As the demand for meat continues to grow in South Asia and Africa and access to communal sources of water and forage shrinks, intensification of small-scale livestock systems in peri-urban areas is expected to expand. In South East Asia, smallholder transition to livestock intensification has been transformative, increasing economic opportunities while also introducing new disease risks. While we have an understanding of the emerging disease burden from livestock intensification; we have just begun to understand the possible public health benefits of sustainable landscapes and the potential health savings accrued from disease avoidance. To date, few studies have attempted to quantify the health benefits attributable to sustainable agro-ecosystems, especially in regard to livestock systems. In this paper, I will examine what is needed to measure and communicate the public health benefits and cost-savings (from disease avoidance) of sustainable agro-ecosystems.