Planetary health event summary

Planetary health Improving human health by healing the planet Summary of a meeting hosted by The Rockefeller Foundation The human health impacts of accelerating global environmental change are likely to be the biggest humanitarian challenge of this century Samuel Myers, research scientist, Harvard School of Public Health With insights from Introduction from the Rockefeller Foundation Since its birth more than 100 years ago, The Rockefeller Foundation has worked in public health because it believes good health underpins human progress Its efforts have ranged from developing the vaccine for Yellow Fever to strengthening disease surveillance systems to advising several Asian and African governments on their new Universal Health Care coverage efforts Over time, this focus on public health has flowed into work on the Foundation’s other three “pillars”: improving cities, ecosystems and livelihoods Bolstering these pillars, the organization believes, best helps meet its two primary goals: advancing inclusive economies that expand opportunities for more Planetary Health broadly shared prosperity, and building greater resilience by helping people, communities and institutions prepare for, withstand and emerge stronger from acute shocks and chronic stresses In this century, the link between environmental change and human health has become ever more apparent Malaria is arriving in new places as temperatures climb Global environmental change is causing rare plant species to vanish along with the forests that harbor them Such plants could be a key ingredient in a life-saving medicine The alarming rate at which these changes occur could have catastrophic consequences not just on our health, but also on the systems and structures that form the bedrock of humanity The very survival of our species and civilization is thus at risk All this begs the question: What if the environment is unable to take care of us because we have not taken care of it? To consider this interdependency and address the potential health crisis implied by dramatic environmental change, in July 2014 The Rockefeller Foundation and British medical journal The Lancet convened a meeting on “The Future of Planetary Health” at the Foundation’s Bellagio Conference Center in Italy More than 30 high-level participants, including scientists, entrepreneurs, public health experts, business executives and government leaders met to better understand planetary system disturbances, and to explore possible solutions to future threats Insights from the meeting flowed into a subsequent smaller Rockefeller Foundation–Lancet Planetary Health Commission meeting “The Future of Planetary Health” was the third in the Foundation’s series of high-level meetings focused on imagining a very different future by 2025 in its four pillar areas By bringing together diverse, sometimes opposing perspectives, the Foundation hopes to help develop vital strategies and solutions that will fortify humanity’s ability to anticipate and adapt to rapidly emerging opportunities and challenges For more information on the series, please go to www.visionariesunbound.com The Economist Intelligence Unit wrote this summary report, with the exception of the Introduction and Conclusion, which were written by The Rockefeller Foundation The Planetary Health meeting was convened by The Rockefeller Foundation and The Lancet with support from The Rockefeller Foundation Planetary Health Executive Summary Planetary Health brought together more than 30 experts to explore ways to improve human health by healing the planet The progress we’ve made in global health is only sustainable if we also consider the health of the planetary systems on which human health depends Judith Rodin, president, The Rockefeller Foundation Planetary Health Humanity’s heavy ecological footprint on the planet is well known Factories, farms, cars and our consumption patterns have changed the earth and its natural environment in many irrevocable ways Far less understood is how these environmental changes are influencing human health Signs have surfaced that point to a startling link between these two areas, and beg for action These include a rise in the incidence of or exposure to tropical disease such as Dengue fever as temperatures rise in higher latitudes and natural habitats like forests disappear, and a rise in famine, flood, drought and intense storms stemming from climate change Now is the time for a focused study on the complex, interdependent and powerful impact of natural systems change on our human health, say prominent scientists such as Richard Horton Ignoring or failing to address these changes, Horton, The Lancet editor-in-chief argues, threatens our social fabric, systems, structures and civilization As evidence mounts and attention shifts to this urgent area, a number of ideas are emerging Many of these surfaced at a July 2014 “Future of Planetary Health“ meeting, hosted by The Rockefeller Foundation They range from harnessing data, analytics and predictive modeling to build the business case for different policy and natural resource use decisions; to storytelling to inform and incite action; to bringing new players, such as millennials and local communities into the fold to lead behavioral change Five of these are believed to be particularly applicable to help solve some of the critical, enmeshed challenges They are outlined below These ‘future solutions’, or key recommendations, emerged from discussion among five working groups that focused on the human health impacts of changes in our planet’s climate, biodiversity, land-use and in its marine and freshwater ecosystems: Are we able to act quickly enough to reverse our course? Montira Pongsiri, environmental