Designing a Planetary Health Watch: A System for Integrated Monitoring of the Health Effects of, and Responses to, Environmental Change

Abstract

In the new geological epoch of the Anthropocene impacts of human activity on the Earth’s systems may pose major risks to human health. We propose the development of a Planetary Health Watch (PHW) system for integrated monitoring of health effects of, and responses to, global environmental changes. The PHW system will harness new capabilities emerging from the digital revolution to motivate and enable effective responses to threats posed by the transgression of planetary boundaries. It will build on the existing monitoring initiatives as a system aimed at integrated monitoring of environmental change, health effects, and intermediating factors along with the drivers of change and policy responses to protect health. In July 2019, we held a two-day engagement workshop at the Wellcome Trust in London, UK. We convened 59 experts, representatives of existing monitoring initiatives, and potential users of the system to discuss and make recommendations on key aspects of the design of such a system, particularly its scope, opportunities for building on existing initiatives, target users and use cases, strategies for generating impact and key communities for engagement. The scope of monitoring was defined by a framework integrating eight planetary boundaries (climate change, ocean acidification, atmospheric aerosol loading, novel entities, freshwater use, biogeochemical flows, land system change and biosphere integrity) with human health outcomes. (Discussion of the ninth boundary – ozone layer depletion – was omitted because the ozone hole is now healing as a result of the implementation of the Montreal protocol.) As the initial crosscutting areas for the prototype development of PHW, we selected cities, food systems, and links between land use change and human health (emerging diseases and air pollution) to act as foci for the discussion. To build on the existing monitoring efforts, PHW will purse three levels of integration: (1) across health and environmental monitoring, (2) across top down and bottom up monitoring approaches, (3) between advancing knowledge and action that can be taken to protect planetary health. Existing data platforms, large-scale initiatives and networks such as the Multi-Country Multi-City Collaborative Research Network, INDEPTH network of health and demographic surveillance sites in low- and middle-income countries, Resource Watch, Global Burden of Disease project, C40, Global Covenant of Mayors, Sustainable Development Solutions Network and many others will be essential to this process. PHW will aim to add to - the evidence on the emerging risks for human health and the most effective solutions by engaging researchers as a key user community; - awareness of the evidence on impacts and solutions by investing in an outreach strategy that includes clear messages, narratives, and strategically selected messengers; - action to protect planetary health by motivating and enabling decision-makers who influence relevant policies and their implementation across sectors to incorporate planetary health as a priority. The strategies for generating impact will include generation of clear messages comprised of both data and narratives compelling to the individual users, proposing solutions and engaging with those in power to implement them. Scientific oversight and inclusive governance processes will ensure the system’s credibility and legitimacy. The next steps involve engagement with key stakeholders, facilitation of new partnerships, and development of a long-term funding strategy.