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Closing event: Planetary Health - Sam Bickersteth, Rockefeller Foundation Economic Council on Planetary Health

  1. Climate change, agriculture and planetary health Rockefeller Foundation Economic Council on Planetary Health
  2. What is planetary health? • Balancing environmental change and human wellbeing • At scale - across countries, continents, and human generations • Council focus on economic drivers and solutions; addressing externalities “Put simply, planetary health is the health of human civilization and the state of the natural systems on which it depends.” – Lancet Commission on Planetary Health
  3. Our World in Data 2018 World Bank 2018
  4. Raworth (2017) The Lancet Planetary Health Steffen et al (2015) Science
  5. Outdoor air pollution attribution to source (Lelieveld et al, Nature 2015) Residential energy 31% Agriculture 20% Natural 18% Power generation 14% Industry 7% Biomass burning 5% Land traffic 5%
  6. Environmental impacts associated with agriculture (Springmann et al, Nature 2018):
  7. Climate change: health burden adds up to 640,000 additional deaths in 2050 (WHO, 2014; Springmann et al, Lancet 2016)
  8. Water and Sanitation Human health ANTIBIOTIC USAGE IN AGRICULTURE • Reduce AMR • Healthier people • Healthier diets Animal welfare • Less crowded conditions • More hygienic conditions GHGs • Better Waste management • Less methane Food systems Health Equity
  9. Border Forest loss Intact forest More diarrhea Lower treatment $ Higher treatment $ Less diarrhea Biodiversity underpinning ecosystems Link Confidence EcosystemsBiodiversity Medium Example 30% greater upstream rural forest cover has the same effect on diarrhea incidence as access to improved sanitation in LMIC2 Catchment degradation increases maintenance costs by an average of 50% in 29% of cities globally3 Biodiversity underpins ecosystem efficiency, resilience, and functioning1 LowHealthEcosystem MediumTreatment $Ecosystem Biodiversity, ecosystems, health and water treatment linkages in two imagined transboundary watersheds
  10. The economists’ toolkit Drivers of change Environmental impacts Air – Water – Land Wellbeing & health Market incentives, “command and control”, or behavioural interventions Transboundary/cross- jurisdiction coordination and governance Better measurement and monitoring
  11. What next? • Decisions around land use, food systems and agriculture sit at the heart of future planetary health • Ecosystem degradation harms water quality and health; joint health and environmental monitoring and valuation can aid decision-making • Reformed subsidies, taxes, regulations and behavourial nudges needed to achieve planetary health outcomes • International collaboration of state and non-state actors critical to accelerating solutions

