The COVID-19 pandemic thrust into the global spotlight how infectious diseases originating in animals can have devastating effects on humans, something researchers have long known.
On the front lines of that research was PREDICT, an epidemiological research program funded by the U.S. Agency for International Development. Founded in 2009 in the wake of H5N1 avian influenza, PREDICT focused on identifying and combating zoonotic diseases caused by pathogens that jump from animals to humans.
“It’s hard to say you’re doing global health if you’re not doing it through a planetary health lens.”
— Jonathan Jennings, executive director, Health in HarmonyThe program, which former U.S. President Donald Trump’s administration shuttered, identified more than 1,000 viruses and trained staff in over 60 foreign laboratories, including the lab in Wuhan, China, that identified SARS-CoV-2, the virus that causes COVID-19. Its work highlighted the importance of early warning programs that engage epidemiologists and veterinarians to examine the kinds of interactions between humans and animals that researchers believe led to the pandemic.
Those interactions are only increasing as humans degrade natural systems at rates that affect every dimension of human health. Human activity is driving people and wildlife to closer proximity than ever: Forty percent of land surface is now used for croplands and pasture, half of all tropical and temperate forests have been cleared, and livestock make 60% of the total biomass of all mammals. It’s all driving a surge in zoonotic diseases. And research shows those trends may drive the majority of global health threats in the years to come.
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This series explores how climate change and other planetary imbalances impact the rising trend of human inequality. We look into the potential solutions to eliminate inequality and support a healthy planet.
Among policymakers, funders, and practitioners, there is a growing recognition that it is impossible to safeguard human health without protecting natural systems. Many are calling for greater adoption of a collaborative approach called planetary health.
“It’s hard to overstate the way that we’re sort of crowding out life on the planet and transforming these systems,” said Samuel Myers, principal research scientist at the Harvard School of Public Health and director of the Planetary Health Alliance. “And it’s the urgency of that moment, of those exponential curves that we’re sitting on top of, that explains the emergence of the field of planetary health right now.”
Breaking out of silos
The field of planetary health took shape about five years ago. The pandemic made it more relevant than ever — and scientists like Myers are pushing for it to become more mainstream.
While professionals working on environmental conservation and public health have traditionally worked in parallel, the health impacts of environmental destruction are forcing them out of their silos.
“Those two communities, because of the scale of human activity globally, have really become two sides of the same coin,” Myers said last week at Prescription for Progress, Devex’s annual event on global health partnerships. “We can’t really think about one without thinking of the other.”
Research increasingly supports the connection between environmental conservation and public health.
For example, a study published in The Lancet last month modeled the public health implications of countries aligning with the 2015 United Nations Framework Convention on Climate Change Paris Agreement. It concludes that well-designed mitigation policies across a range of sectors — including energy, the built environment, food and agriculture, and transportation — result in cleaner air, improved housing, better diets, increased physical activity, and therefore fewer deaths.
Air pollution could account for nearly 1 out of 5 deaths globally, nearly double previous estimates, another study found. Cutting air pollution is perhaps the most straightforward environmental intervention with significant public health benefits.
One organization working to tackle the urgent problem of air pollution is AirQo, which collects and analyzes air quality data in Uganda using a network of low-cost sensors. Users can view air quality in their area on a smartphone app.
“You cannot manage what you cannot measure,” said Deo Okure, air quality scientist at AirQo. AirQo sees its work in Uganda as a model for supporting clean air for cities across Africa.
A ‘one health’ approach
The pandemic has also highlighted the importance of “one health,” a transdisciplinary approach within planetary health that recognizes the interconnections between people, animals, plants, and their shared environment.
Experts argue the approach can detect zoonotic diseases at the source in order to design programs to contain them.
“We can only prevent future pandemics with an integrated One Health approach to public health, animal health and the environment we share,” said Tedros Adhanom Ghebreyesus, director-general at the World Health Organization, last month at a meeting of the World Organisation for Animal Health.
One health was more of an academic ideal until PREDICT brought it into the real world over a decade ago, said Jonna Mazet, executive director of the One Health Institute at the University of California, Davis School of Veterinary Medicine, who served as PREDICT’s global director for 10 years.
The Global Virome Project is one new program that can serve as a catalyst for countries to continue working together, Mazet said. Founded in 2018, it aims to identify hundreds of thousands of viruses in wildlife around the world in an effort to stop future pandemics.
Another group that sees COVID-19 as a reason to ramp up planetary health approaches is Health in Harmony, an international nonprofit. While studying orangutans over a decade ago, the group’s founder, Dr. Kinari Webb, learned one of the primary reasons people turned to illegal logging in Indonesian Borneo, near Gunung Palung National Park, was because they needed to pay for health care.
She went on to establish the organization, which collaborates with rainforest communities seeking quality health care and sustainable agriculture training in exchange for protecting the rainforest.
“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,” Webb wrote in a recent editorial.
Many conservation organizations slowed their work at the start of the pandemic, not seeing the connection between environmental health and human health, said Ashley Emerson, Health in Harmony’s program director.
“What we’ve seen is an uptick in fires, slash and burn agriculture, deforestation,” she said. “People are cut off from their typical resources, so they turn to the most precious resource, which is the forest.”
In response, Alam Sehat Lestari, Health in Harmony’s local Indonesian NGO partner, put together a “rainforest stimulus package” for vulnerable populations, providing them with options to prevent them from returning to logging.
High stakes
The international development community has spent far too long working in silos, said Jonathan Jennings, Health in Harmony’s executive director. Global health organizations must, at a minimum, stay attuned to the ecological determinants of health.
“It’s hard to say you’re doing global health if you’re not doing it through a planetary health lens,” he said.
Environmental destruction impacts every dimension of health — whether it’s global mental health, infectious disease exposure, vector-borne diseases, pandemics, air pollution and food systems and non-communicable diseases, said Myers of the Planetary Health Alliance.
“The stakes are the future of humanity and civilization,” he said. “And that’s because we’re transforming our natural systems at a scale and pace that is inconsistent with human health and wellbeing.”
“We need a fundamental transition in how we live on earth,” Myers continued. “Food systems, built environment, energy systems, circular economy. Really across the board we need to change how we’re living, and so every sector of development is relevant.”
This focus area, supported by the U.N. Development Programme, explores how climate change and other planetary imbalances impact the rising trend of human inequality and vice versa. Visit the Focus on: People and the Planet page for more.