Climate change, land cover change, and overharvesting threaten a widely used medicinal plant in South Africa.

Medicinal plants contribute substantially to the well-being of people in large parts of the world, providing traditional medicine and supporting livelihoods from trading plant parts, which is especially significant for women in low-income communities. However, the availability of wild medicinal plants is increasingly threatened; for example, the Natal Lily (Clivia miniata), which is one of the most widely traded plants in informal medicine markets in South Africa, lost over 40% of individuals over the last 90 years. Understanding the species' response to individual and multiple pressures is essential for prioritizing and planning conservation actions. To gain this understanding, we simulated the future range and abundance of C. miniata by coupling Species Distribution Models with a metapopulation model (RAMAS-GIS). We contrasted scenarios of climate change (RCP2.6 vs. RCP8.5), land cover change (intensification vs. expansion), and harvesting (only juveniles vs. all life-stages). All our scenarios pointed to continuing declines in suitable habitat and abundance by the 2050s. When acting independently, climate change, land cover change, and harvesting each reduced the projected abundance substantially, with land cover change causing the most pronounced declines. Harvesting individuals from all life stages affected the projected metapopulation size more negatively than extracting only juveniles. When the three pressures acted together, declines of suitable habitat and abundance accelerated but uncertainties were too large to identify whether pressures acted synergistically, additively, or antagonistically. Our results suggest that conservation should prioritize the protection of suitable habitat and ensure sustainable harvesting to support a viable metapopulation under realistic levels of climate change. Inadequate management of C. miniata populations in the wild will likely have negative consequences for the well-being of people relying on this ecosystem service, and we expect there may be comparable consequences relating to other medicinal plants in different parts of the world.