Editor's Notes

  1. Overview: We’re here to introduce the concept of Planetary Health and how it can help us find solutions to emerging global health challenges. Then provide an overview of the breadth of planetary health Before using climate change as an example to demonstrate challenges and opportunities
  2. What is PH: Planetary Health is the wellbeing and health of the worlds people, and the state of the natural systems that support it The Economic Council is concerned with the connections between environmental change, wellbeing and health. These connections can be direct, like the effect of air pollution on respiratory illness, or indirect, such as declining agricultural productivity from climate change, harming nutritional health. The Council also focuses on these connections at scale. This includes both over time and human generations and transboundary and international scales, but with an awareness that a solution that works in one location may not work in another. We recognise that there is a balance between the environment, wellbeing and health which can be understood from an economic perspective
  3. Why do we need PH: Planetary Health has emerged from the awareness that human health is dependent on natural systems and the degradation of those systems is increasingly harming health and wellbeing globally. We have seen massive improvements in quality of life in the last decades. For instance, in the last 50 years global under fives mortality has fallen from over 16% to nearly 4%. However, there is growing concern that the systems that underpin health and wealth are being eroded. Within some of the systems driving these trends, there are likely to be strongly non-linear changes, and potentially tipping points that can create rapid, hard to reverse and unpredictable changes. Figure details for the negative trends. Annual deaths from air pollution: at least 7m annually – 90% in low and middle income countries; welfare cost estimated at 6.2% of global GDP (Landrigan 2017); other impacts on productivity (study by Matt and Josh on reduction of ag worker productivity decline by 5%); learning ability. 1·24 million deaths in India in 2017, 12·5% of total deaths, were attributable to air pollution, including 0·67 million) from ambient particulate matter pollution and 0·48 million from household air pollution - average life expectancy reduced by 1·7 years Temperature anomaly: Global average land-sea temperature anomaly relative to the 1961-1990 average temperature in degrees celcius (°C). The red line represents the median average temperature change. “On the y-axis, we see the global average temperature rise above or below the 1961-1990 baseline temperature. This means that we use the average temperature over the 1961-1990 period as a baseline against which yearly changes in temperature are measured.” “The red line represents the average annual temperature trend through time.” Freshwater use: “Global freshwater withdrawals for agriculture, industry and domestic uses since 1900.”
  4. Two main drivers of planetary ill health are energy consumption – with its effects on climate change and air pollution food consumption with its effects on unhealthy diets and agricultural production – with related environmental and health related consequences
  5. Not just about climate change Its not just climate change that we should worry about – many enviornmental impacts – several other planetary boundaries notably nitrogen and phosphorus loading We estimate that, in 2010, the food system emitted roughly the equivalent of 5.2 billion tonnes of carbon dioxide in GHG emissions in the form of methane and nitrous oxide; the food system also occupied 12.6 million km2 of cropland, used 1,810 km3of freshwater resources from surface and groundwater (bluewater), and applied 104 teragrams of nitrogen (TgN) and 18 teragrams of phosphorus (TgP) in the form of fertilizers  Environmental pressures are allocated to the final food product, accounting for the use and impacts of primary products in the production of vegetable oils and refined sugar, and for feed requirements in animal products. Impacts are shown as percentages of present impacts, given a baseline projection to 2050 without dedicated mitigation measures for a middle-of-the-road socioeconomic development pathway (SSP2)
  6. See decisions made in G20 Buenos Aires on AMR
  7. We are experiencing unprecedented rates of biodiversity loss globally; there is growing concern about how this may affect human health and wellbeing. Connection between biodiversity and water quality is not well understood, at large scales. However, there is strong evidence that biodiversity is essential for maintaining ecosystems in the long term. Ecosystem degradation, particularly deforestation and agricultural expansion, harm water quality Combining existing frameworks, we’ve developed a conceptual model to help us understand how biodiversity and health may be linked. We then focused on the example of water quality – which is an important ecosystem service, but closely linked to health with an estimated 1.3 million additional deaths from diarrhea disease each year globally. Using this example, there where a couple of key findings: This issue is strongly transboundary, with over 200 transboundary watersheds covering around half the worlds ice free service, overlapping some 140 countries. The direct links between biodiversity and water quality are uncertain. Yet, biodiversity is critical to ecosystem functioning and resilience. There is growing evidence that those living downstream of more intact ecosystems have less diarrhea disease than those living within ecologically degraded watersheds among those dependent on surface water for drinking – so protecting ecosystem may also protect health. Moreover, even in even in countries with regular access to improved water sources – upstream degradation can increase the cost of water treatment, even when taking into account the opportunity cost of development upstream. So efforts like the Nile Basin Initiative, which seeks to create an enabling environment for transboundary integrated water resource management, may help protect ecosystems that support health. Other projects, such as the Wessex Water – a utility company – are trading with farmers to change agricultural practices, which has proved to be more economically efficient than using water treatment facilities. Building on the joint CBD-WHO report Connecting Global Priorities: Biodiversity and Human Health: A State of Knowledge Review (CBD and WHO 2015), a number of policy pointers are proposed: Development approaches to evaluating links between biodiversity, ecosystem services, and health. These approaches should also seek to account for direct, indirect, and feedback costs and benefits across multiple health outcomes over time, and between locations and groups. Enhance the capacity of national health systems to prevent, prepare, and respond to emerging health threats from ecosystem degradation. Address number of key research gaps, particularly generating robust estimates of the disease burden of biodiversity and ecosystem change, including on mental and social health, Support the implementation of joint health and environmental monitoring for evidence-based decision-making, through appropriate indicators.
  8. Tools: Market incentives – such as subsidies, taxes or cap and trade Command and control interventions – such as regulations and standards Behavioral interventions – like employing nudge theory Implementing these at scale, often across jurisdictions' Whilst trying to overcome barriers to implementation That include limited institutional capacity Technology constraints International negotiations – collective action challenges For example the European Union Emission Trading Scheme Its an important part of the EU’s strategy for climate change Has been undergoing several trial phases Although there have been criticisms of the scheme It remains an ambitious cap-and-trade policy
  9. Its not just about climate change
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