For seven years, I’ve worked to understand the problem of plastics in the world’s ocean and endeavored to advance strategies to address it. But last week’s new study in the journal Science hit me like a ton of bricks. It’s now clear that to save the world’s coral reefs we first need to solve our global waste problem.

Thanks to work of Dr. Jenna Jambeck and her colleagues in 2015, we know that a huge amount of plastic (8 MMT) flows into the global ocean each year and the majority of that plastic then flows into the western Pacific Ocean from the countries surrounding the area. Now, an international team of scientists led by Dr. Joleah Lamb and Dr. Drew Harvell of Cornell University has linked this influx to a massive increase in disease susceptibility in the coral reefs across this area. Their findings show that the incidence of disease grows 20-fold when corals become entangled in plastic waste and that this is mostly driven by an increase in three known deadly diseases: skeletal eroding band disease, white syndrome, and black band disease.

The size and scale of this study was impressive. A team of investigators from nearly a dozen institutions worked across the Asia-Pacific region sampling 124,884 individual reef-building corals from four countries and eight latitudinal regions. They found that nearly a third of the corals sampled in the field were entangled in plastic waste, with the greatest amount off Indonesia (a country with limited modern-day waste management) and the lowest amount off Australia (a high income country with a relatively sophisticated approach to dealing with waste). All told, as many as 11 billion plastic items could be contaminating coral reefs across the Asia Pacific right now. And Lamb predicts that this number will increase to nearly 16 billion by 2025 if no improvements are made in how the region deals with its waste.

Corals provide $375 billion worth of goods and services to people around the world through not only fisheries and tourism but also coastal protection from storms and climate-driven rising sea levels. Coral reefs are also the “rainforests of the sea,” hosting 25% of the ocean’s biodiversity but covering only 0.1% of the ocean’s surface. Before last week’s publication, we knew that corals were under extreme stress from a number of threats including overfishing, coastal development, warming seas and ocean acidification.  In fact, bleaching of coral reefs has become one of the most visible—and visceral—signs of climate change impacts. Even without the enhanced risk of disease from plastics, the long term survival of corals is at serious risk. Lamb’s findings show that the harm humans are causing to coral reefs extends even further.

Hope is not lost but we must redouble our efforts.  We must halt overfishing. We must rapidly and aggressively move away from a fossil fuel economy. And it is now clear that we must also solve our global waste problem. If we don’t, corals will suffer even as we alleviate these other threats.

The good news is plastic pollution is now very much on the global ocean agenda. Just this week in Davos, Switzerland, there has been an overwhelming emphasis on ocean plastics from international decision makers as well as from some of the biggest corporations on the planet. Coca-Cola launched its #WorldWithoutWaste vision that includes recovering one bottle or can for every one sold by 2030. Evian committed to make all of its plastic bottles from recycled material by 2025. The global packaging giant Amcor just announced it will make all of its packaging recyclable or reusable by 2025. At Ocean Conservancy, we are leading the Trash Free Seas Alliance® to advance new funding mechanisms like the Closed Loop Ocean to improve the fundamentals of waste management in Southeast Asia. When combined with efforts to reduce the overall production of plastics and to create a “circular economy” to ensure materials are collected and repurposed, we can stem the tide of plastics into the world ocean.

It won’t be easy, but last week’s study makes clear that to save corals we must solve the global waste problem.

In doing so, we can save the oceans—and ourselves.