scientist, US Environmental Protection Agency1 Better governance structures for managing global resources: Coveted global “commons” such as freshwater, air, forests and oceans have not been sufficiently protected, because market economies often fail to fairly value healthy commons, or to extract costs for damaging them To help protect the ocean commons and reduce overfishing, the Oceans Working Group proposed an oceans-focused United Nations agency To provide a viable commercial alternative to the current fishing industry, the group recommended establishing and scaling up a sustainable aquaculture industry by 2030 Other suggested goals included developing a global fisheries lab to measure and monitor the health of wild fisheries through, for example, innovative technologies such as deep-sea robots monitoring progress in rebuilding fish stocks Evidence-based input about the likely impact of land-use changes to influence decision-making: Those who make land-use decisions often fail to grasp the positive and negative impacts of their decisions on the health of often distant ”downstream” communities, particularly in areas with robust agro-industrial development around rapidly growing cities To better inform natural resources management and public health decisions, the Land Use Working Group proposed case studies to explore the human health impact of ecosystem changes on such areas as infectious diseases, nutrition and mental health Such studies may demonstrate how alternative approaches that explicitly account for the public health consequences of environmental change can increase system sustainability and resilience To provide city leaders with realtime, relevant information for key decisions, the group also recommended generating relevant health and environmental data through personal and site-based monitoring Such quantifiable measures might trigger a range of market-based solutions, such as payments for ecosystems services or tax incentives More evidence-based information about the potential benefits of ecosystems protection to spur policy change: Policy makers will be more apt to craft laws and incentives and fund programs that protect vital ecosystems with quantitative measures of their benefits The Biodiversity Working Group proposed the increased use of national ”natural capital” accounts, forecasting models and environmental-impact statements to help measure the long-term human health impacts of environmental change to motivate businesses, communities and government to change their behavior New business models to deliver scarce resources to underserved and vulnerable regions: Vital goods and services like water often fail to reach the poor in small and remote villages because infrastructure costs are prohibitively high But many innovative financing and delivery schemes have emerged that make this possible and protect the environment Such models—including microfinancing, crowdsourced In her personal capacity Planetary Health EXECUTIVE SUMMARY funds and payment-for-ecosystem-services programs—were the cornerstone of the Freshwater Working Group’s proposal to help bring clean water to the world’s billion people with insufficient to no water supply Suggested building blocks include webbased proposal templates for communities to begin fund-raising efforts, and a global Water Corps to advise communities on building and maintaining water infrastructure Small-scale water-collecting solutions like cisterns, open data for stakeholders to track water distribution and conservation progress, and alternative payment currencies such as “water coin” (like Bitcoin) were among other recommendations The creation of an entirely new field to focus attention, resources and action on this urgent area: At watershed moments in history, new institutions and ways of thinking have surfaced for a singular focus on critical issues The Climate Change Working Group called for an entirely new discipline to tackle accelerating and complex problems linked to the environmental change–human health nexus in a rapid and We need more minds like those who built cathedrals They will never see the light of day until it is finished But they continue to work Derek Yach, senior vice president, Vitality Group Planetary Health calibrated way It recommended communications campaigns and convening investors and funders within a year to finance and focus on the programmatic aspects of this new field The commission and future work will explore this undertaking We must be disruptive and revolutionary Change cannot be incremental Fred Boltz, managing director of Ecosystems, The Rockefeller Foundation As we pass critical environmental thresholds, the threats are great to both human health and survival We can intervene and shift bit by bit the trajectory of environmental change and these threats We can collaborate across many sectors that are directly impacted by these changes, such as environmental science, food production, construction and public health But without a distinct focus by public-health practitioners on the accelerating, complex and profoundly interdependent drivers of ecological change and human health, our very civilization is at risk Only then will all the critical players in the private sector, government and science fall into place, to advance research, policies and action at global, regional and local levels Planetary Health Planetary health Improving human health by healing the planet Human health and the environment have been interwoven since the beginning of time Temperate conditions helped societies thrive in lush coastal regions like Mesopotamia, the Mediterranean and the Mississippi Delta over five millennia Rainfall quantity and soil quality in an agrarian world first determined health and wealth and drove