Down to Earth: The Emerging Field of Planetary Health

Planetary health and its relevance in the modern era: A topical review

Planetary health is a relatively new concept that has gained traction in recent years due to the urgent need to address the health of our planet and its inhabitants. It refers to the interdependent health of both humans and the environment, recognizing that the two are inseparable and that the health of one is intricately linked to the health of the other. This article aims to advocate changes in how health care for both the environment and humans is envisaged, and aligned with sustainable development goals using ethically sound, solution-oriented, and practical approaches to education. Rapid industrialization, urbanization, and population growth led to environmental degradation and climate change in this era. These factors have profound implications for human health, with the World Health Organization estimating that 23% of global deaths are linked to environmental factors. Climate change and extreme weather events are exacerbating existing health problems. Air pollution, water pollution, and toxic chemicals are additional environmental factors that add to it and lead to health issues, including non-communicable diseases and death. A collaborative and interdisciplinary approach is needed to address planetary health challenges, including working across sectors and investing in research to understand better the complex interactions between human health and the environment. By promoting sustainable development and protecting the planet's health and inhabitants, we can ensure a healthy future for generations.

Horizon Scanning: Rise of Planetary Health Genomics and Digital Twins for Pandemic Preparedness

The Covid-19 pandemic accelerated research and development not only in infectious diseases but also in digital technologies to improve monitoring, forecasting, and intervening on planetary and ecological risks. In the European Commission, the Destination Earth (DestinE) is a current major initiative to develop a digital model of the Earth (a "digital twin") with high precision. Moreover, omics systems science is undergoing digital transformation impacting nearly all dimensions of the field, including real-time phenotype capture to data analytics using machine learning and artificial intelligence, to name but a few emerging frontiers. We discuss the ways in which the current ongoing digital transformation in omics offers synergies with digital twins/DestinE. Importantly, we note here the rise of a new field of scholarship, planetary health genomics. We conclude that digital transformation in public and private sectors, digital twins/DestinE, and their convergence with omics systems science are poised to build robust capacities for pandemic preparedness and resilient societies in the 21st century.

Building a Methodological Foundation for Impactful Urban Planetary Health Science

Anthropogenic environmental change will heavily impact cities, yet associated health risks will depend significantly on decisions made by urban leaders across a wide range of non-health sectors, including transport, energy, housing, basic urban services, and others. A subset of planetary health researchers focus on understanding the urban health impacts of global environmental change, and how these vary globally and within cities. Such researchers increasingly adopt collaborative transdisciplinary approaches to engage policy-makers, private citizens, and other actors in identifying and evaluating potential policy solutions that will reduce environmental impacts in ways that simultaneously promote health, equity, and/or local economies-in other words, maximising 'co-benefits'. This report presents observations from a participatory workshop focused on challenges and opportunities for urban planetary health research. The workshop, held at the 16th International Conference on Urban Health (ICUH) in Xiamen, China, in November 2019, brought together 49 participants and covered topics related to collaboration, data, and research impact. It featured research projects funded by the Wellcome Trust's Our Planet Our Health (OPOH) programme. This report aims to concisely summarise and disseminate participants' collective contributions to current methodological practice in urban planetary health research.

COVID-19 and future pandemics: a global systems approach and relevance to SDGs

Background

The COVID-19 pandemic is adversely impacting modern human civilization. A global view using a systems science approach is necessary to recognize the close interactions between health of animals, humans and the environment.

Discussion

A model is developed initially by describing five sequential or parallel steps on how a RNA virus emerged from animals and became a pandemic: 1. Origins in the animal kingdom; 2. Transmission to domesticated animals; 3. Inter-species transmission to humans; 4. Local epidemics; 5. Global spread towards a pandemic. The next stage identifies global level determinants from the physical environments, the biosphere and social environment that influence these steps to derive a generic conceptual model. It identifies that future pandemics are likely to emerge from ecological processes (climate change, loss of biodiversity), anthropogenic social processes (i.e. corporate interests, culture and globalization) and world population growth. Intervention would therefore require modifications or dampening these generators and prevent future periodic pandemics that would reverse human development.

Addressing issues such as poorly planned urbanization, climate change and deforestation coincide with SDGs such as sustainable cities and communities (Goal 11), climate action (Goal 13) and preserving forests and other ecosystems (Goal 15). This will be an added justification to address them as global priorities. Some determinants in the model are poorly addressed by SDGs such as the case of population pressures, cultural factors, corporate interests and globalization. The overarching process of globalization will require modifications to the structures, processes and mechanisms of global governance. The defects in global governance are arguably due to historical reasons and the neo-liberal capitalist order. This became evident especially in the aftermath of the COVID-19 when the vaccination roll-out led to violations of universal values of equity and right to life by some of the powerful and affluent nations.

