NOTE FROM THE EDITORS OF THE JBSP
Questions about the relations between environmental crises, health and injustices have become increasingly important to phenomenological inquiry in recent years. These questions also have an urgency and existential significance that extends beyond any academic domain. The JBSP is thus happy to join this initiative and publish this editorial to mark the occasion of COP28.
– The JBSP Editorial Team
Over 200 health journals call on the United Nations, political leaders, and health professionals to recognize that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency.
The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. The research communities that provide the evidence for the two COPs are unfortunately largely separate, but they were brought together for a workshop in 2020 when they concluded that: “Only by considering climate and biodiversity as parts of the same complex problem … can solutions be developed that avoid maladaptation and maximize the beneficial outcomes.” (1)
As the health world has recognized with the development of the concept of planetary health, the natural world is made up of one overall interdependent system. Damage to one subsystem can create feedbacks that damage another—for example, drought, wildfires, floods, and the other effects of rising global temperatures destroy plant life, and lead to soil erosion and so inhibit carbon storage, which means more global warming. (2) Climate change is set to overtake deforestation and other land-use change as the primary driver of nature loss. (3)
Nature has a remarkable power to restore. For example, deforested land can revert to forest through natural regeneration, and marine phytoplankton, which act as natural carbon stores, turn over one billion tonnes of photosynthesizing biomass every eight days. Indigenous land and sea management has a particularly important role to play in regeneration and continuing care. (4)
Restoring one subsystem can help another – for example, replenishing soil could help remove greenhouse gases from the atmosphere on a vast scale. (5) But actions that may benefit one subsystem can harm another – for example, planting forests with one type of tree can remove carbon dioxide from the air but can damage the biodiversity that is fundamental to healthy ecosystems. (6)
The impacts on health
Human health is damaged directly by both the climate crisis, as the journals have described in previous editorials, (7,8) and by the nature crisis. (9) This indivisible planetary crisis will have major effects on health as a result of the disruption of social and economic systems – shortages of land, shelter, food, and water, exacerbating poverty, which in turn will lead to mass migration and conflict. Rising temperatures, extreme weather events, air pollution, and the spread of infectious diseases are some of the major health threats exacerbated by climate change. (10) “Without nature, we have nothing,” was UN Secretary-General António Guterres’s blunt summary at the biodiversity COP in Montreal last year. (11) Even if we could keep global warming below an increase of 1.5°C over pre-industrial levels, we could still cause catastrophic harm to health by destroying nature.
Access to clean water is fundamental to human health, and yet pollution has damaged water quality, causing a rise in water-borne diseases. (12) Contamination of water on land can also have far- reaching effects on distant ecosystems when that water runs off into the ocean. (13) Good nutrition is underpinned by diversity in the variety of foods, but there has been a striking loss of genetic diversity in the food system. Globally, about a fifth of people rely on wild species for food and their livelihoods. (14) Declines in wildlife are a major challenge for these populations, particularly in low- and middle-income countries. Fish provide more than half of dietary protein in many African, South Asian and small island nations, but ocean acidification has reduced the quality and quantity of seafood. (15)
Changes in land use have forced tens of thousands of species into closer contact, increasing the exchange of pathogens and the emergence of new diseases and pandemics. (16) People losing contact with the natural environment and the decline loss in biodiversity have both been linked to increases in noncommunicable, autoimmune, and inflammatory diseases and metabolic, allergic and neuropsychiatric disorders. (9,17) For Indigenous people, caring for and connection with country is especially important for their health. (18) Nature has also been an important source of medicines, and thus reduced diversity also constrains the discovery of new medicines.
Communities are healthier if they have access to high-quality green spaces that help filter air pollution, reduce air and ground temperatures, and provide opportunities for physical activity. (19) Connection with nature reduces stress, loneliness and depression, while promoting social interaction. (20) These benefits are threatened by the continuing rise in urbanization. (14)
Finally, the health impacts of climate change and biodiversity loss will be experienced unequally between and within countries, with the most vulnerable communities often bearing the highest burden. (9) Linked to this, inequality is also arguably fuelling these environmental crises. Environmental challenges and social/health inequities are challenges that share drivers and there are potential co-benefits of addressing them. (9)
A global health emergency
In December 2022 the biodiversity COP agreed on the effective conservation and management of at least 30% percent of the world’s land, coastal areas, and oceans by 2030. (21) Industrialized countries agreed to mobilize $30 billion per year to support developing nations to do so. (21) These agreements echo promises made at climate COPs.