the development of a merchant economy, as cotton, fish and timber were bought, sold and traded As a result, some societies prospered and others floundered These forces ebbed and flowed, largely with the earth’s natural order Why did the Mesopotamian and Roman civilizations collapse? What was the role of environmental factors? Richard Horton, editor-in-chief, The Lancet The coal furnaces and factories of the Industrial Revolution changed all that A surge in production brought prosperity to many But the belching smokestacks of the 1800s rained toxins on many homes and farms and triggered lung infections; progress in the use of chemicals and fertilizers improved lives, but also often brought unintended health consequences, such as other diseases Medicine made great gains over that time, as public-health systems and resources to fund them triggered medical innovation, treatment and cures But scientists struggled to keep pace with the spate of new illnesses Still, in no other era has the natural rhythm of our planet’s weather, air and landuse patterns changed so dramatically as in our own, largely due to humanity’s very visible hand While the world is much wealthier than it was a century ago, the wealth accumulation has come at a price to our planet’s lungs and our own Paradoxically, while illness triggered by discrete environmental impacts such as pollution has decreased with improvements in medicine, water and food safety, the vulnerability of our health increases due to unpredictable climate change patterns Rising affluence and rapid population growth are likely to accelerate the pace of environmental change and threats to human health Scientists and policy makers are sounding the alarm They are calling for deeper and broader research into the interdependent and complex nature of the relationship between our environment and our health so that governments, organizations and companies can respond more effectively They are also calling for institutional change to address threats to our enmeshed environmental, human health and social and economic systems as we cross critical thresholds By devising the right strategies and spotting opportunities to shift the trajectory, experts hope to improve our stewardship of the planet and safeguard human health Planetary Health The conversation To imagine a different future by 2025 and surface strategies that may help us get there, in July 2014 British medical journal The Lancet and The Rockefeller Foundation convened a high-level, four-day conversation with experts for an honest assessment of the health of the earth and of humanity—and the connections between the two The meeting aimed to identify gaps in our knowledge and to build an accelerated, global and multi-sectoral plan to advance research and spur action Climate change is seen as a remote threat in space and time Howard Frumkin, dean, School of Public Health, University of Washington It also sought to inform international policy and incite proactive responses before we cross critical environmental thresholds With the world population set to soar to 9.6 billion by 2050—and with more than half of all people already living in cities— addressing this problem is all the more urgent Global leaders at the meeting hailed from over 30 institutions, organizations and companies, including Harvard Medical School, the United Nations, the African Development Bank, the X-Prize Foundation, PepsiCo and Monsanto (see list of participants in the appendix) “The world is undergoing enormous stress Many parts of the world are suffering from the human footprint, which is testing the biosphere’s capacity,” said Richard Horton, editor-in-chief of The Lancet, at the meeting’s opening “If we transcend critical environmental boundaries, we get into deep trouble Meanwhile, we struggle with partisan gridlock, stressed financial institutions and fractured nation-states As we move forward, I have a feeling of immense danger,” he said “How we present the science to motivate behavioral change?” Planetary Health Planetary Boundaries A useful starting point for understanding the environmental and human health nexus is “planetary boundaries,” or tipping points in our planet’s air, land, fresh water and ocean natural systems that are most influenced by environmental shifts These boundaries were defined in 2009 by a group of 28 internationally renowned scientists (http://www.stockholmresilience.org/21/research/research-programmes/ planetary-boundaries/planetary-boundaries/about-the-research/the-nine-planetaryboundaries.html) The framework considers changes in our natural systems, including ozone levels, biodiversity loss, atmospheric greenhouse gases, ocean acidification, land use change (see chart, pp 11), and other environmental changes that threaten the conditions under which humanity can “safely operate.” If one or more of these boundaries is breached, altered environmental trajectories could cause rapid, nonlinear and irreversible changes in planetary systems that could jeopardize the very survival of the human species Notably, three planetary boundaries have already been crossed—those of climate change, biodiversity and the global nitrogen cycle—according to the framework’s architects Atmospheric CO2 has increased by 40% since 1800, primarily from burning fossil fuels and land-use changes that have resulted in increased polar-sheet ice melting, a sea-level rise of 0.19 meters since 1900 and ocean acidification 10 Planetary Health RECENT RESEARCH diseases; and health outcomes driven by multiple changes, such as resource scarcity, land-use changes and climate change The tight link between the biosphere and our health is becoming ever more apparent But this connection remains poorly understood and largely invisible to the