Mass tourism has been creating increasing complaints and resistances in many tourist cities worldwide. The global Covid-19 health emergency has further affected the complex relationship between the activities of city dwellers and those of the tourist flows. Be the visitors present or abruptly absent, the effects of tourism on housing, labour, and the urban economy as a whole can threaten the very survival of a tourist destination. The ultimate goals of tourist-based transformations are not clear, nor their relationship with the resilience of destinations. A systemic perspective is here offered on tourism in cities, with a focus on the city that likely exhibits the highest level of tourist attraction with respect to its vulnerability, that is, Venice, Italy. Various aspects of its sustainability and resilience, along with the involved interconnection and dependency links, are taken into consideration. Currently proposed alternative scenarios are presented, and their weaknesses commented. Some implications are also addressed for sustainable and resilient transformations. The comprehension of the dynamics that drive a tourist city system, together with the study of its systemic leverage points, appear to be mandatory for effective urban policies and planning.

The sustainability concept in its current form suffers from reductionism. The common interpretation of “meeting the needs of the present without compromising the ability of future generations to meet their own needs” fails to explicitly recognize their interdependence with needs of current and future non-human generations. Here we argue that the focus of sustainability on human well-being – a purely utilitarian view of nature as a resource for humanity – limits its conceptual and analytical power, as well as real-world sustainability transformation efforts. We propose a broadened concept of ‘multispecies sustainability’ by acknowledging interdependent needs of multiple species’ current and future generations. We develop the concept in three steps: 1) discussing normative aspects, fundamental principles underlying the concept, and potential visual models, 2) showcasing radically diverging futures emerging from a scenario thought experiment based on the axes sustainable-unsustainable and multispecies-anthropocentric, and 3) exploring how multispecies sustainability can be applied to research and policy-making through two case studies (a multispecies stakeholder framework and the Healthy Urban Microbiome Initiative).

Health services represent a cornerstone to ensure well-being and human rights everywhere, particularly in deprived areas with limited access to resources. We investigate the resource cost and appropriate use for the implementation of a top-quality hospital in Sudan. An integrated Life-Cycle Assessment and systems-based Emergy Accounting approach is applied to assess its sustainability and resilience. Very few similar studies have addressed civil works so far, even less bioclimatic buildings, while our focus on health systems is an absolute novelty. Particular attention is paid to bioclimatic design in adverse climate and economic conditions, to the humanitarian nongovernmental organisation running the hospital, and to the cutting-edge medical staff and technologies imported from abroad that at the same time allow local practitioners to train in excellence medicine. The system's direct and indirect socio-ecological requirements are expressed as emergy (resource investment) per patient-day, per cardiac surgical operation, per outpatient visit, and per year. From a quantitative viewpoint, these indicators represent a benchmark for improvement scenarios, comparison with new studies in a deserving field, and future investments, driven by effective healthcare policies. They also provide an overview of the efforts required by nature and society to ensure a human right in conditions of scarcity. In addition to the possibility to lower a hospital's environmental impact (sustainability-oriented) and to keep it functioning over time in changing climate, resource, societal, economic, and geo-political scenarios (resilience-oriented), this study leads to original remarks upon societal priorities and upon the challenges of guaranteeing high-quality health systems in an uncertain century. Highlights: • A layout and novel indicators are introduced for the evaluation of health systems • Health provision crucially relies on societal priorities and resource allocation • Remarkable performances in sustainable resource use are reached in our case study • The largest fraction of embedded energy lies in medical labour and services • Savings from a bioclimatic building can further pursued through this approach

Non-technical summary The sustainability concept seeks to balance how present and future generations of humans meet their needs. But because nature is viewed only as a resource, sustainability fails to recognize that humans and other living beings depend on each other for their well-being. We therefore argue that true sustainability can only be achieved if the interdependent needs of all species of current and future generations are met, and propose calling this ‘multispecies sustainability’. We explore the concept through visualizations and scenarios, then consider how it might be applied through case studies involving bees and healthy green spaces.

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