At a Beijing conference in 2013, Richard Horton, editor-in-chief of The Lancet, one of the world’s leading medical journals, proposed the concept of “planetary health” as a challenging issue for the 21st century, suggesting that “the planet’s potential to sustain our species is slowly declining” and that we need to adopt “a planetary view of human health.”
This was not just about the state of the Earth’s ecosystems, he noted, but about “the quality of human socio-political and economic institutions that shape human responses to the dangers.”
In 2014, he and several others published a brief Manifesto for Planetary Health in The Lancet. They called for public health and the wider society to address the threats we face to human health and well-being, to the sustainability of our civilization, and to the natural and human-made systems that support us.
At the same time, the Rockefeller Foundation funded and supported the creation of the Lancet Commission on Planetary Health. The commission’s report — for which I was an expert reviewer — was released this week. It makes for sombre reading.
The commission examines not only climate change but also ocean acidification, land degradation, water scarcity, overexploitation of fisheries and biodiversity loss, all of which “pose serious challenges to the global health gains of the past several decades and are likely to become increasingly dominant during the second half of this century and beyond.”
The members of the commission — leading scientists and practitioners from the health, environmental and social sciences — report they are “deeply concerned that … we have been mortgaging the health of future generations to realize economic and development gains in the present.”
The drivers of these alarming trends, they note, are “highly inequitable, inefficient, and unsustainable patterns of resource consumption and technological development, together with population growth.”
The commission identifies three sets of challenges. The first are conceptual and empathy failures, including our use of GDP as a measure of human progress, the failure to factor in the harm we do in the future due to our decisions today and the unfair impact of the harm we do to disadvantaged communities, especially in the global South.
The second set of challenges, which they call knowledge failures, include our failure to fully recognize the health impacts of broad environmental and social conditions. We also fail to work holistically and across disciplines, and we are poor at coping with uncertainty in our decision-making.
Third, there are implementation failures, or governance challenges. We delay response, especially in the face of uncertainty, and we fail to account for the lag-time inherent in both ecological and social change. We also, I would add, fail to allow for the potential for sudden, rapid and dramatic change that is inherent in the complex adaptive systems that are our ecosystems and social systems.
The commission’s report is a serious warning to which people and governments should pay heed. There are some, undoubtedly, who will try to wish away this report, as they have so many other reports, so many times before. But we can only bury our heads in the sand and ignore our responsibility towards future generations for so long.
There is growing evidence of accelerating global ecological change, and this will have profound impacts on the health and well-being of many alive today.
The sign of true leadership is to recognize the global ecological, social and human crisis we face and take action now, not punt it down the road 50 or 100 years, as the G7 leaders recently did on the fossil-free energy file. The challenges are mounting, and the time we have left to take decisive action is narrowing.
In my next two columns, I will discuss the signs of accelerating ecological change and the possibility and indeed importance of hope as an antidote to despair.
Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy.