Summary

A systems approach leads us to a model that shows the need to tackle several factors, some of which are not adequately addressed by SDGs and require restructuring of global governance and political economy.

Using internet search data to understand information seeking behavior for health and conservation topics during the COVID-19 pandemic

Emerging zoonotic diseases, such as COVID-19, exist at the intersection of human health and the environment. Public interest and support are required to maximize the effectiveness of policies to combat the current pandemic and prevent future outbreaks of zoonoses. Here, we use internet search data from the United States to investigate changes in public information seeking about topics at the intersection of health and the environment during the COVID-19 pandemic. Using breakpoint detection methods, we identify sharp increases in interest for 'wildlife trade', 'bats', and 'pangolins' in the early stages of the pandemic (on Jan. 12, Jan. 19, and Jan. 26, 2020, respectively). Network analyses also revealed increasing connectivity between terms related to human health and the environment, as well as the emergence of novel search terms pointing to a greater interest in wildlife trade and consumption. During the pandemic, the network connectivity between coronavirus keywords and conservation keywords increased, which we measured using the number of unique connections (edge connectivity, k' (G)) and the number of simple paths (Sp) between keywords. Both measures of network connectivity increased between 'coronavirus' and 'bats' or 'pangolins' (Δk' (G) = 1, ΔSp = 37), and between 'coronavirus' and 'conservation' (Δk' (G) = 1, ΔSp = 160). These findings suggest that policy and outreach efforts aimed at engaging public interest in intersectional approaches to pandemic prevention (eg: One Health, Planetary Health), may be able to take advantage of increases in public information seeking following catalyzing events during the pandemic. Further monitoring is needed to determine if these changes persist over time.

One Biosecurity: a unified concept to integrate human, animal, plant, and environmental health

In the wake of the SARS-CoV-2 pandemic, the world has woken up to the importance of biosecurity and the need to manage international borders. Yet strong sectorial identities exist within biosecurity that are associated with specific international standards, individual economic interests, specific research communities, and unique stakeholder involvement. Despite considerable research addressing human, animal, plant, and environmental health, the science connections between these sectors remain quite limited. One Biosecurity aims to address these limitations at global, national, and local scales. It is an interdisciplinary approach to biosecurity policy and research that builds on the interconnections between human, animal, plant, and environmental health to effectively prevent and mitigate the impacts of invasive alien species. It provides an integrated perspective to address the many biosecurity risks that transcend the traditional boundaries of health, agriculture, and the environment. Individual invasive alien plant and animal species often have multiple impacts across sectors: as hosts of zoonotic parasites, vectors of pathogens, pests of agriculture or forestry, as well as threats to biodiversity and ecosystem function. It is time these risks were addressed in a systematic way. One Biosecurity is essential to address several major sociological and environmental challenges to biosecurity: climate change, increasing urbanisation, agricultural intensification, human global mobility, loss of technical capability as well as public resistance to pesticides and vaccines. One Biosecurity will require the bringing together of taxonomists, population biologists, modellers, economists, chemists, engineers, and social scientists to engage in a new agenda that is shaped by politics, legislation, and public perceptions.

Current Global Health Impact Assessment Practice

Health impact assessment (HIA) practice has expanded across the world, since it was established more than two decades ago. This paper presents a snapshot of current global HIA practice based on the findings of an online questionnaire survey. HIA practitioners from all world regions were invited to participate. A total of 122 HIA practitioners from 29 countries completed the survey, following a broad international outreach effort. The large variety in the types of HIAs conducted, and the application of HIA in various fields reported by respondents, demonstrates that HIA practice has evolved over the past two decades. Although differences in the use of HIA were reported across world regions, an overall increasing trend in global HIA practice can be observed. In order to sustain this upward trend, efforts are needed to address the main barriers in the utilisation of HIA. The establishment of new national and international HIA teaching and training offerings seems to be an obvious strategy to pursue along with the strengthening of policies and legal frameworks that specify the circumstances, under which HIA is required, and to what extent.