public The result is little action to safeguard our planet and our well-being “Let’s connect the dots between health and the environment and appreciate the interdisciplinary nature of these fields What are the pressure points? What are the areas of dynamism? Think fifteen years out and develop a road map and strategies for change,” urged Vijay Vaitheeswaran, The Economist’s China business and finance editor, who facilitated the meeting “There is tremendous opportunity to strengthen links and shape organizational change.” Planetary Health 19 Strategies There is no time to waste in developing road maps and strategies for change Even as we work to improve our understanding of the size, scope and complexity of the environmental changes we are experiencing and their impact on humanity, we must mobilize several forces to take action An expansive range of sound strategies are emerging to tackle these complex and interlinked problems, many of which were discussed in Bellagio They include: It’s not a scientific, intellectual discussion How we get people engaged? Anne Fudge, Trustee, Rockefeller Foundation Use evidence-based science to drive policy change Scientists and policy makers speak different languages, operate in different time frames and respond to different incentives Broadly speaking, policy makers represent their constituencies and build coalitions for broader action that provide a basis for change, while managing political risk Simple language and clearly articulated, quantifiable “high-impact” proof matters most to decision makers For instance, information on the immediate impact of environmental changes on the health of their constituencies could help convince policy makers to develop new laws, incentives and resources to address these linkages “This is very different from building the body of objective evidence [that scientists seek],” said Anthony Kaplan, director of Global Health at United Nations University Harness data, analytics, predictive modeling and other innovative tools to build the business case for change and to reduce the impact of naturalresource extraction and use through more-efficient, holistic approaches that involve local communities Collecting vast data from satellites and handheld devices, examining them with analytical tools, and modeling how different choices can alter environmental outcomes can help inspire powerful behavioral change among businesses and individuals Quantifying the impacts and possible savings that could be realized by incentive-based initiatives, such as programs that pay individuals to protect the environment (for example, to prevent cattle grazing near rivers or streams), could help scientists and government leaders win the support of companies and the public – and inspire them to act “We need to bring financiers, economists, accountants, scientists and engineers together to create open-source tools to join up everyone on real practical outcomes for human and ecological health,” said Professor Peter Head, an engineer and executive chairman of the Ecological Sequestration Trust “This is the moment We have earth observations, adequate data computing power, systems algorithms and communications bandwidth to use it all from the cloud.” 20 Planetary Health STRATEGIES Raise awareness and galvanize action on the full breadth of climate risks Hurricane Sandy and Typhoon Haiyan focused attention on the link between climate change and extreme weather events Such storms have severe implications for health, life and property loss, if they cause a breakdown of water-supply systems vital to sanitation and irrigation, enable the spread of disease, or slow the delivery of critical supplies to health clinics and hospitals But scientists, activists and others must also find ways to raise awareness of the slower-moving and less dramatic – but possibly even more alarming – impacts of climate change, such as the loss of ”buffers” to shore up coastlines against storm surges, vanishing reefs due to ocean acidification, and the spread of disease to new regions Only under the glare of the spotlight can we raise awareness and inspire behavior change Cross-pollinate ideas across sectors through collaboration, coalitions and change agents Business executives respond to profits and shareholder pressure, scientists to breakthrough research and peer recognition, government officials to a smoothly functioning society and satisfied constituencies, individuals to their wellbeing and happiness Each group has a role to play in raising awareness and sharing ideas about effective ways to solve the environmental/ human-health change nexus problem These areas of self-interest need to be explored, incentives aligned and concrete actions assigned to each party, if we are to have rapid, coordinated and systems-based responses Challenges include winning buy-in from large, complex institutions and overcoming ”pride of ownership” issues Particular efforts should be made to level individual silos and to agree on a common language Storytelling to inform, incite action and change behavior Campaigns that speak to the heart rather than the head are more likely to inspire broad individual and collective change in how we live, what we buy and eat, and how we move “Naming and shaming” can help keep a check on businesses and individuals But illustrating a new vision of prosperity, such as the Joint US-China Collaboration on Clean Energy (JUCCCE) campaign ”China Dream,” may more effectively alter people’s outlooks and lifestyles now and in the future Sharing personal stories about the impact of our consumption habits on the health of our planet and that of our community may spark change The media, marketers and advertisers must be engaged in telling stories about people and places