“On World Health Day 2022, WHO will focus global attention on urgent actions needed to keep humans and the planet healthy and foster a movement to create societies focused on well-being.” The World Health Organization
The theme for World Health Day on April 7 reflects a growing global concern with the health impacts of massive and rapid human-driven ecological changes. While climate change is front of mind, having been recognized as “the single biggest health threat facing humanity” by the WHO as far back as 2008, the changes and challenges we face are far greater than that.
In 2015, the Canadian Public Health Association (CPHA) released a discussion paper and accompanying background paper on what it called the “ecological determinants of health.” Put simply, these are the basic ecosystem “goods and services” we and other species need to survive – air, water and food. For humans, we also depend on nature for all our materials and fuels, for UV protection, decomposition and recycling of wastes, and for the past 11,000 years or so of the Holocene epoch, a relatively stable and benign climate.
“A healthy planet is essential to the health and well-being of current and future generations and for enabling all to flourish.” – Geneva Charter for Well-being
But now we have entered the Anthropocene, a new geological epoch in which the extent of our social and economic development, the growth of our population and the power of our technology has made us a force of nature – one that threatens to undermine the Earth’s natural systems that are the very roots of our well-being.
This was further explored in the report of the Rockefeller-Lancet Commission on Planetary Health, released a few months after the CPHA’s report. The commission defined planetary health as being concerned with “the health of human civilization and the state of the natural systems on which it depends.” The Lancet went on to establish a dedicated journal (Lancet Planetary Health) while the Rockefeller Foundation supported the creation of an important global alliance.
As UN Secretary General Antonio Guterres put it in December 2020: “Humanity is waging war on nature. This is suicidal.” Then in its February 2021 report, Making Peace with Nature, the UN Environment Program noted, “a healthy planet is important for the health and well-being of all people” and identified climate change, biodiversity loss and pollution as a “triple crisis” that threatens well-being.
The WHO is equally concerned. Thus, as the first of six “prescriptions” in its 2020 Manifesto for a Healthy Recovery from Covid-19, the WHO identified “Protect and preserve the source of human health: Nature,” while the recent WHO Geneva Charter for Well-being (December 2021) identified “Value, respect and nurture planet Earth and its ecosystems” as the first of five key action areas.
Given that the Earth’s natural systems are the most fundamental determinants of our health and that our “war on nature” is suicidal, it is vital that society as a whole and health professionals in particular pay heed to Guterres’ admonition that “making peace with nature must be the top, top priority for everyone, everywhere.”
In the rest of this article, I explore what this means for the wider society, while an article to be published on World Health Day will suggest what health-care professionals can do – as practitioners, as part of the health-care system and as citizens – to address the challenge of planetary health.
“Well-being societies provide the foundations for all members of current and future generations to thrive on a healthy planet, no matter where they live.” – Geneva Charter for Well-being
The Geneva Charter for Well-being, created in December 2021, provides the basis for the WHO’s focus on creating what it calls a well-being society, the societal response needed both to make peace with nature and to ensure health for all. The charter describes a well-being society as one that is committed to “achieving equitable health now and for future generations without breaching ecological limits.”
Such a society, the charter continues, is underpinned by:
- A positive vision of health integrating physical, mental, spiritual and social well-being.
- The principles of human rights, social and environmental justice, solidarity, gender and inter-generational equity and peace.
- A commitment to sustainable low-carbon development grounded in reciprocity and respect between humans and nature.
- New indicators of success beyond GDP that take account of human and planetary well-being and lead to new priorities for public spending.
- The focus of health promotion on empowerment, inclusivity, equity and meaningful participation.
Achieving such a society, the charter states, requires coordinated action in five areas, the first three of which are particularly relevant to our theme:
- Value, respect and nurture planet Earth and its ecosystems.
- Design an equitable economy that serves human development within planetary and local ecological boundaries.
- Develop healthy public policy for the common good.
These approaches are further developed both in the charter and in the WHO’s recommended actions to protect our planet and our health. The key task for governments, states the WHO, is to “prioritize long-term human well-being and ecological stability in all decision-making.”
An important aspect of the first action area, consistent with the theme of making peace with nature, is to centre Indigenous knowledge and leadership; the UN, in numerous recent reports, has stressed the importance of this. In Canada, this should be thought of as part of reconciliation, as noted in the report of the Truth and Reconciliation Commission on principles: “Reconciliation between Aboriginal and non-Aboriginal Canadians, from an Aboriginal perspective, also requires reconciliation with the natural world. If human beings resolve problems between themselves but continue to destroy the natural world, then reconciliation remains incomplete.
“This is a perspective that we as Commissioners have repeatedly heard: that reconciliation will never occur unless we are also reconciled with the Earth.”
Another key is the need to create a new economy, one that is fit for purpose in the 21st century. “The present design of the economy,” the WHO notes, “leads to inequitable distribution of income, wealth and power, with too many people still living in poverty and instability. A well-being economy has human well-being, equity and ecological sustainability as its goals.”
There is a growing interest in the concept of a well-being economy, led by Aotearoa New Zealand, which introduced a well-being budget in 2019. In Canada, the 2021 budget papers included a discussion paper on a Quality of Life Framework, which is central to the Aotearoa New Zealand well-being budget, while a new Well-being Economies Alliance for Canada and Indigenous Sovereign Nations is under development.
Finally, the third key action area is to develop healthy public policy for the common good, which the Geneva Charter links to the UN’s Sustainable Development Goals to which all countries, including Canada, are committed. While too numerous to list here, some of the more dramatic such policies in the WHO’s recommended actions to protect our planet and our health include:
- Keep fossil fuels in the ground. Stop new fossil fuel exploration and projects and implement policies on clean energy production and use.
- Stop fossil fuel subsidies. Re-invest fossil fuel subsidies in public health.
- Tax the polluters. Incentivize carbon reduction.
- Tax highly processed foods and beverages high in salt, sugars and unhealthy fats.
- Implement policies to reduce food wastage.
- Repurpose agriculture subsidies towards sustainable and healthy food production.
Next week’s article will speak directly to the role of health professionals as practitioners and as part of the health-care system; they also have a role as citizens (and hopefully as members of civic organizations and NGOs) to push the public and private sectors, at all levels, to make peace with nature and create well-being societies.