<POINTS>

• The historic shift in areas addressed by public health due to changes in human activities that occurred alongside globalization has increased the interest in planetary health.
• Events like the adoption of the Sustainable Development Goals (SDGs) and the Paris Agreement in 2015 as well as the COVID-19 pandemic in 2020 can be linked to increased interest in planetary health.
• At the G7 Summit 2022, people and organizations in the healthcare sector were called upon to make efforts for maintaining the relationship between climate change and human health, to incorporate these efforts into specialist education and training programs, and to share best practices.
  

Introduction

Health and Global Policy Institute (HGPI) recently launched a new initiative in the area of planetary health, which is attracting attention as part of the major global movement toward decarbonization. HGPI will work with multi-stakeholders to outline an agenda for all of Japan, deepen understanding, communicate that agenda in Japan and overseas, and create opportunities for taking the next steps in order to ensure sustainable health for the Earth and humanity. In this column, which will be the second column of our series on planetary health, we will first discuss the position of planetary health within public health, and will introduce recent global trends in this area by continuing the discussion from our previous column.

Positioning of public health: from international health, global health, to planetary health

Until the 1980s, the term “planetary health” referred to exactly what the name suggests – the health of the planet Earth. Previously, researchers in the field of public health and organizations like the World Health Organization (WHO) were unaware of the potential effects on human health caused by climate change and the destruction of life-supporting systems on the Earth.*1 However, as mentioned in our previous column, the term “planetary health” has been used to refer to “the consequences of human plundering the Earth.” Here, we will trace changes in the concept of health to reexamine the position of planetary health in the field of public health.

Initiatives relevant to public health in the modern era can be traced back to before the Common Era, such as when water and sewage systems were developed in ancient Rome. In the 1700s, the science of hygiene as a means to step beyond treating individual patients to support the health of the masses started to become advocated.*2 Each country then began establishing laws and government institutions for public health to address the health needs of their people as a group instead of responding to diseases on the individual level. In the latter half of the 1800s, colonizing countries began to introduce measures to protect the health of their citizens living in colonies from diseases specific to tropical regions. This became known as tropical medicine. As tropical regions are home to many developing countries, this led to interventions from countries with more resources aiming to address health and medical problems in the countries with fewer resources. This resulted in the birth of the concept of international health, in which aid was provided across borders, usually from one country to another, and with all parties maintaining an awareness of the sovereignty, territories, and peoples of each country. Then, starting in the 1990s, alongside advances in industrialization and transportation, humanity entered an era in which diseases like HIV/AIDS and avian influenza could rapidly spread on a global scale. The term “global health” began to be used in place of “international health” to deemphasize attitudes focusing on each country as an independent unit separated by its national borders and to emphasize the importance of healthcare activities for addressing global health concerns.*3*4 “One Health” began to emerge in 2004. In addition to human health, this concept considers animals and the environment with a focus on diseases transmissible between animals and humans.

These developments resulted in the formation of the concept of planetary health. The main difference between planetary health and One Health is that planetary health focuses on impacts on human health more than on other ecosystems.*5 Furthermore, compared to global health, planetary health can be characterized by how the perspective on the sustainability of human health expands over related fields and time. Fields related to planetary health are not limited to the fields of medicine and health. The scope of analysis encompasses all ecological systems and cross-sectoral areas in economics and development. In addition to changes in ecosystems and land use, which are the focus of One Health, planetary health also considers climate change and air pollution among changes to the global environment. Regarding the expansion of timeframes, planetary health considers sustainability for people living on Earth today while taking responsibility for the health of future generations. In 2022, an article in The Lancet titled “No Public Health Without Planetary Health,” which described the intimate relationship between the health of the future planet and human health, portrayed this concept.*6 These trends in public health demonstrate how the concept of health has expanded as humanity has developed.

Issues and actions on planetary health in the age of SDGs

Now that we have taken a look at the position of planetary health within public health, we will continue our discussion from our first column on global trends in planetary health since “2030 Agenda for Sustainable Development” was adopted and SDGs were set forth in 2015.