that offer meaning and messages that will move people “People’s thinking is guided by set patterns and beliefs While we need the science, science has precious little to with how people reach conclusions,” said Howard Frumkin, dean of the School of Public Health at the University of Washington “We need to understand much better how to change behavior.” Harness generational power to push for change Millennials are viscerally aware of the environmental harm that human activities are reaping on the planet in an era that is better informed about the planet’s declining capacity to sustain the human species This cohort has also shown a willingness to act; many demonstrate personal dissatisfaction through protests and with their wallets through green purchases The collective power of young people can be further harnessed by identifying and enlisting youth leaders, targeting Millennials with information campaigns, and collaborating with the social enterprises they have Planetary Health 21 founded “Whose earth are we talking about? There’s a mismatch between those who pollute and those who suffer the consequences,” said Dr Frumkin You’re a lot more effective when you engage the crowd Paul Bunje, XPRIZE Foundation Bring new players into the fold and identify leaders to accelerate action Engaging and connecting groups like businesses, financiers and local communities can broaden awareness and trigger quick, calibrated action We need to find new approaches for natural resource use that are more sustainable and environmentally friendly, to finance these measures in creative ways, and to inspire local communities to demand market-based change through their purchases, activities and protests To so we must identify champions and change agents in these groups and work with them to harness their power “This is about corporate survival and death It’s not about CSR,” said Derek Yach, founder of the Vitality Group, referring to corporate social responsibility “PepsiCo was given a license to operate in perpetuity They have to be long-term stewards of the earth It’s absolutely material to the bottom line of companies, not because it’s a nice thing to do.” Tear down old structures, such as institutions, incentives and disciplines, to advance work in this area Deeply rooted incentives and approaches to research at universities and research centers often dissuade scientists from working with outsiders to accelerate the real-world applications of their work The tenure process, the slow pace of academic publishing, empire building, and the tenacity with which researchers pursue research are among the obstacles that too often get in the way of progress Public health needs to become less prescriptive and more proactive “Like a dog with a bone, people don’t like to give up on their ideas,” said The Economist’s Vaitheeswaran Create new structures and initiatives to galvanize action The unprecedented environmental changes occurring on our planet and the widespread and potentially catastrophic consequences of changes yet to come demand a radical rethink of how to confront and tackle the challenges we all face Incremental change will not suffice New institutions, leaders and approaches are required to heal our planet and safeguard human health “Unless there is a global mindshift in thinking this will be at the margins,” said Michael Meyers, managing director at The Rockefeller Foundation 22 Planetary Health 23 Planetary Health Future solutions A handful of promising solutions are taking shape that address specific problems at the nexus between human health and environmental change and so in ways that address the knotty and interlinked forces at work Working groups focusing on the human health impacts of changes in our planet’s climate, biodiversity, land-use and in its marine and freshwater ecosystems in Bellagio identified a number of emerging solutions for future problems that particularly merit exploration, including: We need to stop talking to people’s heads, but to their hearts We need to use emotion Peggy Liu, founder, Joint US-China Collaboration on Clean Energy Better governance structures for managing global resources: Coveted global “commons,” such as air, forests and oceans, have not been sufficiently protected A key reason for this is the failure of market economies to adequately value healthy commons or to extract costs for damaging them For example, oceans cover 70% of the earth’s surface, absorb half the world’s everrising levels of CO2, supply fish that nourish some 2.5 billion people, and employ millions in the $200 billion fishing industry Yet the two-thirds of the oceans that lie outside natural boundaries are currently unregulated, with fish stocks at or beyond their ability to replenish themselves A predicted doubling in demand for fish by 2050 is particularly worrisome The commercial importance of oceans is also rising as sea ice melts, clearing the way for new seafaring routes, oil drilling and mineral extraction and the specter of growing territorial disputes There are far-reaching implications for the human populations who depend on fish for nutrition and livelihoods To help protect the ocean commons—and, specifically, to rapidly reduce overfishing—the Oceans Working Group explored a range of possible solutions It recommended establishing a new oceans-focused United Nations agency to regulate this shared resource and territory, and to forge guidelines to ensure the health of the oceans To provide a viable commercial alternative to the current fishing industry, it recommended establishing and scaling a sustainable aquaculture industry by 2030 to meet rising human demand and reduce the overfishing of wild populations Other recommendations included developing a global fisheries lab to monitor