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Human and planetary health: towards a common language

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Relatório da Convenção sobre Diversidade Biológica da Fundação Rockfeller

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Human and planetary health: towards a common language

  1. 1. Comment www.thelancet.com Published online July 16, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61044-3 1 Human and planetary health: towards a common language With less than 5 months until the Conference of the Parties to the UN Framework Convention on Climate Change is held in Paris, France, the world has a unique but fast-closing window of opportunity. It is vital that the global community recognises that human and planetary health are two sides of the one climate coin, and that together they present a critical road for comitigation. But as we enter the second half of 2015— a year that will bring a new global development agenda with the Sustainable Development Goals, a World EXPO on Feeding the Planet, Energy for Life, and a defining juncture for climate action—it is the intersections of sustainability and health and their effect on climate mitigation that must be recognised, prioritised, and leveraged. Reflecting the strong stewardship of The Lancet and others, planetary health is increasingly understood as a global health issue. Translating this understanding into action is now key, as outlined in the report of The Rockefeller Foundation–Lancet Commission on Planetary Health.1 Finding a common language for this translation is a crucial step. When the 2013 Global Burden of Disease Study ranked the top causes of global disability and deaths, it was no surprise to many of us that diet-related, non-communicable diseases (NCDs) topped the list.2 Simultaneously, as the world looks to curb and reduce climate emissions and protect major freshwater, land, and ocean resources, our food systems are now responsible for an estimated 32% of global emissions— more than from all land, sea, and air transport combined.3 Agriculture is also the world’s single largest consumer of freshwater, undermining the resilience of land-based ecosystems, which function as critical carbon sinks and habitats for biodiversity, and the largest source of nitrogen and phosphorus loading, causing eutrophication of freshwater and marine systems and emissions of nitrous oxide, a greenhouse gas.4 If we can get it right on food, we will have come a long way to getting it right for people and the planet. Moreover, timelines are tight because humanity has now entered the Anthropocene. Science can say with disturbing certainty that our modern world constitutes a global force of change at the planetary scale; that humanity can disrupt the Earth’s natural systems and therefore the Earth’s life support processes.5–7 To safeguard our planet, and enable a prosperous future for humanity, we must keep global warming below 2°C, which means zero carbon emissions by 2050 or soon thereafter.8 To achieve such dramatic change will require a global transformation, so we must look to new opportunities that reach across traditional communities. Our food system is pivotal for us to succeed and represents important shared ground. The collective question we must now answer, for human health, wealth, and for a safe climate future on a stable and resilient planet, is how can we feed 9–10 billion healthy people within planetary boundaries? Healthier diets have the potential to reduce not only rates of NCDs and undernutrition, but also our climate emissions.2,3,9,10 For much of the planet, this would involve reducing intakes of ultra-processed foods, red meat, saturated fats from animals, and unsustainable oils such as palm oil, and instead increasing consumption of plant-based diets. Reducing red meat consumption in many high-income countries alone, for example, could reduce the carbon intensiveness of diets, lead to a decrease in certain cancers and heart disease, and have profound effects throughout the food system—including water and land savings through a reduction in ecosystem and climate degrading monocultures of grain and other animal feedstocks.9,10 From common risks to common opportunities, a more united global agenda must align planetary and YvaMomatiuk&JohnEastcott/MindenPictures/Corbis Published Online July 16, 2015 http://dx.doi.org/10.1016/ S0140-6736(15)61044-3 See Online/ The Lancet Commissions http://dx.doi.org/10.1016/ S0140-6736(15)60901-1
  2. 2. Comment 2 www.thelancet.com Published online July 16, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61044-3 human health targets, and their translation. We should immediately explore the potential synergies between the Global Action Plan for the Prevention and Control of NCDs,11 the Sustainable Development Goals, and efforts to close the nutrition divide manifested in the triple burden of malnutrition; all within the Earth’s critical and non-negotiable planetary boundaries.8 Comitigation policies need to build in health and ecosystem externalities through appropriate and progressive pricing mechanisms; protect freshwater resources; tackle and reduce food waste; invest in scalable plans and financing models for implementing renewable energies, emphasising the potential indirect health gains through lower rates of pollution- related disease; and encourage regional investment in urban active transport infrastructure which benefits both the cardiovascular health of populations and environmental health. These are just some of the examples of win–win policies that must be fought for, from all sides. Achieving these goals will be crucial, but powerful corporate and political interests exist that have the potential to impede progress. With this in mind, we must forge and grow new partnerships for action. Linking health and environmental sustainability across science, business, politics, and civil society, the EAT Initiative strives to do just this. A multistakeholder platform that uses food as a vector for change, EAT identifies and exploits common solutions to these global challenges and aims to realise a sustainable food system for all. We commend the report of The Rockefeller Foundation–Lancet Commission1 and call on the global community to focus on synergies between human and planetary health. Communities, leaders, scientists, and advocates from both sides must align thinking, language, and points of action. Ours is a shared agenda and the stakes could not be higher. These risks to both human and planetary health are issues we, as humanity, have created and therefore can and must solve. The future health of our planet, and our populations, depends on it. *Alessandro R Demaio, Johan Rockström Harvard Global Equity Initiative, Harvard Medical School, Boston, MA 02115–6018, USA (ARD); School of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark (ARD); and Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden (JR) demaio@sund.ku.dk We are both members of the EAT Advisory Board. We declare no competing interests. 1 Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health. Lancet 2015; published online July 16. http://dx.doi.org/10.1016/S0140-6736(15)60901-1. 2 GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385: 117–71. 3 Bellarby J, Foereid B, Hastings A, Smith P. Cool farming: climate impacts of agriculture and mitigation potential. Amsterdam: Greenpeace, 2008. 4 Rockström J, Karlberg L. The quadruple squeeze: defining the safe operating space for freshwater use to achieve a triply green revolution in the Anthropocene. Ambio 2010; 39: 257–65. 5 Folke C, Jansson Å, Rockström J, et al. Reconnecting to the biosphere. Ambio 2011; 40: 719–38. 6 Field CB, Barros VR, Mastrandrea MD, et al. IPCC, 2014: summary for policymakers. In: Climate change 2014: impacts, adaptation, and vulnerability. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge: Cambridge University Press, 2014. 7 Field CB, Barros VR, Dokken DJ, et al. IPCC, 2014: Summary for policymakers. In: Climate change 2014: impacts, adaptation, and vulnerability. Part A: global and sectoral aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge: Cambridge University Press, 2014: 1–32. 8 Steffen W, Richardson K, Rockström J, et al. Planetary boundaries: guiding human development on a changing planet. Science 2015; 347: 1217. 9 Food and Agriculture Organization of the United Nations. Tackling climate change through livestock. Rome: Food and Agriculture Organization of the United Nations, 2010. 10 Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and mortality: results from 2 prospective cohort studies. Arch Intern Med 2012; 172: 555–63. 11 WHO. Global action plan for the prevention of noncommunicable diseases 2013–2020. Geneva: World Health Organization, 2013.