edited by

A. Alonso Aquirre, Richard S. Ostfield, Gary M. Tabor, Carol House and Mary
Pearl. Oxford University Press,
Oxford and New York 2002.
407 pages. ISBN 0-19-515093-7

The term conservation medicine has come to the fore in recent years, as has

the related discipline of ecosystem health. The former is the prime concern

of this book which is described in the Preface as a broad survey of the

intersection of ecology and health sciences as it applies to achieving a

more sustainable future for our species and others. In fact, it is the

outcome of a conference held in 1999 at the White Oak Plantation and

Conservation Center in Florida, USA, which brought together people from a

range of disciplines to discuss what were considered to be the key

components of conservation.

The history of this book is reflected in the format of this book. There are

five parts, covering I. Ecological Health and Change, II Monitoring

Ecological Health, III. Ecological Health and Humans, IV. Implementing

Conservation Medicine, and V. Conservation Medicine and Challenges for the

Future. There are 65 contributors to 29 chapters (many are, understandably,

in view of the books interdisciplinary theme, multi-authored) but only nine

of these come from outside North America. Eleven authors are Canadians but

the remainder all from the USA their preponderance illustrated, perhaps, by

the fact that, in contrast to the other contributors, they are listed only

by State, not by their country. While this orientation may be

understandable in view of the location of the 1999 conference, it is

disappointing to note the paucity (possibly the absence?) of indigenous

Africans or Asians even as co-authors. If the proponents of conservation

medicine are to achieve their laudable aim, genuine partnerships with poorer

countries are essential. This message is stated repeatedly in the text but

appears not have been put into practice in the organization of the

conference or the compilation of its proceedings.

That said, this book must be considered a landmark in the development of

conservation medicine as a bona fide new discipline. The wide range of

subjects covered, many by specialists in their own field, means that the

publication will serve as an essential reference work for some years to

come. Note must be made of the generosity of the senior editor in making

available a certain number of complimentary copies to institutions in the

developing world: this will do much to counter the reviewers concern

referred to above.

The exact relationship of conservation medicine to ecosystem health remains

unclear. The origins and definition of the latter are clearly discussed in

Chapter 26, where Rapport and colleagues summarize succinctly the debate as

to whether or not there are significant parallels between the health of

complex ecosystems and that of individuals or populations of humans and

other animals. While many significant differences exist, there are

similarities in how (for example), vegetation and animals can respond to,

and recover from, stressors. As an increasing number of medical terms are

now used by ecologists, it behooves members of the two disciplines to work

more closely together.

The design of the overlapping circles on the cover of this book, together

with relevant portions of the text, suggest that conservation medicine might

be used as an umbrella term for human health, animal health and ecosystem

health. This could be criticized on the grounds that, for instance, plant

health is subsumed into a broader and less precise category. The use of the

term conservation medicine can also be challenged on the basis that it

implies a therapeutic approach, with a preponderance of medical

professionals, rather than the prevention of global health problems.

The debate will continue, as is to be expected with any new discipline. In

the meantime, there is no doubt that this book represents an important

landmark in promoting a more holistic approach to our world, its inhabitants

and the health challenges that they will increasingly face in the future.

John E. Cooper, DTVM. FRCPath DECVP, FIBiol, FRCVS

School of Veterinary Medicine

The University of the West Indies