Soil biota, antimicrobial resistance and planetary health

The concept of planetary health acknowledges the links between ecosystems, biodiversity and human health and well-being. Soil, the critical component of the interconnected ecosystem, is the most biodiverse habitat on Earth, and soil microbiomes play a major role in human health and well-being through ecosystem services such as nutrient cycling, pollutant remediation and synthesis of bioactive compounds such as antimicrobials. Soil is also a natural source of antimicrobial resistance, which is often termed intrinsic resistance. However, increasing use and misuse of antimicrobials in humans and animals in recent decades has increased both the diversity and prevalence of antimicrobial resistance in soils, particularly in areas affected by human and animal wastes, such as organic manures and reclaimed wastewater, and also by air transmission. Antimicrobials and antimicrobial resistance are two sides of the sword, while antimicrobials are essential in health care; globally, antimicrobial resistance is jeopardizing the effectiveness of antimicrobial drugs, thus threatening human health. Soil is a crucial pathway through which humans are exposed to antimicrobial resistance determinants, including those harbored by human pathogens. In this review, we use the nexus of antimicrobials and antimicrobial resistance as a focus to discuss the role of soil in planetary health and illustrate the impacts of soil microbiomes on human health and well-being. This review examines the sources and dynamics of antimicrobial resistance in soils and uses the perspective of planetary health to track the movement of antimicrobial-resistance genes between environmental compartments, including soil, water, food and air.

Planetary Epidemiology: Towards First Principles

PURPOSE OF REVIEW

To combine evolutionary principles of competition and co-operation with limits to growth models, generating six principles for a new sub-discipline, called "planetary epidemiology." Suggestions are made for how to quantify four principles.

RECENT FINDINGS

Climate change is one of a suite of threats increasingly being re-discovered by health workers as a major threat to civilization. Although "planetary health" is now in vogue, neither it nor its allied sub-disciplines have, as yet, had significant impact on epidemiology. Few if any theorists have sought to develop principles for Earth system human epidemiology, in its ecological, social, and technological milieu. The principles of planetary epidemiology described here can be used to stimulate applied, quantitative work to explore past, contemporary, and future population health, at scales from local to planetary, in order to promote enduring health. It is also proposed that global well-being will decline this century, without radical reform.

Climate Change, Human Health, and Social Stability: Addressing Interlinkages

BACKGROUND

Abundant historical evidence demonstrates how environmental changes can affect social stability and, in turn, human health. A rapidly growing body of literature, largely from political science and economics, is examining the potential for and consequences associated with social instability related to current climate change. However, comparatively little of this research incorporates the effects on human health or the role of health systems in influencing the magnitude and types of instability that could occur.

OBJECTIVE

The objective of this commentary is to articulate a conceptual framework incorporating health outcomes and health systems into theorized and observed linkages between climate change and social instability, illustrating in particular the health effects of natural resource shortages, infectious disease outbreaks, and migration.

DISCUSSION

Although increasing evidence exists that climate change, health, and social instability are related, key questions remain about the pathways linking these factors, as well as the magnitude, causality, and directionality of relationships across spatial and temporal scales. Models seeking to explain and predict climate-related social unrest should incorporate the many linkages between climate change, human health, and social instability. Members of the environmental health research community should work closely with those in the political science and economics communities to help deepen understandings of climate-related stressors and shocks that affect instability and worsen health outcomes. https://doi.org/10.1289/EHP4534.

Training in Cardiovascular Epidemiology and Prevention: A 50-Year Journey From Makarska to Goa

The first International Ten-Day Teaching Seminar on Cardiovascular Epidemiology and Prevention was held in Makarska, in the former Yugoslavia in August 1968. The goals of the Seminar were to help bridge the gap between cardiology and cardiovascular epidemiology, promote international collaboration, and provide training in cardiovascular epidemiology and prevention. The 50th Seminar took place in Goa, India in June 2018. This perspective article provides an overview of the major accomplishments of the Seminar as well as its persisting challenges. It also addresses unique opportunities as the Seminar embarks on the next phase of international training seminars in cardiovascular epidemiology and prevention. In particular, this article highlights strategies that offer the opportunity to significantly increase the number of Seminar participants annually, especially from low- and middle-income countries and Small Island Developing States where the burden and trend in cardiovascular diseases and cardiometabolic risk factors pose the greatest concerns. It also discusses the importance of using big data for descriptive, predictive, and prescriptive analytics at the local level, and the need to leverage information technology and digital platforms to create greater access to and sharing of lessons learned. The article also highlights the opportunity to embrace active dissemination and implementation research and the science of health care delivery as important components of training in cardiovascular disease epidemiology and prevention.