Most people consider saving the Amazon rainforest a noble goal, but nothing comes without a cost. Cut down a rainforest, and the planet loses untold biodiversity along with ecosystem services like carbon dioxide absorption. Conserve that tract of forest, however, and risk facilitating malaria outbreaks in local communities, a recent study finds.

Nearly half of malaria deaths in the Americas occur in Brazil, and of those nearly all originate from the Amazon. Yet few conservationists consider the forest’s role in spreading that disease. Those researchers who do take malaria into account disagree on what role forest cover plays in its transmission.

Some think that living near a cleared patch of forest–which may be pockmarked with ditches that mosquitoes love to breed in–increase malaria incidence. Others find the opposite–that living near an intact forest fringe brings the highest risk for malaria. Still more find that close proximity to forests decrease malaria risk because the mosquitoes that carry the disease are kept in check through competition with mosquitoes that don’t carry the disease. Most of the studies conducted in the past only focused on small patches of land, however.

To get to the bottom of how rainforests contribute to malaria risk, two Duke University researchers collected 1.3 million positive malaria tests from a period of four-and-a-half years, and ranging over an area of 4.5 million square kilometers in Brazil. Using satellite imagery, they added information about the local environment where each of the cases occurred and also took rainfall into account, because precipitation affects mosquitoes’ breeding cycles. Using statistical models, they analyzed how malaria incidences, the environment and deforestation interacted.

Their results starkly point towards the rainforest as the main culprit for malaria outbreaks. “We find overwhelming evidence that areas with higher forest cover tend to be associated with higher malaria incidence whereas no clear pattern could be found for deforestation rates,” the authors write in the journal PLoS One. People living near forest cover had a 25-fold greater chance of catching malaria than those living near recently cleared land. Men tended to catch malaria more often the women, implying that forest related jobs and activities–traditionally carried out by men–are to blame by putting people at greater risk for catching the disease. Finally, the authors found that people living next to protected areas suffered the highest malaria incidence of all.

Extrapolating these results, the authors calculated that, if the Brazilian government avoids just 10 percent of projected deforestation in the coming years, citizens living near those spared forests will contend with a 2-fold increase in malaria by 2050. “We note that our finding directly contradicts the growing body of literature that suggests that forest conservation can decrease disease burden,” they write.

The authors of the malaria study do not propose, however, that we should mow down the Amazon in order to obliterate malaria. “One possible interpretation of our findings is that we are promoting deforestation,” they write. “This is not the case.” Instead, they argue that conservation plans should include malaria mitigation strategies. This could include building more malaria detection and treatment facilities, handing out bed nets and spraying for mosquitoes.

This interaction between deforestation and disease outbreakis just one example of the way efforts to protect the environment can cause nature and humans to come into conflict. Around the world, other researchers have discovered that conservation efforts sometimes produce negative effects for local communities. Lyme disease–once all but obliterated–reemerged with a vengeance (pdf) in the northeastern U.S. when abandoned farmland was allowed to turn back into forest. Human-wildlife conflict–including elephants tearing up crops, tigers attacking livestock, and wolves wandering into people’s backyards–often comes to a head when a once-declining or locally extinct species makes a comeback due to conservation efforts.

“We believe there are undoubtedly numerous ecosystem services from pristine environments,” the PLoS One authors conclude. “However, ecosystem disservices also exist and need to be acknowledged.”