This Earth Day, let’s consider the health of the planet. The coronavirus crisis is perhaps the biggest wakeup call we have ever had to the fact that failing to take nature into account puts our own health in danger. The result of a zoonotic virus that transferred from animals due to a lack of attention to the interface between humanity and the rest of the natural world, this pandemic highlights the need for us to reframe health in terms of planetary health, defined in 2015 by the Lancet as “the health of human civilization and the state of the natural systems upon which it depends.”

You can think of planetary health in terms of a nest: the ecological determinants of our health, things like water and soil quality, biodiversity and climate, form the foundation of the nest. If they are stable enough, they create the conditions for us to line the nest with financial and economic structures that allow us to build things like houses, universities and complex industry. These give rise to what we term the social determinants of health — factors like housing, education and income. If these elements generate concentrated resources, we can build and nurture the incredibly complex structures that are hospitals and health systems.

Just like the foundation of a house, the foundation of the nest — the ecological determinants of our health — is something we can easily take for granted until it fractures. Then we need to pay attention in a hurry. When cracks appear, as coronavirus demonstrates vividly, the crises that occur don’t just happen to “other people.” They happen to us all.


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As we consider how best to patch this crack in the foundation of our nest, it is important to recognize that the coronavirus pandemic is one of many interconnected challenges we face. The World Economic Forum’s 2020 Global Risks Report makes clear that the majority of risks our civilization faces exist at the intersection of humanity and the natural world, with climate change being a critical factor in most of them.

To get ourselves to safety in a world of finite time and resources, we must take steps that help us overcome multiple challenges at the same time. Our solutions must build bridges between high-income countries and low-and-middle-income countries; between the pre-pandemic world where we endangered ourselves by failing to take nature into account, and the post-COVID world where that must be a priority; between economic recovery, health and wellness.

In Gunung Palung National Park, Borneo, Indonesia, there is a modest, but vital, example of what is possible when society is built on interdependencies. In a project that began over 10 years ago, financial and technical resources from high-income countries have helped implement the locally-designed solutions of rainforest communities. In order to stop logging, the community required access to affordable, quality health care and training in organic farming and small business management. This provided an alternative way to earn a living and eliminated the need to pay for costly chemical soil fertilizer and expensive transport to poor quality, far away health clinics.

Ten years after these solutions were implemented, illegal-logging households dropped by 90 percent and forest loss stabilized; 52,000 acres of forest were regenerated and infant mortality reduced 67 percent within a population of 120,000 people. To date, their actions have kept approximately 53 million USD worth of forest carbon out of Earth’s atmosphere — an important contribution to curbing the climate crisis.


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Imagine if planetary health approaches like this could be scaled globally. We could eliminate poverty and save ecosystems like tropical rainforests. This would get us 15 to 30 percent of the way towards keeping Earth’s warming within 1.5 to 2 degrees Celsius above pre-industrial temperatures. It would also mean greater habitat protection for the thousands of plant and animal species that pollinate our food crops, regulate our temperatures, clean our air and water and provide scientists with the molecules needed to cure cancer and other diseases.

So, as we sit apart but together, spinning in the stillness around the solar system on this Earth Day 2020, let’s bring to life a vision of planetary health — the nest that will keep us and our kids safer and healthier, and help make sure a global crisis of COVID’s magnitude never happens again.

Dr. Courtney Howard is an emergency physician, board president of the Canadian Association of Physicians for the Environment, and Earth Policy Director at CODA. Motivated by work on a Médecins Sans Frontières(Doctors Without Borders) pediatric malnutrition project in Djibouti, and by climate-related health impacts on her Northern patient population, she spends approximately half of her time working at the intersection of climate change and health.

Dr. Kinari Webb developed the vision for Health In Harmony on an undergraduate trip, studying orangutans at Gunung Palung National Park in Indonesian Borneo in 1993. She founded Health In Harmony to support the combined human and environmental work that she envisioned. Dr. Webb also co-founded Alam Sehat Lestari (ASRI) with Hotlin Ompusunggu and Antonia Gorog. She currently splits her time between Indonesia, international site assessments, and the San Francisco Bay Area. 


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Published on Apr 22, 2020