Yet many commitments made at COPs have not been met. This has allowed ecosystems to be pushed further to the brink, greatly increasing the risk of arriving at “tipping points,” abrupt breakdowns in the functioning of nature. (2,22) If these events were to occur, the impacts on health would be globally catastrophic.
This risk, combined with the severe impacts on health already occurring, means that the World Health Organization should declare the indivisible climate and nature crisis as a global health emergency. The three pre-conditions for WHO to declare a situation to be a Public Health Emergency of International Concern (23) are that it: (1) is serious, sudden, unusual or unexpected; (2) carries implications for public health beyond the affected State’s national border; and (3) may require immediate international action. Climate change would appear to fulfil all of those conditions. While the accelerating climate change and loss of biodiversity are not sudden or unexpected, they are certainly serious and unusual. Hence we call for WHO to make this declaration before or at the Seventy-seventh World Health Assembly in May 2024.
Tackling this emergency requires the COP processes to be harmonized. As a first step, the respective conventions must push for better integration of national climate plans with biodiversity equivalents. (3) As the 2020 workshop that brought climate and nature scientists together concluded, “Critical leverage points include exploring alternative visions of good quality of life, rethinking consumption and waste, shifting values related to the human-nature relationship, reducing inequalities, and promoting education and learning.” (1) All of these would benefit health.
Health professionals must be powerful advocates for both restoring biodiversity and tackling climate change for the good of health. Political leaders must recognize both the severe threats to health from the planetary crisis as well as the benefits that can flow to health from tackling the crisis. (24) But first, we must recognize this crisis for what it is: a global health emergency.
Kamran Abbasi, Editor-in-Chief, BMJ; Parveen Ali, Editor-in-Chief, International Nursing Review; Virginia Barbour, Editor-in-Chief, Medical Journal of Australia; Thomas Benfield, Editor-in-Chief, Danish Medical Journal; Kirsten Bibbins-Domingo, Editor-in-Chief, JAMA; Stephen Hancocks, Editor-in-Chief, British Dental Journal; Richard Horton, Editor-in-Chief, The Lancet; Laurie Laybourn-Langton, University of Exeter; Robert Mash, Editor-in-Chief, African Journal of Primary Health Care & Family Medicine; Peush Sahni, Editor-in-Chief, National Medical Journal of India; Wadeia Mohammad Sharief, Editor-in-Chief, Dubai Medical Journal; Abdullah Shehab, Editor-in-Chief, New Emirates Medical Journal; Paul Yonga, Editor-in-Chief, East African Medical Journal; Chris Zielinski, University of Winchester.
Correspondence: [email protected]
References
- Altveş S, HK Yildiz, and HC Vural. “Interaction of the Microbiota with the Human Body in Health and Diseases.” Bioscience of Microbiota, Food and Health 39 (2020): 23–32.
- Armstrong McKay DI, et al. “Exceeding 1.5°C Global Warming Could Trigger Multiple Climate Tipping Points.” Science 377 (2022): eabn7950.
- Atwoli L, et al. “COP27 Climate Change Conference: Urgent Action Needed for Africa and the World.” British Medical Journal 379 (2022): 02459.
- Atwoli L, et al. “Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health.” British Medical Journal 374 (2021): n1734.
- Birchenough SNR, Williamson P, and Turley C. (2017). “Future of the Sea: Ocean Acidification.” Foresight – Future of the Sea Evidence Review Foresight, Government Office for Science https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/645500/Ocean_Acidification_final_v3.pdf (last accessed 24/11/2023)
- Bossio DA, et al. “The Role of Soil Carbon in Natural Climate Solutions.” Nature Sustainability 3 (2020): 391–8.
