‘Planetary health’ describes how the limits of natural resources like clean air, water and food production shape our long-term health, with climate change as a “threat-multiplier” for future COVID-19 like crises. Experts at the Geneva Health Forum explored the links, ahead of next week’s launch of the 2020 Lancet Countdown Report on Health and Climate Change.

On Monday 23, US president-elect Joe Biden announced that John Kerry would be his administration’s special climate envoy, indicating that his administration would also rejoin the Paris Climate Agreement.

That represents an about-face in the decision by the outgoing administration of President Donald Trump earlier this month to formally withdraw from the 2015 Paris Agreement. Biden is also expected to rescind outgoing President Donald Trump’s withdrawal from the World Health Organization (WHO) on the day after inauguration – and he has placed tackling COVID-19 among his top priorities.

Climate and Global Health Deeply Interrelated

In fact, as those recent moves might suggest, for policymakers who care about science, climate and global health are deeply interrelated. And in the wake of the pandemic, more and more political leaders from both the developed and developing world are speaking out about the long-term impacts of climate on health – include the prospects that global warming could increase the likelihood of future pandemics.

The concerns have been reflected in a string of recent statements by WHO’s Director General Dr Tedros Adhanom Ghebreyesus, France’s Emmanuel Macron, and other leaders from Europe, Africa, Latin America and the Pacific region at November’s World Health Assembly (WHA), the Paris Peace Forum 2020, and last week’s Geneva Health Forum (GHF). While each forum and speaker may have had different agendas, they agree that climate change poses significant threat to global health.

One key framework for exploring the climate – health connection is ‘’planetary health’’. The concept was discussed in depth in a session at last week’s GHF – ahead of the Lancet Countdown’s launch of it’s 2020 report on health and climate change.

What is planetary health?

The Lancet’s Manifesto for Planetary health was one of the first major scientific articles to articulate the concept, in March 2014 – as a holistic attitude towards life and a philosophy for living.

“It emphasises people, not diseases, and equity, not the creation of unjust societies. We seek to minimise differences in health according to wealth, education, gender, and place,” Richard Horton and co-authors wrote. “We support knowledge as one source of social transformation, and the right to realise, progressively, the highest attainable levels of health and wellbeing.”

According to the Planetary Health Alliance, the field is focused on characterizing the health impacts of human-caused disruptions of earth’s natural systems. It encompasses the health of human civilization and the state of the natural systems upon which it depends.

Speaking at the GHF last week, speakers flagged examples of the vicious cycle of climate drivers and health impacts that is becoming stronger by the year. For instance:

• According to the 2019 report, researchers observed 220 million heatwave exposures affecting vulnerable populations in 2018, increasing risk of heat stress, heart disease, and kidney disease. This was an increase of 11 million since 2015.
• Regarding wildfires, 152 out of 196 countries saw increases in populations exposed to wildfires from the early 2000s to present day there are also changes in rainfall patterns. According to the report, South America and Southeast Asia have experienced the largest increase in extreme rainfall from 2000 to 2018.

Jessica Beagley, policy manager for the Lancet Countdown report said: “The global impacts of climate change on health are worsening year on year.”

“And there were areas of significantly increased job exposure in all six WHO regions. Parts of Brazil actually experienced the full 12 months of drought and the whole 2018 also seeing impacts on food insecurity,” Beagley added.

The Lancet reports also connect undernutrition to a changing climate’s impact on crop production especially the productivity of maize and soybean crops. Land degradation further exacerbates climate impacts. Together the two may reduce crop yields by up to 10% globally and up to 50% in certain regions, according to a new report by the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, released on Wednesday. And food and economic insecurity give rise to migration and conflict in the worst cases, as well as immeasurable mental health impacts.

Renzo Guinto, a Philipino physician and chief planetary doctor at the Manila-based PH Lab, which explores human and planetary health through a similarly holistic lens said: “Climate change is very real in this country, planetary health challenges are very real and raw. People are facing them every day. It’s not just the extreme weather events. It’s also increasing the sea level. The Philippines’ coastlines are also facing the fastest rate of sea level rise in the world.”

He added: “Climate change is very real, just like health challenges. Increasing sea level rise, volcanoes, tsunamis. Then infectious disease pandemic which may not be the last if we don’t put our house together. A planetary health approach is critical.”

Climate Change is a “Threat Multiplier” Leading More COVID-like Crises

COVID-19 and the climate crisis share another common trait: they are both threat multipliers. As the pandemic dominated 2020 news cycles, climate change continued to exacerbate the same risks that often lead to humanitarian crises.

At the GHF, Beagley said: “COVID-19 has shown the extent to which a large scale health threat can jeopardize even the strongest economies and can entirely redefine ways of life.

“We really need to start minimizing future health threats that are related to infectious disease or the wider health risks of warming climate.”

According to the United Nations Development Programme (UNDP), 90% of COVID-19 cases are in the world’s cities where people are already experiencing the impact of climate change, pollution, widening inequality, and economic crisis.

In the Philippines, citizens have been dealing with what ReliefWeb has described as “typhoon after typhoon after typhoon”.