and track the health of wild fisheries, and to quantify the link to the physical and economic health of the communities that depend on them Change might come from the use of innovative technologies, such as deepsea robots that monitor our progress in rebuilding fish stocks; and creative 24 Planetary Health FUTURE SOLUTIONS campaigns that have broad appeal, such as “Saving Dora,” built around the star of the upcoming sequel to ”Finding Nemo.” “It’s unrealistic to dismantle a massive industry without presenting a viable commercial alternative,” said Freya Williams, group head of Business + Social Purpose at Edelman “In our optimistic narrative, we’re focusing on abundance and opportunity.” Evidence-based input about the likely impact of land-use changes to influence decision-making: Those who make land-use decisions often fail to grasp the potential far-reaching impacts of their decisions on human health These choices can cause significant harm—or bring benefits—to the health of often distant “downstream” communities, or to those in rapidly growing urban areas, as land near cities is developed for industrial or agricultural use To better inform natural-resources management and public health policy and decisions, the Land Use Working Group proposed a range of solutions These include case studies to document the human health impacts of changes to environments within cities and of alterations of ecosystems in more remote, pristine areas Case studies would focus on environmental changes believed to disproportionately influence human health in such areas as respiratory, waterborne and infectious disease, and in nutrition and mental health This type of explicit analysis of the public health impacts of environmental change would emphasize co-benefits for human health, sustainability and system resilience The group also recommended a “climate-friendly cities portfolio” to generate relevant health and environmental data through personal and site-based monitoring, to provide city leaders with real-time, relevant information as they make key decisions These approaches would provide quantifiable measures of health impacts, which would facilitate a range of market-based solutions such as payments for ecosystems services or tax incentives to solve pressing problems at the environmental change– human health nexus More evidence-based information about the potential benefits of ecosystems protection to spur policy change: Decision makers are often unaware of the benefits that healthy ecosystems bring to human health, of the complex interactions among their components (including people), and of the negative consequences of environmental change on natural systems As participants in the Biodiversity Working Group noted, policy makers will be more apt to craft policies and incentives and fund programs that protect vital ecosystems with quantitative measures of their benefits One approach is through the use of national “natural capital” accounts – or logs of the values of each Planetary Health 25 FUTURE SOLUTIONS country’s ecosystems’ resources and servicing capabilities, and changes to their condition over time Such tools—as well as forecasting models and integrated health-environmental impact statements that help measure the long-term human health impacts of environmental change—might motivate businesses, communities and governments to change their behavior Quantifying the long-term human health consequences of environmental change and clearly communicating findings to authoritative organizations like WHO and the World Bank could also inform global and country guidance and technical assistance The group urged the United Nations to recognize the biodiversity– human health link in the UN’s Sustainability Development Goals, which is a set of global guidelines being established to help ensure that sufficient natural resources are available for the prosperity and health of future generations New business models to deliver scarce resources to underserved and vulnerable regions: Don’t give up on anything; we need to pursue parallel paths Anne Fudge, Trustee, Rockefeller Foundation Vital goods and services like electricity and water often fail to reach the poor in small and remote villages because infrastructure and delivery costs may be prohibitively high Other barriers include ineffective but entrenched methods of supplying these goods and services, due to vested business or government interests and a lack of awareness within local communities that there are affordable and decentralized alternatives for such services At the same time, local communities are rarely motivated to protect the natural resources they depend on for food, sanitation and other services But in recent years, a number of innovative financing, delivery and incentive models have emerged that can make the supply of these vital goods and services more efficient and scalable—while protecting the environment Such models include microfinancing, crowdsourced funds, and outsourced and payment-for-ecosystem-services programs These approaches were the cornerstone of the Freshwater Working Group’s proposal to help bring clean water to the world’s over billion who lack access to safe drinking water As building blocks, the group suggested raising funds through initiatives like the Whole World Water campaign; providing web-based proposal templates to communities to begin fund-raising efforts; and a global Water Corps to advise communities on building and maintaining new infrastructure It also proposed small-scale water-collecting solutions like cisterns; conservation measures such as watershed protection to help make communities environmental stewards, and monitoring and fixing leaky pipes to maximize the supply available Finally, the group suggested