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Pulling Back From the Brink: Embracing a Planetary Health Approach

07 Apr 2022
By Robyn Norton AO
Floods in Bangladesh's Gaibandha district in 2017.
Source: Sentinel Hub, Flickr, https://bit.ly/3uXUgeA.

It is becoming increasingly clear that the degradation of our environment is taking a toll on our physical and mental well-being. On this World Health Day, we must finally adopt a planetary health approach.

There is no doubt that climate change is the greatest health and humanitarian crisis the world has ever seen. It is becoming increasingly clear that global environmental changes are driving rising rates of illness and disease and exacerbating inequities. The inextricable links between these changes and human health are further supercharged by unhealthy and unsustainable behaviours, such as the consumption of poor diets, accelerating epidemic-like rates of non-communicable diseases (NCDs) and shortages of arable land and freshwater around the world.

On 7 April, the global health community will mark World Health Day. This year’s theme, “Our Planet Our Health,” is a timely reminder that the future of human health is contingent on the health of the planet.

Last year, UN Secretary General António Guterres called the 2021 Intergovernmental Panel on Climate Change (IPCC) report a “code red for humanity.” The report showed just how close to the brink we are. Without immediate and ambitious action, global temperature increases due to human-induced climate change will exceed 1.5 degrees Celsius above pre-industrial levels by 2030. This level of warming is going to be devastating for people everywhere. All of us will suffer the health consequences, but those who have contributed least to climate change will be hit the hardest.

The burden of NCDs, already the biggest killer of people globally, will continue to grow. Rates of injury, cardiovascular and kidney diseases, respiratory illness, and premature mortality will rise along with temperatures. Communities experiencing marginalisation due to deep-seated inequities — exacerbated by the COVID-19 pandemic — will be impacted the most, and decades of hard-won progress on health, development, and human rights will be undermined.

Recently, Guterres called the latest instalment from the IPCC report “an atlas of human suffering and a damning indictment of failed climate leadership.” This statement leaves nothing to the imagination — our leaders have failed us on climate.

A planetary health approach to improving human health

We need action and we need it now — could the framing of “planetary health” be the solution? The Planetary Health Alliance defines planetary health as a “transdisciplinary field and social movement focused on analysing and addressing the impacts of human disruptions to Earth’s natural systems on human health and all life on Earth.” It goes to the heart of the way society is organised and operates, and the outcomes of those approaches. A planetary health framing creates the opportunity for a fundamental shift in the traditional siloed approach to global challenges.

As a medical research institute dedicated to improving the health of millions of people worldwide, The George Institute for Global Health is committed to embedding a planetary health lens in its research and advocacy efforts. It is growing its Planetary Health program, which is exploring how global environmental changes are undermining human health and equity outcomes. The George Institute is committed to ensuring that the Traditional Knowledges of First Nations and Tribal peoples, and the voices of other communities experiencing marginalisation, are at the heart of its work, not just a component of it. It achieves this by engaging with policymakers at local, national, and multi-national levels, and the communities which our research intends to benefit.

A planetary health approach requires that all of us step up. This includes the health sector, which is responsible for up to five percent of total global greenhouse gas emissions. The George Institute is committed to reducing its carbon footprint, and a sustainability audit is underway to identify strategies that can accelerate decarbonisation efforts. We are committed to sharing what we learn, including with other health and medical research stakeholders who may benefit from the insights we gain.

More research needs to be funded into the health and equity implications of rising global temperatures and environmental contamination. Recent Lancet Countdown reports on health and climate change highlighted that India and Indonesia have suffered the greatest economic productivity losses globally due to heatwaves, while Bangladesh is one of the most vulnerable countries to environmental change, particularly flooding.

In collaboration with a multiplicity of partners, we are establishing a Global Health Research Centre on NCDs & Environmental Change that aims to generate evidence to better understand and address the intersection between environmental changes and the rapidly growing NCDs burden, particularly in low- and middle-income countries. We are working with Indonesian partners to better understand the impact of plastic burning on health, in particular air pollution’s impact on chronic obstructive pulmonary disease and cardiovascular disease. In India, we’re studying how increasing temperatures may impact levels of chronic kidney disease, Type 2 diabetes, and cardiovascular disease. Our research projects in Bangladesh are examining flooding’s effects on farmland salt levels and their relationship to rising hypertension rates — a key risk factor for heart disease, one of the world’s biggest killers.

Food systems, planetary health, and human health

The food system is one of the largest contributors to environmental degradation through greenhouse gas emissions, water use, and deforestation, and one of the sectors hardest hit by climate change. The food industry needs to reduce high-emission agricultural practices that create the unhealthy food options driving escalating obesity and diabetes rates globally.

We must also rapidly transition away from food processing practices that damage the environment and undermine human health, and re-formulate processed food to reduce harmful fats, sugars, and salt. A range of regulatory and fiscal measures should be adopted to reduce ultra-processed foods in the food system and ensure access to healthy, sustainable, and affordable diets, rich in plant-based foods, using an equity lens.

Our Centre of Research Excellence (CRE): Healthy Food, Healthy Planet, Healthy People is tracking the planetary impact of over 25,000 products on our Foodswitch platform to empower consumers and policymakers with ways to improve planetary health. By developing evidence-based recommendations for government-led and market-based strategies to improve the nutritional quality and sustainability of the food supply, the CRE aims to provide consumers with the choice to contribute to building a healthier and more planet-friendly food system.

Our efforts are but a small contribution to those already underway to advance the planetary health cause, and far more action can and must be taken. It is now non-negotiable for governments to stabilise earth’s life support systems. It is essential to prepare for future warming scenarios with robust mitigation and adaptation strategies that take a planetary health approach. We must ensure that any solutions to these challenges do not disproportionately affect those already experiencing disadvantage. The communities most affected and at risk of global environmental changes must be engaged to ensure priorities and solutions are self-determined.

We need to build resilient, climate-ready health systems that can respond to extreme weather events and the increasing climate-related disease burden. We need to embed climate change into all existing and future health-related policy to recognise and better understand the impacts of rising temperatures on human health and equity outcomes.

It is the most urgent health crisis facing humanity. We must act now.

Robyn Norton AO is the co-founder and Principal Director of The George Institute for Global Health, Professor of Public Health at UNSW, Sydney, and Professor of Global Health at Imperial College London. The George Institute was established in 1999 to address the growing burden of non-communicable diseases and injuries, especially among disadvantaged populations worldwide. The Institute has offices in Australia, China, India, and the UK, and collaborates with partners in more than 50 countries across the globe.

This article is published under a Creative Commons License and may be republished with attribution.