Thursday, July 10, 2014

What is Planetary Health?

On the shores of Lake Como in Italy, among fragrant jasmine and wild thyme, a new discipline was born this week. Its parents--in the fields of health and the environment--are not quite sure yet what to call it. Some say it should be called Planetary Health. Others are not so sure. But what everyone knows for certain here is that it is important. Critical even, because human health is at great risk from forces that remain largely invisible to society. And so a pioneering group of scientists, entrepreneurs, public health experts and folks from business, government and public health have come together to assist at its birth.

The world needs to understand planetary health to develop sustainably. In a nutshell, many human activities damage the environment and with it human health. Some of the links are obvious and direct such as pollution in lakes and rivers. Others are not. For example, there is growing awareness of the link between biodiversity damage and disease risk. Most scary of all is the rise in new human diseases that come from animals. So called zoonotic diseases whether from birds, pigs or camels are on the rise. We know that our environment provides us fish, clean water, medicines and resilience from natural disasters. We have not accounted for all that it gives us, and possibly never will. We certainly need to do more to understand it.  

But the beauty of the surroundings of Lake Como are deceptive because ugly difficulties lay ahead. Firstly, forging a new discipline is less easy than it might sound. Here you must first marry the parents. Combine ideas, research, and information from environment and public health two fields that have lived entirely separately until now and rarely spoken to one another. Yet when everyone goes home from their workshop for the most part people will fall comfortably back into their old ways of doing things and concerns and hope that someone else does the child rearing.

The second problem is that a new science is not enough--even as scientists demand more of it. There is another ingredient that is missing. A secret sauce. At the end of last year, Europe banned for a trial period the use of three pesticides suspected to damage bee populations. There isn’t hard evidence here. Yet the same collection of nations have failed to rein in overfishing where the science is perfectly clear.  

At the same time, we know that corporations and other NGOs are happy to put their thumbs on the scale in a way that suits them. In China KFC and MacDonalds and Dunkin donuts have moved into the cities and are winning the locals over to their largely unhealthy foods by arguing that they are safe to eat. Where are the advocates for putting sustainable health agenda onto the table? The individuals who are willing to stand up and say why what they are doing matters and this is important to you. But this leads us to our third problem is human nature. We all want someone else to solve our problems to recognise the importance of what we believe to be true.

The fundamental issue is that supporters of Planetary Health need to bring their ideas down to earth, they need to come from the bottom up from humanity itself and its needs. Because in truth rich countries have mostly discovered already the nature of the problem in many ways. Environmental agencies regularly consider the impact on human health when they look at the impact of new projects. And as the science grows, showing for example that green space in cities improves health, we can imagine the rich world will respond with further measures. But elsewhere there needs to be a far stronger effort to forge a relationship between human health and the environment that sustains it.

Those who wish to forge ahead in Planetary Health need find the human dimension to the problems that are out there. The stories, the people, the places, the meaning and the messages.  And who is going to knock on the doors and stand up and make the pitch to NGOs, politicians, bureaucrats and to anyone who will listen? International organisations will help eventually, and so will innovation in many unexpected ways. But at the heart of every decision we take are humans.  

In Washington they call it lobbying. The soft science of persuasion. Does anyone in the field of planetary health have the guts to do this--potentially in the face of resistance? Many people and companies make good money from environmental destruction. And our economic system is one that values products and services greatly and the quality of life barely at all.

Traditionally environmental change has been set squarely against human development. Very often we argue to cut down forests, drain rivers, use pesticides and fertilisers, belch pollution into the atmosphere to aid humans to improve development. We are unapologetic in saying that our traditional form of development is good for humans. We say that when people get rich then they will take care of the environment. But what if the environment does not continue to take care of us? And is it really necessary for the developing world to repeat the model of development that caused so much human and environmental sickness? China has a thriving economy. But can a country whose people and environment are so burdened with pollution really rich. Do we need a new vision of what prosperity means?

During the World Cup, everyone saw in Brazil what happens when two key components of a system are taken out, there was a catastrophic failure. This is exactly what has happened in ecosystems. For a hundred years our technology has largely protected us, delivering globally unprecedented gains in human health. But the worry is that as the planet comes close to its boundaries, this is now at risk.

Scientists will weakly suggest the precautionary principle. It is true much more science is needed to understand the connections. But perhaps what we need is an idea that goes beyond all of this, a vision of better human health from sustainable development.

The wealthiest in society live in idylls such as is found on the slopes of Lake Como. If we do not embrace a sustainable vision of health, not only will our chances of having everyone live this way vanish--there is a risk to the sustainability of many of our societies around the world. If this sounds too dramatic consider those in Bangladesh, or in Fiji, threatened by climate change or in communities challenged by reckless development such as the Maldives. The sad truth is that the world needs a science of Planetary Health, or whatever it is called, whether it realises it or not. We need its insight and assistance to develop sustainably and protect the future. But is the field ready to meet this need?


This piece was written during a meeting held by the Rockefeller Foundation and The Economist Intelligence Unit, and was intended as a view by an Economist journalist on a project to create a new field that connects human and environmental health. It has been slightly edited since delivered.

Views, as ever, are my own and not that of The Economist. But they should be. NL, Bellagio, July 2014.