opening up access to data sources on the web so that stakeholders can track water distribution and progress on conservation for the benefit of both the community and funders; enabling payment with alternative currencies like “water coin,” (a proposed currency similar to bitcoin); and the establishment of pilot cities to test project elements needed in arid, coastal and temperate environments, so that several formats can be created that apply to similar locales “There are a lot of ways to scale once you get past the limiting factors,” said Peggy Liu, founder of JUCCCE 26 Planetary Health FUTURE SOLUTIONS The creation of an entirely new field to focus attention, resources and action on this urgent area: At watershed moments in global history, new institutions and ways of thinking have surfaced for a singular focus on critical issues Such was the case with the Marshall Plan, the United Nations Earth Summit and U.S civil rights legislation Indeed, as the existential nature of the threat of environmental change on our health, our social and political systems, and our society becomes more apparent, a global reframing and rethinking of the tangle of issues is required This was the determination of the Climate Change Working Group It called for entirely new institutions and approaches to tackle accelerating problems in a rapid and calibrated way Scholars and business and government leaders must come together to develop a road map to address planetary health, and to roll it out Only when many disciplines converge in a holistic manner to build and shape new institutions will true and rapid progress be possible, the group argued This requires the concerted creation of a new field of study and practice: an integrated and institutionalized field of planetary health “Our entire conversation about how we communicate the challenges and engage our institutions is rational and linear,” said Paul Bunje of the XPRIZE Foundation “But these challenges are complex and exponential We should communicate in the same way We need an army of thinkers, doers and communicators to establish a holistic field of Planetary Health.” To get there, we will need communications campaigns To achieve a goal of creating a professional class exclusively focused on this field with established leaders by 2020, we will need to convene in the next year funders, investors and insurers to finance and focus on the programmatic aspects of this new field Global centers of excellence could be valuable, too With concerted effort, “by 2020 this will all exist,” predicted Bunje “We will be unstoppable.” Planetary Health 27 28 Planetary Health Conclusion As we look ahead to a world in which our health will suffer from stretched resources and stressed systems, the environmental harm we have wrought weighs heavily To be sure, governments and businesses that rely on nature for food production, raw materials, energy and freshwater are increasingly aware of the impact of our activities on the planet But the world has yet to grasp the complex and far-reaching human health consequences of our choices Yet our civilization continues to evolve, to innovate, to achieve scientific breakthroughs, and to find novel solutions that could yet be our salvation As experts underscored at the Planetary Health meeting and beyond, solving these problems requires deep and broad collaboration across many sectors, dramatic institutional and system change, and moving storytelling that can inspire behavioral change Many of the strategies and solutions the experts have identified can be put into action in a piecemeal fashion But truly understanding and addressing the problem of ecological change and its health impact requires a more radical approach, new ways of thinking and an entirely new discipline dedicated to exploring solutions and implementing widespread change We at The Rockefeller Foundation stand ready to help drive this process forward We hope you will join us on this journey Planetary Health 29 Planetary health Meeting Participants Bottom, left to right: Steven Osofsky, Montira Pongsiri, Carolyn Whelan, Judith Rodin, Robert Garris, Gabriela Burian, Peggy Liu, Paul Bunje, Fred Boltz and Selina Lo Middle: Ann Fudge, Tara Acharya, Samantha Silberberg, Fernanda Bak, Elizabeth Williams, Howard Frumkin, Derek Yach, Sarah Whitmee, Srinath Reddy Kolli, Agnes Soucat, and Natasha Loder Top: Michael Myers, Wai Chiong Loke, Peter Head, Richard Horton, Braulio Ferreira de Souza Dias, Samuel Myers, Subhrendu Pattanayak, Anthony Capon, Sania Nishtar and Vijay Vaitheeswaran 30 Planetary Health Tara Acharya Senior Director, Nutrition PepsiCo Chris Beyrer Professor, Epidemiology Johns Hopkins University Fred Boltz Managing Director, Ecosystems Rockefeller Foundation Paul Bunje Senior Director, Oceans XPRIZE Foundation Gabriela Burian Environment Lead Monsanto – Sustainability Anthony Capon Director United Nations University Braulio Ferreira de Souza Dias Executive Secretary Convention on Biological Diversity Alex Ezeh Executive Director African Population and Health Research Center 12 Andy Haines Professor of Public Health and Primary Care London School of Hygiene and Tropical Medicine 24 Steven Osofsky Executive Director, Wildlife Health & Health Policy Wildlife Conservation Society 13 Peter Head Executive Chairman The Ecological Sequestration Trust 25 Subhrendu Pattanayak Professor, Public Policy & Environment Duke University 14 Richard Horton Editor The Lancet 26 Montira Pongsiri Environmental Scientist Environmental Protection Agency 15 Srinath Reddy Kolli President Public Health Foundation of India 27 Judith Rodin President The Rockefeller Foundation 16 Peggy Liu Chairperson JUCCCE 28 Timothy Shorten The Lancet 17 Selina Lo Senior Editor The Lancet 18 Natasha Loder