The human impact on life on Earth has increased sharply since the 1970s, driven by the demands of a growing population with rising average per capita income. Nature is currently supplying more materials than ever before, but this has come at the high cost of unprecedented global declines in the extent and integrity of ecosystems, distinctness of local ecological communities, abundance and number of wild species, and the number of local domesticated varieties. Such changes reduce vital benefits that people receive from nature and threaten the quality of life of future generations. Both the benefits of an expanding economy and the costs of reducing nature’s benefits are unequally distributed. The fabric of life on which we all depend — nature and its contributions to people — is unravelling rapidly. Despite the severity of the threats and lack of enough progress in tackling them to date, opportunities exist to change future trajectories through transformative action. Such action must begin immediately, however, and address the root economic, social, and technological causes of nature’s deterioration.

The rate of global change in nature during the past 50 years is unprecedented in human history. The direct drivers of change in nature with the largest global impact have been (starting with those with most impact): changes in land and sea use; direct exploitation of organisms; climate change; pollution; and invasion of alien species. Those five direct drivers result from an array of underlying causes – the indirect drivers of change – which are in turn underpinned by societal values and behaviours that include production and consumption patterns, human population dynamics and trends, trade, technological innovations and local through global governance. The rate of change in the direct and indirect drivers differs among regions and countries.

The increasing availability of data and improved analytic techniques now enable us to better understand when and where investing in nature can deliver net benefits for people − especially with respect to the most vulnerable populations in developing countries. These advances open the door for efficient interventions that can advance multiple SDGs at once. Recently, we harmonized a suite of global datasets to explore the critical nexus of forests, poverty and human health – an overlap of SDGs 1, 2, 3, 6 and 15. Our approach combined demographic and health surveys for 297,112 children in 35 developing countries with data describing the local environmental conditions for each child4 (Fig. 1a; see online materials for details). This allowed us to estimate the effect forests may play in supporting human health, while controlling for the influence of important socio-economic differences. We extended this work to look at how forests affect three childhood health concerns of global significance – stunting, anemia, and diarrheal disease.