The year 2015 saw major advances in the fight against climate change. The SDGs were adopted that September. While the Millennium Development Goals (MDGs) focused on issues related to development in developing countries, the SDGs require all countries to take action for economic, social, and environmental issues in addition to those related to development. The thirteenth SDG is, “Take urgent action to combat climate change and its impacts,” and a concrete measure toward that goal was the adoption of the Paris Agreement at the 21th Session of the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP21) held in Paris, France in December 2015. Even today, member states make important agreements on climate change at these Conferences, which are held annually. Other developments that began in 2015 were the launch of The Lancet Planetary Health journal by the medical journal The Lancet and the Rockefeller Foundation and the publication of a special issue on planetary health by the international political and economic journal The Economist, as mentioned in our first column. While few people in Japan were raising their voices regarding the human health effects of climate change in 2015, momentum for planetary health was already starting to build around the world.

Increased attention on the concept of One Health during the COVID-19 pandemic

It is safe to say planetary health began attracting more attention in Japan around the year 2020. COVID-19 is thought to be of animal origin and its outbreak has led to strong interest in zoonosis. The pandemic has reinforced recognition of the need to protect the health of people, animals, and the environment simultaneously under the concept of One Health. The concept of One Health emerged separately from the climate crisis, which is currently viewed as an urgent issue. Its origin is the Berlin Declaration adopted at the World Veterinary Association (WVA) Congress in 1993, which pledged to promote the prevention of epidemics of infectious diseases common to both humans and animals, to establish connections among humans and animals, and to make devoted efforts for a peaceful society and environmental conservation. Since then, discussions on a One Health approach have advanced under a shared understanding that measures to combat antimicrobial resistance (AMR) to antimicrobials used in various fields (particularly in the livestock, fishery, and agriculture industries) will also be crucial for protecting human health. A number of developments in One Health that further reinforced perspectives on ecosystem protection occurred in November 2020, when representatives of the United Nations Environment Programme (UNEP) participated in an expert meeting on human and livestock health alongside the heads of leading organizations in the One Health movement, namely the WHO, the Food and Agriculture Organization of the United Nations (FAO), and the World Organization for Animal Health (L’Office international des epizooties, OIE). In January 2021, WWF Japan and eleven other organizations including the Japan Medical Association, Japan Veterinary Medical Association, and the Japan Committee for the International Union for Conservation of Nature (IUCN-J) formulated a joint declaration that positions One Health as a preventive approach for zoonotic diseases, titled “Humans, Animals, and Ecosystems are One – A Joint Declaration for One Health.”*7 Around the same time, WWF Japan presented a Japanese translation of “COVID19: Urgent Call to Protect People and Nature,”*8 a report on the urgent need for a One Health response that includes the increase in zoonotic diseases caused by the collapse of the relationship between humans and nature. As these developments show, partially due to the impact of the COVID-19 pandemic, attention toward the health of all ecosystems and environments including humans is growing in the environmental field.

The launch of the Health System Task Force in 2021

Among recent initiatives in the medical, health, and environmental sectors, one development that can be considered highly significant for future global trends is the launch of the Health System Task Force*9 at the 26th Session of the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP26) held in Glasgow, U.K. in October 2021. The Health System Task Force was established following the presentation of the Terra Carta by Prince Charles at the World Economic Forum (WEF, also known as the Davos Forum) in January 2020. The Terra Carta is inspired by the Magna Carta of 1215 and aims to encourage the reconstruction of societies and economies for sustainability. Discussions on a roadmap to 2030 to help industries advance toward a sustainable future are now underway as part of the Sustainable Market Initiative*10 (SMI), which is based on the concept of the Terra Carta. As of July 2022, ten task forces have been established in various sectors including agriculture, carbon, finance, and fashion. One of these is the Health System Task Force established at COP26, which has identified three priority areas for action: digital healthcare, net zero supply chains, and patient care pathways. Establishing such an agenda for the health sector might become necessary for the international community and can serve as an important guide for determining how to best structure the global market and for when Japan formulates concrete initiatives for the future.

