO Chief Executive O˚cer COP Chief of Party DHRU Development and Health Research Unit DFHC DEEP FOREST Human Contact DGFC Danau Girang Field Centre DVS Department of Veterinary Services Malaysia DWNP Department of Wildlife and National Parks Peninsular Malaysia DNPWPC Department of National Parks, Wildlife and Plant Conservation, Thailand DCOP Deputy Chief of Party EHA EcoHealth Alliance EID Emerging Infectious Disease EMEconomic Modeler FBE UMS Faculty of Business and Economics, Universiti Malaysia Sabah FMHS UMS Faculty of Medical and Health Sciences, Universiti Malaysia Sabah GDP Gross Domestic Product ICID International Congress on Infectious Diseases IPBES Plenary of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services IRB Institutional Review Board J&J Johnson & Johnson KKPHL Kota Kinabalu Public Health Laboratory KUKasetsart University M&E Monitoring and Evaluation MOHMinistry of Health MOPHT Ministry of Public Health Thailand MORU Mahidol – Oxford Tropical Medicine Research Unit LIST OF ACRONYMS INFECTIOUS DISEASE EMERGENCE AND ECONOMICS OF ALTERED LANDSCAPES (IDEEAL)

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Executive Summary | Page 7 EcoHealth Alliance™s Infectious Disease Emergence and Economics of Altered Landscapes (IDEEAL) project began in October 2013. The primary objective of IDEEAL was to quantify the economic costs of the impact of deforestation on malaria outcomes in Sabah, Malaysia, and determine the optimal amount of land to be converted to agriculture that minimized these costs. In the second phase of the project, research expanded to Peninsular Malaysia, Thailand, and in a limited capacity, Indonesia and Sarawak (on Malaysian Borneo). Local communities, private entities, and local and international governments were involved throughout the project, and informed about the project process and outcomes over the course of the project. Baseline and end line surveys were collected to determine knowledge about relevant topics in conservation and health. IDEEAL examined how di˜erent ecological and land use change variables impacted the number of malaria cases in each location. The results showed that these variables di˜ered across regions and timescales, ranging from precipitation to amount of ˚ood, forest, or cropland. When considering the link between deforestation and malaria, the IDEEAL economic model indicates that Sabah, Malaysia has exceeded the optimal amount for forest to agricultural land conversion. The economic loss from the overdeveloped amount of forest cover from the social optimal today exceeds US$21M annually. In all sites in South East Asia, including health costs in land use planning substantially lowered the optimal level of converted land. The IDEEAL project also supported the founding of the Development and Health Research Unit (DHRU) at the Universiti Malaysia Sabah. The DHRU functions as a center of excellence for research and education on the intersection of health, land use change, and economics. Furthermore, IDEEAL supported three Master™s students and the training of 156 stakeholders on the following topics: R, a statistical program; GIS mapping techniques; and our IDEEAL Interactive Web Modeling App. 42% of these were women. To support the dissemination of the results, a Position Paper summarizing this research has been developed and will be presented to the Sabah Cabinet on behalf of Sabah Wildlife Department and Sabah State Health Department. Additionally, the IDEEAL project and its results have been presented by scientists at 12 conferences and in two peer-reviewed journal articles.

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Background and Context | Page 9 Emerging Infectious Diseases and Land Use Change Over the past three centuries, land-use change has grown exponentially to keep pace with human population growth and the subsequent demand for natural resources 1-3 . Intact forests provide invaluable bene˜ts to people and our planet, including water ˜ltration, carbon storage and sequestration, ˚ood prevention, biodiversity conservation, and the maintenance of human health and welfare. Although changes in land-use practices have bene˜ted people through economic and social development, they have also led to long-term negative impacts on human health and the provision of ecosystem services. Critically, there is increasing evidence that land-use change is a major driver of emerging infectious diseases (EIDs) 4,5 . Previous analyses demonstrate that over 30% of the EIDs a˛ecting people are causally linked to land use change (FIGURE 1 )6,7 . This includes deadly diseases such as HIV/AIDS, Ebola, and Zika Virus; all of which originated in 6% Climate and weather 31% Land use changes 15% Agricultural industry changes 13% International travel and commerce 11% Medical industry changes 7% War and famine 4% Human demography and behavior 4% other 3% Breakdown of public health 3% Bushmeat 2% Food industry change FIGURE 1: Approximately 31% of the infectious diseases that have originated in wildlife since 1940 have been related to some form of land use change. Primary drivers of past disease emergence. Land use change is the most important driver. Derived (6, 7) PRIMARY DRIVERS OF PAST DISEASE EMERGENCE

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