Planetary Health: Recommendations for a Post-Pandemic World

Climate and health: Two sides of the same coin

The year 2019 was marked by increased awareness of the climate crisis, driven in part by youth movements around the world. Yet while this urgency was reflected in the language of many politicians, it did not translate into concrete action. The UN Climate Summit in Madrid (COP25) exposed the huge disparity between growing societal demands for strong climate action and official outcomes driven by the diplomatic communities responsible for crafting global rules under the Paris Agreement. Considered “disappointing” by UN Secretary-General Antonio Guterres, COP25 did not deliver.

The year 2020 has been marked by a new global crisis, the COVID-19 pandemic, which has focused public and political attention on health like never before. And although they have not yet been foregrounded in climate discourse or action, the health impacts of climate change are also profound and far-reaching. These health risks – some of which are highlighted below – deserve to be elevated within the climate community.

• Climate change endangers food security and access to clean drinking water. Increased temperatures and changes in precipitation patterns are likely to reduce the production of staple foods in many of the poorest regions of the world, increasing the incidence of malnutrition and undernutrition – which already contribute to 3.1 million premature deaths each year.
• Extreme weather events destroy homes, medical facilities, and other key infrastructure, and their frequency and intensity is expected to increase under climate change.
• Climate change will shift and potentially expand the geographic zones that are favourable for the transmission of vector-borne diseases, such as dengue, malaria and Zika.

On top of this, social, economic, and gender inequalities make it difficult for communities to deal with climate-related health impacts. Unsurprisingly, such impacts tend to affect the most vulnerable first. Without assistance to prepare and respond, regions with weak health infrastructure – mostly in developing countries – will be the least able to cope.

The COVID-19 virus – which is thought to have crossed over from wild animals to humans, as is the case for 75% of all emerging infectious diseases – clearly illustrates the urgency of uniting the health and environmental policy agendas to bring the world on a path towards sustainability. The fundamental interdependency of human health and the health of the environment is encapsulated in the concept of planetary health, which emphasises that the health of the planet and the humans that inhabit it are inextricably linked. Planetary health is a scientific field and social movement that has been gaining force since the 2015 publication of the Rockefeller Foundation–Lancet Commission report “Safeguarding human health in the Anthropocene epoch.” Among other things, this is evidenced by the formation of the Planetary Health Alliance, which has attracted a diverse community of academics and practitioners, including public health professionals, since its foundation in 2016.

Given these considerations, the authors have developed the IASS Policy Brief “Moving as One: Integrating the Health and Climate Agendas for Planetary Health in a Post-Pandemic World,” with recommendations based on in-depth qualitative interviews with experts, an updated literature review, and participant observation by the authors in the policy sphere.

The IASS Policy Brief highlights three recommendations:

1. Health professionals should engage strategically with climate planning processes.

Although it is clear that climate change will have far-reaching effects on human health, the issue of health has yet to play a larger role in climate politics or policies. One of the difficulties of integrating the climate and health agendas stems from the fact that their synergies are often overlooked by policymakers and practitioners. Given the urgency of climate action for human health specifically and planetary health more broadly, there is a need for communication tools and strategies that effectively demonstrate climate-health synergies, challenging the misperception that climate and health are two independent problems. Efforts to raise awareness of these synergies should focus on climate planning processes, particularly within the formal processes related to the implementation of the Paris Agreement, in which health has played only a minor role to date. Targeting climate planning processes at all levels is an important opportunity for the health community: not only to raise the profile of health within the climate policy arena, but also to enhance ambition and anchor support for climate action in the context of other societal priorities. Integration of health considerations within climate planning should also lead to improved health outcomes, particularly when it comes to preparing for the health impacts of a changing climate. Good health is something that is valued at both an individual and societal level; this has only been underscored by the recent Covid-19 pandemic. The current heightened attention on health is an opportunity to highlight the importance of climate action for health and ensure that this is reflected in the implementation of climate plans.

2. Use climate finance to unleash health co-benefits of climate action.

The task of decarbonising the world is neither easy nor inexpensive. Estimates of the investment required to achieve a low-carbon transition range from $1.6 trillion to $3.8 trillion annually between 2016 and 2050. Within the Global Climate Fund (GCF), developed countries have pledged to provide $100 billion annually to developing countries from 2020 on for climate change adaptation and mitigation. So far, little action has been taken on health within the world of climate finance, despite the acknowledgement of its importance. Countries can take the lead by including public health considerations in their Nationally Determined Contributions (NDCs) to the Paris Agreement and associated plans and programmes. At the same time, funds should support this effort by providing structural guidelines and incentives for countries to incorporate health benefits, as well as mechanisms to monitor their achievement, into project proposals. Looking at the landscape of climate and development finance more broadly, one cannot ignore the COVID-19 pandemic, which will inevitably disrupt our economies and cause development setbacks. This disruption is both a risk and an opportunity for climate action. No economy has been left untouched, but the impact of this pandemic could and should drive more inclusive growth and sustainable development.

3. Scale up gender-just solutions as a lever to implement the Paris Agreement and the SDGs.

Climate change impacts the lives of women disproportionately. Furthermore, gender and other social inequalities lower the capacity of communities to cope with climate-related health challenges and dangerous environmental degradation. We recommend scaling up gender-just climate solutions as a way to synergistically advance the UN Sustainable Development Goals (SDGs).

Gender equality, a cross-cutting societal objective, is embodied in SDG5: Achieve gender equality and empower all women and girls. Good health well-being and Climate action are likewise represented in SDGs 4 and 13, respectively. As the SDGs make clear, the path towards sustainability encompasses many goals, with action required across all sectors of economy and society. Given the enormity of this challenge, it is inefficient, and even counterproductive, to consider these goals in isolation; a synergistic approach is necessary. Here, the concept of “multi-solving” is appropriate: we need to design interventions that solve multiple problems at once. On a planet whose natural resources are increasingly under pressure from a human population of almost 8 billion, we don't have the luxury of addressing one crisis at a time. Beyond the normative goal of gender equality and the pragmatic case for “multi-solving” approaches, gender-just solutions can and should harness the potential of women to make economic contributions if decision-making processes were more equitable.

The urgency to integrate health into the climate agenda has never been greater. In a world struggling with the devastating effects of the COVID-19 pandemic, it is more important than ever to examine the deep and complex links between human health and the health of our environment and social systems, including our economy. While building robust health systems and supporting health workers is essential, it is not enough to ensure collective, long-term human health. True resilience results from investing in the social and environmental determinants of health, among other things by limiting and preparing for climate change, reducing pollution, and minimising social inequality.

Before the pandemic, it was clear that implementation of the UN Sustainable Development Goals was at risk. Beyond the evident stress on global health systems, another fundamental area that came under threat was our food systems. COVID-19 provides us additional reasons to rethink how the world produces food and nourishes the most vulnerable populations, while simultaneously considering environmental impacts and the pressures from climate change. As is often the case, research on these challenges continues largely in separate silos of environment, agriculture, economics, and public health. In an open letter to world leaders, scientists called  for more transdisciplinary research to develop increased resilience of our agricultural and food security systems, underscoring the need for integrative approaches such as planetary health. In an attempt to boost this theme, the UN will be holding the Food Systems Summit in 2021 to highlight the major opportunities for a well-organized and participatory global effort to address these challenges. If some leaders in the environmental arena did not see the direct connection between environment and human health prior to COVID-19, the pandemic has opened important avenues for a more integrative agenda.