The WHO also presented a special report at COP26, titled “Climate change and health: the health argument for climate action.”*11 It includes ten recommendations for climate change and health that aim to maximize gains for health from climate action in various sectors while avoiding the worst health impacts of the climate crisis. That event also marked the presentation of an open letter titled “Healthy Climate Prescription,”*12 which has been signed by over two-thirds of the global health workforce (300 organizations representing at least 45 million health professionals worldwide). However, there was only a limited number of signatories among organizations and individuals in Japan, so action must be taken to gain the understanding of as many stakeholders as possible moving forward.

Mentions of climate change and health at the G7 Summit 2022

Many key international agreements on climate change have been made at forums like the aforementioned Conference of the Parties to the United Nations Framework Convention on Climate Change (COP). In recent years, climate change and health have also been important topics at high-level international meetings like the G7 and G20 summits. There was mention of the issue of climate change and health in the G7 Health Ministers’ Communiqué released in May 2022 after the G7 summit in Berlin, Germany, which emphasizes that “climate protection equals health protection.” In addition, the Communiqué discusses how climate change, directly and indirectly, impacts health, such as how it affects ecosystems, the spread of infectious diseases, the effects of heat waves, and negative mental health impacts from disasters and extreme weather events. It calls on organizations and individuals in the health sector to measure and reduce greenhouse emissions, educate and train healthcare professionals on the health impacts of climate change, plan and conduct those actions, and share best practices. In addition to the Health Ministers’ Meeting, climate change and health were also included in the Foreign and Development Ministers’ Communiqué and the Climate, Energy and Environment Ministers’ Communiqué at the G7 summit in May 2022. The impact of climate change on human health has become clear, and discussions on countermeasures like global adaptation and mitigation are advancing. In addition to the healthcare industry, it seems that it will be necessary to promote interest in domestic initiatives for climate change among a greater number of healthcare professionals serving in Japan’s clinics and hospitals in the future.

In this column, we provided an overview of developments that have occurred since the adoption of the SDGs in recent years, when efforts for planetary health began in earnest. As one small step forward for all of us involved in healthcare, we would be pleased if this column creates opportunities for you to discuss planetary health with your family, friends, and colleagues. In our next column, we will be taking a look at initiatives for planetary health in the healthcare sector which are already underway.

 

Works referenced

*1. Nagasaki University (Supervised Translation). “Planetary Health: Protecting Nature to Protect Ourselves.” Maruzen Publishing Co., Ltd. 2022:18.
*2. Tatara, K. The Dawn of Public Health and Developments to Today. Japanese Journal of Public Health, Vol. 65. 2018:255.
*3. Services for Health in Asian African Regions (SHARE). “A Look at Global Health – From ‘International Health’ to ‘Global Health.’” January 2008.
*4. Sasagawa Memorial Health Foundation. “From Medicine to Public Health: International Health, Global Health, and Planetary Health.” January 14, 2022.
*5. Lerner, H., & Berg, C. A Comparison of Three Holistic Approaches to Health: One Health, EcoHealth, and Planetary Health. Frontiers in Veterinary Science, 4, 163. 20717.
*6. The Lancet Public Health. No public health without planetary health. Lancet Public Health. 2022 Apr;7(4):e291. doi: 10.1016/S2468-2667(22)00068-8. PMID: 35366401; PMCID: PMC8967336.
*7. WWF Japan. “Humans, Animals, and Ecosystems are One – A Joint Declaration for One Health.” January 15, 2021.
*8. WWF Japan. “COVID 19: urgent call to protect people and nature.” 2022.
*9. Health Systems Taskforce. Sustainable Market Initiative.
*10. Sustainable Market Initiative.
*11. World Health Organization. “COP26 special report on climate change and health: the health argument for climate action.” October 11, 2021.
*12. Healthy Climate Prescription.

Column author

• Sayaka Honda (Intern, HGPI)
• Shu Suzuki (Associate, HGPI)
• Joji Sugawara (Senior Manager, HGPI)

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HGPI Policy Column (No.28) -From the Planetary Health Policy Team- >