How are the three environmental threats challenging health systems’ resilience?

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Abstract Background Known avoidable environmental risks cause about one quarter of all deaths and disease burden worldwide, amounting to at least a steady 13 million deaths each year. Indeed, diseases caused by the environment weigh heavily on health systems. These not only harm directly human health increasing the burden of disease but also potentiate other threats, by acting as drivers (e.g. pandemics, antimicrobial resistance). In addition, the increased burden due to these environmental threats also put in risk the capacity of health systems to adapt to the new healthcare needs and to provide a proper answer to the diseases caused by other health determinants. Methods Based on a review of the literature, the presentation addresses the question of potential options in public health climate action at the interface of environmental sustainability and health systems sustainability and resilience. It identifies possible priority areas in order to guarantee environmental and healthcare sustainability. Results Approaches that focus on treatment of individual diseases rather than improvement of environmental determinants of health will be insufficient to tackle the triple environmental crises of climate change, biodiversity loss and pollution. Single-determinant approaches are unlikely to achieve expected improvements, given the complex interaction of environmental factors. Conclusions Approaches that are more integrated are required to address the root causes of disease and guarantee health systems sustainability, which are often defined by policies in key sectors other than health, such as the environment. Multi-sectoral actions are needed to prevent and mitigate the threats to human health from the ongoing and interconnected environmental crises of climate change, biodiversity loss and pollution, contributing to a Planetary Health perspective on health systems’ resilience.