Evolutionary medicine – i.e. the application of insights from evolution and ecology to biomedicine – has tremendous untapped potential to spark transformational innovation in biomedical research, clinical care and public health. Fundamentally, a systematic mapping across the full diversity of life is required to identify animal model systems for disease vulnerability, resistance, and counter-resistance that could lead to novel clinical treatments. Evolutionary dynamics should guide novel therapeutic approaches that target the development of treatment resistance in cancers (e.g.,viaadaptive or extinction therapy) and antimicrobial resistance (e.g.,viainnovations in chemistry, antimicrobial usage, and phage therapy). With respect to public health, the insight that many modern human pathologies (e.g., obesity) result from mismatches between the ecologies in which we evolved and our modern environments has important implications for disease prevention. Life-history evolution can also shed important light on patterns of disease burden, for example in reproductive health. Experience during the COVID-19 (SARS-CoV-2) pandemic has underlined the critical role of evolutionary dynamics (e.g., with respect to virulence and transmissibility) in predicting and managing this and future pandemics, and in using evolutionary principles to understand and address aspects of human behavior that impede biomedical innovation and public health (e.g., unhealthy behaviors and vaccine hesitancy). In conclusion, greater interdisciplinary collaboration is vital to systematically leverage the insight-generating power of evolutionary medicine to better understand, prevent, and treat existing and emerging threats to human, animal, and planetary health.

Wealth inequality is widespread across human societies, from pastoral and small-scale agricultural groups to large modern social structures. The intergenerational transfer of wealth privileges some individuals over others through the transmission of resources external to an individual organism. Privileged access to household wealth (e.g., land, shelter, silver) positively influences the destinies of some (and their descendants) over others in human societies. Strikingly parallel phenomena exist in animal societies. Inheritance of nongenetic commodities (e.g., a nest, territory, tool) external to an individual also contributes greatly to direct fitness in animals. Here, we illustrate the evolutionary diversity of privilege and its disparity-generating effects on the evolutionary trajectories of lineages across the Tree of Life. We propose that integration of approaches used to study these patterns in humans may offer new insights into a core principle from behavioral ecology—differential access to inherited resources—and help to establish a broad, comparative framework for studying inequality in animals.

Beyond Zoonoses in One Health: Non-communicable Diseases Across the Animal Kingdom

The extent of (in)equality is highly diverse across species of social mammals, but we have a poor understanding of the factors that produce or inhibit equitable social organizations. Here, we adopt a comparative evolutionary perspective to test whether the evolution of social dominance hierarchies, a measure of social inequality in animals, exhibits phylogenetic conservatism and whether interspecific variation in these traits can be explained by sex, age or captivity. We find that hierarchy steepness and directional consistency evolve rapidly without any apparent constraint from evolutionary history. Given this extraordinary variability, we next consider multiple factors that have evolved to mitigate social inequality. Social networks, coalitionary support and knowledge transfer advantage to privilege some individuals over others. Nutritional access and prenatal stressors can impact the development of offspring, generating health disparities with intergenerational consequences. Intergenerational transfer of material resources (e.g. stone tools, food stashes, territories) advantage those who receive. Nonetheless, many of the same social species that experience unequal access to food (survival) and mates (reproduction) engage in levelling mechanisms such as food sharing, adoption, revolutionary coalitions, forgiveness and inequity aversion. Taken together, mammals rely upon a suite of mechanisms of (in)equality to balance the costs and benefits of group living. This article is part of the theme issue ‘Evolutionary ecology of inequality’.

The evolved adaptations of other species can be a source of insight for novel biomedical innovation. Limitations of traditional animal models for the study of some pathologies are fueling efforts to find new approaches to biomedical investigation. One emerging approach recognizes the evolved adaptations in other species as possible solutions to human pathology. The giraffe heart, for example, appears resistant to pathology related to heart failure with preserved ejection fraction (HFpEF)—a leading form of hypertension-associated cardiovascular disease in humans. Here, we postulate that the physiological pressure-induced left ventricular thickening in giraffes does not result in the pathological cardiovascular changes observed in humans with hypertension. The mechanisms underlying this cardiovascular adaptation to high blood pressure in the giraffe may be a bioinspired roadmap for preventive and therapeutic strategies for human HFpEF.

Soon, German dog-owners will be legally required to walk their dogs for a total of at least an hour each day. The most pampered Pomeranian, though it has grown used to couches and carpets, must now be allowed to answer the call of the wild by moving its little body through the park. The new Hundeverordnung (‘Dog Act’) recognizes that not only every hound but even a skinny, shaking Chihuahua contains, somewhere deep inside, an ancestral wolf.