“Even by the area’s stern storm season standards, 2020 has been a terrible year. In the past month alone, five storms have hammered the Philippines, from Typhoon Molave (locally named Quinta) on October 25 to Vamco (Ulysses) last week, which came less than a fortnight after the season’s strongest storm, Typhoon Goni (Rolly),” said Minaz Kerawala, Communications and Public Relations Advisor at ReliefWeb.

Climate Impacts Vector-borne Diseases As Well

Aside from its impacts on food production and nutrition, attention has also been drawn to the ways in which climate change can also exacerbate transmission of vector borne diseases. At the recently held resumed session of the 73rd WHA, a representative from Mexico said climate change goals are important in stemming the tide of vector-transmitted diseases.

While WHO has affirmed the direct connection between climate change and health outcomes, it has largely stressed the threats posed to clean air, safe drinking water, nutritious food supply, and safe shelter.

“Climate change has the potential to undermine decades of progress in global health,” the WHO climate change homepage says. “Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress alone. The direct damage costs to health is estimated to be between USD 2-4 billion per year by 2030.”

More than a decade of science also links climate change to expanded transmission of vector-borne diseases.

In the 2015 paper on ‘Climate change and vector-borne diseases: what are the implications for public health research and policy?‘, the authors said vector-borne diseases are sensitive in different ways to weather and climate conditions such that the ongoing trends of increasing temperature and more variable weather threaten to undermine recent global progress against these diseases.

“For operational health agencies, the most pressing need is the strengthening of current disease control efforts to bring down current disease rates and manage short-term climate risks, which will, in turn, increase resilience to long-term climate change,” the authors reported.

Dilemma for Humanitarian Organizations

Addressing climate change has been regarded as a development issue that should be addressed by development organisations leaving humanitarian establishments to tackle crisis and emergencies.

As Mexico stated at the WHA, not only are health and climate change deeply interrelated, but together they impact deeply on people’s fundamental human rights.

Organizations including the International Committee of the Red Cross (ICRC) are increasingly being challenged to get more actively involved in combating climate change. This was on display at the GHF.

Speaking at the 2020 Paris Peace Forum, Peter Maurer, President of the ICRC said climate change is one of the factors that increase vulnerabilities to diseases and outbreaks in societies.

“The vulnerabilities through poverty, climate change, violence, wars and other challenges in societies tend to be overshadowed by the dominant features of fighting the pandemic,” Maurer said.

He warned that the world needs to learn from the experience of past outbreaks that a more robust approach would be required to achieve desired results.

“We have seen in previous pandemics that just focusing on the pandemic and not keeping a perspective on the overall health system delivery is really the thing not to do. It is important to keep a systematic overview. Whether it is health, water, livelihoods, jobs … the situations have to be analyzed specifically in each and every context; and we need to design programs responding to every need,” Maurer added.

Taking Steps That Matter

At the Paris Peace Forum, Justin Trudeau, Prime Minister of Canada admitted that there is a lot to do in fighting COVID-19, and addressing other key global health-linked issues including fighting climate change, building economies that work for everyone, and advancing gender equality.

“We have a lot to do,” he said.

Jacinda Ardern, Prime Minister of New Zealand asked world leaders to come up with urgent global efforts on climate change, she drew attention to the high seas treaty that would protect biodiversity beyond borders.

But with a vacuum in global leadership in addressing climate change, stakeholders are struggling to coherently get the global community in moving in the same direction and this was expressed by the French Minister for the Economy and Finance, Bruno Le Maire.

At the 2020 Paris Peace Forum, he said making progress in addressing climate change has suffered a similar fate that addressing inequalities is facing — no clear way forward.

“So far, we have been unable to find global answers to these two questions: the rise of inequalities and climate change. This means that capitalism has reached its limits,” Le Maire said.

But in her remarks at the GHF, Beagley said deciding the way forward is not hard as numerous actions that have far-reaching effects can be taken easily considering several threats to climate change are also linked to diseases and illnesses that are of importance to global health.

“Anything to reduce greenhouse gas emissions is already going to have the most impacts to human health in the longer term. But in the near term you’ll see co-benefits and emissions reduction. And because many of the sources of greenhouse gas emissions are the same as sources for air pollution,” she said.

She said transitioning to more renewable energy, and in particular, phasing out coal, will improve air pollution. Other actions including countries and cities remodeling transport systems, and promoting active transport that will also promote physical activity.

On an individual level, she said that transitioning to a whole plant-based diet will mean less red meat and processed food will improve an individual’s health.

“I think it’s also important to look at the lessons that we can learn from the covid 19 pandemic response, and especially as some governments start to consider recovery. So I really want to emphasize here that climate health and economic objectives are not just mutually reinforcing but are also mutually dependent. We can’t have health where we have poverty and it’s clear that extreme poverty is possible with extreme climate change and public health issues,” Beagley said.

Image Credits: Jason/Flickr, The Lancet Countdown, Geneva Health Forum, THE ASSESSMENT REPORT ON LAND DEGRADATION AND RESTORATION, Geneva Health Foundation, Nadir Hashmi/Flickr.