Richard Horton is the Editor-in-Chief of The Lancet, one of the world’s leading medical journals. In January 2013 he was invited by the Rockefeller Foundation to participate in a conference in Beijing on ‘Innovation for the next 100 years’ as part of the Centennial celebrations of the Foundation.
At that event he 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”. In particular he noted that this was not just about the state of the Earth’s ecosystems 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 wellbeing, 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 somber 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”. In other words, we are pursuing short-term gain at the expense of long-term pain, leaving it to our children and grandchildren to cope with the mess we are creating.
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.” And they suggest that “the way we organize society’s actions in the face of threats is more important than the threats themselves”.
The Commission identifies three major challenges we need to address. 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, includes 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.
Thirdly, 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 wellbeing 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 a 100 years, as the G-7 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. The time for action is now.
© Trevor Hancock, 2015
Published in Times Colonist 20 July, 2015