Terrestrial wildlife is the primary source of meat for hundreds of millions of people throughout the developing world. Despite widespread human reliance on wildlife for food, the impact of wildlife depletion on human health remains poorly understood. Here we studied a prospective longitudinal cohort of 77 preadolescent children (under 12 y of age) in rural northeastern Madagascar and show that consuming more wildlife was associated with significantly higher hemoglobin concentrations. Our empirical models demonstrate that removing access to wildlife would induce a 29% increase in the numbers of children suffering from anemia and a tripling of anemia cases among children in the poorest households. The well-known progression from anemia to future disease demonstrates the powerful and far-reaching effects of lost wildlife access on a variety of human health outcomes, including cognitive, motor, and physical deficits. Loss of access to wildlife could arise either from the diligent enforcement of existing conservation policy or from unbridled unsustainable harvest, leading to depletion. Conservation enforcement would enact a more rapid restriction of resources, but self-depletion would potentially lead, albeit more slowly, both to irrevocable local wildlife extinctions and loss of the harvested resource. Our research quantifies costs of reduced access to wildlife for a rural community in Madagascar and illuminates pathways that may broadly link reduced natural resource access to declines in childhood health.ecosystem services | epidemiology | protected areas | hunting

Wildlife consumption can be viewed as an ecosystem provisioning service (the production of a material good through ecological functioning) because of wildlife’s ability to persist under sustainable levels of harvest. We used the case of wildlife harvest and consumption in northeastern Madagascar to identify the distribution of these services to local households and communities to further our understanding of local reliance on natural resources. We inferred these benefits from demand curves built with data on wildlife sales transactions. On average, the value of wildlife provisioning represented 57% of annual household cash income in local communities from the Makira Natural Park and Masoala National Park, and harvested areas produced an economic return of U.S.$0.42 ha−1 · year−1. Variability in value of harvested wildlife was high among communities and households with an approximate 2 orders of magnitude difference in the proportional value of wildlife to household income. The imputed price of harvested wildlife and its consumption were strongly associated (p< 0.001), and increases in price led to reduced harvest for consumption. Heightened monitoring and enforcement of hunting could increase the costs of harvesting and thus elevate the price and reduce consumption of wildlife. Increased enforcement would therefore be beneficial to biodiversity conservation but could limit local people’s food supply. Specifically, our results provide an estimate of the cost of offsetting economic losses to local populations from the enforcement of conservation policies. By explicitly estimating the welfare effects of consumed wildlife, our results may inform targeted interventions by public health and development specialists as they allocate sparse funds to support regions, households, or individuals most vulnerable to changes in access to wildlife.

Pica, the craving and purposive consumption of non-food substances, is of public health concern for its potential deleterious and salubrious health consequences. However, neither its prevalence nor demographic correlates have been well characterized. Therefore, we conducted the first population-based study of pica and amylophagy in Madagascar. From February to December 2009, we surveyed pica and amylophagy behaviors in a random sample of 760 individuals >5 years in 167 households among two ethnic groups in 16 villages in the Makira Protected Area of Madagascar. Of the 760 individuals interviewed, 62.5% were children (5–11 years), 5.4% were adolescents (12–16 years), and 35.1% were adults (≥17 years). Thirteen non-food items were reported being consumed. Across the entire population in the prior year, the prevalence of geophagy was 53.4%, of amylophagy, 85.2%, and of other pica substances (e.g. charcoal, chalk) was 19.0%. The prevalence of these behaviors was not higher during pregnancy. These findings differ from previous studies in terms of the higher overall prevalence of these behaviors, the high prevalence among men, and the absence of any peak in behaviors during pregnancy. However, there are two categories of substances that elevate our estimates but fall outside the strict definition of pica as a craving: 1) substances consumed for self-medication and 2) substances viewed as food, such as all amylophagic substances in this case. Our results suggest that population-based studies of pica should include males of all ages. Further, the prevalence of the behavior underscores the importance of understanding the etiology and health consequences of these ingestive behaviors (Abstract S1).

Subsistence hunting presents a conservation challenge by which biodiversity preservation must be balanced with safeguarding of human livelihoods. Globally, subsistence hunting threatens primate populations, including Madagascar's endemic lemurs. We used population viability analysis to assess the sustainability of lemur hunting in Makira Natural Park, Madagascar. We identified trends in seasonal hunting of 11 Makira lemur species from household interview data, estimated local lemur densities in populations adjacent to focal villages via transect surveys, and quantified extinction vulnerability for these populations based on species-specific demographic parameters and empirically derived hunting rates. We compared stage-based Lefkovitch with periodic Leslie matrices to evaluate the impact of regional dispersal on persistence trajectories and explored the consequences of perturbations to the timing of peak hunting relative to the lemur birth pulse, under assumptions of density-dependent reproductive compensation. Lemur hunting peaked during the fruit-abundant wet season (March-June). Estimated local lemur densities were roughly inverse to body size across our study area. Life-history modeling indicated that hunting most severely threatened the species with the largest bodies (i.e., Hapalemur occidentalis, Avahi laniger, Daubentonia madagascariensis, and Indri indi), characterized by late-age reproductive onsets and long interbirth intervals. In model simulations, lemur dispersal within a regional metapopulation buffered extinction threats when a majority of local sites supported growth rates above the replacement level but drove regional extirpations when most local sites were overharvested. Hunt simulations were most detrimental when timed to overlap lemur births (a reality for D. madagascariensis and I. indri). In sum, Makira lemurs were overharvested. Regional extirpations, which may contribute to broad-scale extinctions, will be likely if current hunting rates persist. Cessation of anthropogenic lemur harvest is a conservation priority, and development programs are needed to help communities switch from wildlife consumption to domestic protein alternatives.

Madagascar faces dual challenges in biodiversity conservation and public health. In order to identify strategies to reduce the unsustainable hunting of threatened species while maintaining or improving child nutrition, we quantified interactions among ecosystem indicators (lemur density and habitat biodiversity indices), health indicators (stunting, underweight, wasting, and anemia), nutrition, food security, and wildlife hunting through interviews of 1,750 people in 387 households and surveys of 28 wildlife transects with 156 habitat plots at 15 sites on Madagascar's Masoala Peninsula, a UNESCO World Heritage Site. The surveyed population ate 6,726 forest animals (mammals and birds), or a mean of 3.27 kg of wild meat per person (4.48 kg per adult equivalent) during the prior year. Local Malagasy were also highly food insecure (78% of households) and malnourished (for children under five, as many as 67% were stunted, 60% were underweight, 25% were wasted, and 40% were anemic). In some communities, nearly 75% of animal-sourced calories, 76% of protein, and 74% of iron came from forest animals-demonstrating a strong dependence on wild foods. Few micronutrient-rich alternatives to wild meats were available in adequate supply and many were highly volatile; for example, 79% of chickens died from Newcastle disease in the prior year. The survivorship of lemurs (94% of lemur species are threatened with extinction) depends on providing food security to a malnourished human population who commonly hunts wildlife for food. Currently, wildlife provides a critical source of micronutrients, yet the hunting of threatened species is an untenable solution to poor diet and food insecurity. Given the established connection between wild foods and human nutrition, reductions in forests and wildlife populations will also threaten the local food supply. In order to reduce the unsustainable hunting of threatened species while improving household food security and child health, we suggest testing the effects of increasing the affordability, accessibility, and stability of micro-nutrient rich animal-sourced foods in communities where forests contribute the most to food security.