Midwest Correspondent The Economist 19 Wai Chiong Loke Director of Development Jurong Health Services Howard Frumkin Dean and Professor, University of Washington Environmental & Occupational Health 20 Sarah Molton Senior Business Analyst Wellcome Trust—Sustaining Health 10 Ann Fudge Trustee The Rockefeller Foundation 21 Michael Myers Managing Director The Rockefeller Foundation 11 Robert Garris Managing Director The Rockefeller Foundation 22 Samuel Myers Research Scientist Harvard School of Public Health 29 Agnes Soucat Director, Human Development African Development Bank 30 Vijay Vaitheeswaran China Business Editor The Economist 31 Peter Ward Professor of Geobiology University of Adelaide 32 Sarah Whitmee Postdoctoral Researcher University College London – CBER 33 Freya Williams Executive Vice President Edelman 34 Derek Yach Founder The Vitality Institute 23 Sania Nishtar President and CEO Heartfile The Planetary health meeting was convened by The Rockefeller Foundation and The Lancet with support from The Rockefeller Foundation Planetary Health 31 [...]... Foundation Planetary Health 11 12 Planetary Health Planetary Health 13 Areas of risk Scientists are now studying the links between global environmental changes affecting the earth’s essential support systems and human health These primary health impacts were explored in a background paper presented at the meeting by The Lancet The paper examines possible strategy and policy shifts to prevent or reduce... required to heal our planet and safeguard human health “Unless there is a global mindshift in thinking this will be at the margins,” said Michael Meyers, managing director at The Rockefeller Foundation 22 Planetary Health 23 Planetary Health Future solutions A handful of promising solutions are taking shape that address specific problems at the nexus between human health and environmental change and do so... field Global centers of excellence could be valuable, too With concerted effort, “by 2020 this will all exist,” predicted Bunje “We will be unstoppable.” Planetary Health 27 28 Planetary Health Conclusion As we look ahead to a world in which our health will suffer from stretched resources and stressed systems, the environmental harm we have wrought weighs heavily To be sure, governments and businesses... the problem of ecological change and its health impact requires a more radical approach, new ways of thinking and an entirely new discipline dedicated to exploring solutions and implementing widespread change We at The Rockefeller Foundation stand ready to help drive this process forward We hope you will join us on this journey Planetary Health 29 Planetary health Meeting Participants Bottom, left... research into environment -health linkages remains patchy, the paper’s authors say, because it has often focused on a specific disease, rather than the impact of environmental change on several aspects of human health, and often on just one possible trigger, though there may be several Some of these triggers may foster negative health effects in some communities but bring health benefits to others Malaria... between natural-system changes and nutrition and food productivity, and the health value of ecosystem services Among the areas the authors believe particularly merit further research, including field experiments and modeling, are animal husbandry; land-use changes and zoonotic Planetary Health 17 RECENT RESEARCH diseases; and health outcomes driven by multiple changes, such as resource scarcity, land-use... algorithms and communications bandwidth to use it all from the cloud.” 20 Planetary Health STRATEGIES 3 Raise awareness and galvanize action on the full breadth of climate risks Hurricane Sandy and Typhoon Haiyan focused attention on the link between climate change and extreme weather events Such storms have severe implications for health, life and property loss, if they cause a breakdown of water-supply... decisions Our success with the easier health problems may bring some cause for optimism But the next set of challenges due to rapidly changing environmental conditions is far more complex, with multiple interactions These threaten all our gains in health Samuel Myers, research scientist, Harvard School of Public Health The potential range and extent of impacts on human health are startling and beg for action... document the human health impacts of changes to environments within cities and of alterations of ecosystems in more remote, pristine areas Case studies would focus on environmental changes believed to disproportionately influence human health in such areas as respiratory, waterborne and infectious disease, and in nutrition and mental health This type of explicit analysis of the public health impacts of... national “natural capital” accounts – or logs of the values of each Planetary Health 25 FUTURE SOLUTIONS country’s ecosystems’ resources and servicing capabilities, and changes to their condition over time Such tools—as well as forecasting models and integrated health- environmental impact statements that help measure the long-term human health impacts of environmental change—might motivate businesses, ... Foundation Planetary Health Executive Summary Planetary Health brought together more than 30 experts to explore ways to improve human health by healing the planet The progress we’ve made in global health. .. policies and action at global, regional and local levels Planetary Health Planetary health Improving human health by healing the planet Human health and the environment have been interwoven since... Stockholm Resilience Centre; www.stockholmreslience.org/Rockefeller Foundation Planetary Health 11 12 Planetary Health Planetary Health 13 Areas of risk Scientists are now studying the links between global