- Comeros-Raynal MT, et al. “Catchment to Sea Connection: Impacts of Terrestrial Run-off on Benthic Ecosystems in American Samoa.” Marine Pollution Bulletin 169 (2021): 112530.
- Consultation on Australia’s first National Health and Climate Strategy. https://www.health.gov.au/news/consultation-on-australias-first-national-health-and-climate-strategy (accessed 25 July 2023)
- Dawson NM, et al. “The Role of Indigenous Peoples and Local Communities in Effective and Equitable Conservation.” Ecology and Society 26 (2021):19.
- Dunne D. “Climate Change ‘Already’ Raising Risk of Virus Spread Between Mammals.” https://www.carbonbrief.org/climate-change-already-raising-risk-of-virus-spread-between-mammals/ (accessed 15 September 2023), 2022.
- European Academies Science Advisory Council. Key Messages from European Science Academies for UNFCCC COP26 and CBD COP15. https://easac.eu/publications/details/key-messages-from-european-science-academies-for-unfccc-cop26-and-cbd-cop15 (accessed 15 September 2023), 2021.
- Jelskov U. “‘Without Nature, We Have Nothing’: UN Chief Sounds Alarm at Key UN Biodiversity Event.” UN News (2022) https://news.un.org/en/story/2022/12/1131422 (accessed 15 September 2023), 2022.
- Levia DF, et al. “Homogenization of the Terrestrial Water Cycle.” Nature Geoscience 13 (2020): 656–8.
- MacGuire F, Mulcahy E, and Rossington B. “The Lancet Countdown on Health and Climate Change – Policy Brief for the UK.” https://s41874.pcdn.co/wp-content/uploads/Lancet-Countdown-2022-UK-Policy-Brief_EN.pdf (accessed 15 September 2023), 2022.
- Magnano San Lio R, Favara G, Maugeri A, Barchitta M, and Agodi A. “How Antimicrobial Resistance Is Linked to Climate Change: An Overview of Two Intertwined Global Challenges.” International Journal of Environmental Research and Public Health 20 (2023): 1681.
- Otto-Portner H, et al. “Scientific Outcome of the IPBES-IPCC Co-sponsored Workshop on Biodiversity and Climate Change.” 2021.
- Ripple WJ, et al. “Many Risky Feedback Loops Amplify the Need for Climate Action.” One Earth 6 (2023): 86–91. https://www.sciencedirect.com/science/article/abs/pii/S2590332223000040 (accessed 27 June 2023)
- Simkin RD, Seto KC, McDonald RI., and Jetz W. “Biodiversity Impacts and Conservation Implications of Urban Land Expansion Projected to 2050.” Proceedings of the National Academy of Sciences 119 (2022): e2117297119.
- Schultz R and Cairney S. “Caring for Country and the Health of Aboriginal and Torres Strait Islander Australians.” Medical Journal of Australia 207 (2017):8–10.
- Secretariat of the Convention on Biological Diversity . COP15: Nations Adopt Four Goals, 23 Targets for 2030 In Landmark UN Biodiversity Agreement. Convention on Biological Diversity. https://www.cbd.int/article/cop15-cbd-press-release-final-19dec2022 (accessed 15 September 2023), 2022.
- WHO (2005). Annex 2 of the International Health Regulations. Geneva, WHO.
- WHO and the Secretariat of the Convention on Biological Diversity. “Connecting Global Priorities: Biodiversity and Human Health: A State of Knowledge Review.” https://www.cbd.int/health/SOK-biodiversity-en.pdf (accessed 15 September 2023), 2015.
- WHO. “State of the World’s Drinking Water: An Urgent Call to Action to Accelerate Progress on Ensuring Safe Drinking Water for All.” https://apps.who.int/iris/rest/bitstreams/1474551/retrieve (accessed 25 July 2023), 2022.
- Wong FY, Yang L, Yuen JWM, Chang KKP, and Wong FKY. “Assessing Quality of Life Using WHOQOL-BREF: A Cross-sectional Study on the Association Between Quality of Life and Neighborhood Environmental Satisfaction, and the Mediating Effect of Health-related Behaviors.” BMC Public Health (2018) 18: 1113.