STILL ONLY ONE EARTH: Lessons from 50 years of UN sustainable development policy BRIEF #13 COVID-19 and Planetary Health: How a Pandemic Could Pave the Way for a Green Recovery Nicole de Paula, Ph.D. Elizabeth Willetts March 2021 Key Messages and Recommendations • The COVID-19 pandemic magnifies underlying systemic problems, including ineffective environmental policies, social and economic inequalities, and weak healthcare systems. • Policymakers need to strengthen climate resilience in our societies, economies, and ecosystems, and promote greater synergies and convergence between climate, biodiversity, and health finance. • Collaboration between environment and health ministries to form joint agendas and link policy and programming is essential to facilitate a green recovery. • International organizations and agencies need to break down silos, take joint action, and integrate policy and programming to promote planetary health. Before the COVID-19 pandemic began in exposure can cost nearly USD 1 trillion in 2020, policymakers already faced sobering neurodevelopmental effects in middle and health statistics. As noted by the World Health low-income countries. Microplastics, nutrient Organization (WHO) and the United Nations excess from farm run-off, and zoonotic diseases Environment Programme (UNEP), nearly 25% impact health, well-being, and economic of all global deaths are related to economic development in overlapping and complicated decisions affecting the environment. Annually, 7 ways (Myers, 2017). million people die from poor air quality and 3.5 Existing environmental policies do not million die from poor water quality. Chemical effectively support global health and © 2021 International Institute for Sustainable Development Photo: NASA (CC0 1.0) COVID-19 and Planetary Health: How a Pandemic Could Pave the Way for a Green Recovery sustainable development objectives. The COVID-19 pandemic has exacerbated these negative trends and has magnified underlying systemic problems, including social and economic inequality and weak healthcare systems. How can sustainable development policies cohesively and proactively address these interrelated challenges to improve human health? Rethinking the Environment- Health Nexus The COVID-19 pandemic is the ultimate manifestation of an interconnected world. This Respiratory disease associated with air pollution is rampant, zoonotic virus, which jumps pathogenically especially in cities like New Delhi, India, where air quality has between wildlife and humans, reminds us of plummeted over the last few years. (Photo: iStock) the inter-relatedness of our molecular universe. The swift community lockdown in response health,” an emerging field that focuses on to the pandemic reminds us our existence how human-induced changes in our Earth’s depends on interwoven food and economic systems impact human health and well-being. pathways. Our neglect of these microscopic and macroscopic interlinkages between human The Effects of Environmental health and the environment is the root cause of the pandemic. Despite decades of scientific Change and Environmental warnings, we neglected the ecosystem factors Degradation on Health that promote infectious disease transmission. Worldwide, respiratory disease associated Human health in the Anthropocene requires with air pollution is rampant. There is a high an integrated approach. In 2015, the Lancet prevalence of chronic lung inflammation, medical journal in partnership with the increased acute asthma, and nasal and sinus Rockefeller Foundation published a landmark allergies, often requiring life-long medication. report alerting the medical community that According to the Lancet Commission on humans had damaged the Earth’s natural Pollution and Health, respiratory disease can systems to the point of causing reciprocal lead to lung cancers and diseases that affect risk and damage to human health. The report the heart, such as heart attack, stroke, high underlined the urgency and opportunity to blood pressure, and high cholesterol. Heart address modifiable environmental factors disease has been the leading cause of death to reduce the global burden of disease globally for two decades and is rising. and launched an international call for Diseases caused by water contamination world leaders and experts to support a continue to challenge clinicians, especially transdisciplinary approach called “planetary among marginalized and low-income bit.ly/still-only-one-earth 2 COVID-19 and Planetary Health: How a Pandemic Could Pave the Way for a Green Recovery populations, in post-disaster settings, access to green space has also been shown to and in communities in conflict. Without contribute to poor moods and sleep cycles. comprehensive water regulation, antibiotic It is worth noting the increase in the global treatment is a short-term solution to prevalence of depression disorders and their outbreaks of microbial diarrhea that stem correlation with both environmental change from ecosystem disruption in the form of and increasing social and economic inequality. biodiversity loss, excess nutrient run-off from Women and girls’ health and well-being are farms, or other human contamination. Viral impacted by environmental degradation and diseases arising from vectors living in water climate change. This is seen in increased ecosystems, like mosquitos, also strain health stress, higher rates of domestic violence, systems. Communities are grappling with reduced access to reproductive services increasing incidences of acute and chronic and contraception, and reduced access to hematological (Malaria), arthritic (Dengue, education and independent livelihoods. Chikungunya), or developmental (Zika) Moreover, the disproportionate number of disorders. These are exacerbated by climate women and girls affected by the COVID-19 change, which in turn can bring infected pandemic underscores the need to address the mosquitos to non-endemic and immune links between environment, gender inequality, system-naive countries. and poverty. Climate change is one of the greatest threats Food systems are paradoxically a threat to to public health (Haines & Ebi, 2019). Rising human health. According to the sixth Global temperatures, rising sea levels, and extreme Environmental Outlook, the agrifood system weather events pose increasing risks for human is inefficient, environmentally detrimental, and well-being (Watts et al., 2019), including poorly aligned with optimal nutritional needs. injuries, fatalities, mental health impacts, and Current food system production yields high mass migration (Andrews et al., 2018). emission goods, like animal protein and dairy Long-term environmental exposure to and products, and steers dietary habits toward accumulation of toxins, dioxins (persistent the overconsumption of low nutrition foods, organic pollutants), and endocrine disrupting like processed foods and snacks, which are chemicals in our bodies are, or are suspected cheaper and more accessible. As a result, both to be, linked to organ damage, cancer, developed and developing countries face a developmental and neurological disorders, and widespread combined burden of poor eating hormone dysfunction. (overeating or under) and micronutrient deficiency. The global incidence of diabetes Environmental degradation also affects the increased 70% in the last twenty years, and mental and emotional health and well-being clinics treat numerous obese patients taking of communities and individuals. Communities multiple chronic medications to regulate their may suffer forced displacement, contributing metabolism. The disruption caused by the to mental and emotional trauma. These COVID-19 pandemic led to the closure of events may additionally trigger psychological markets, decreased production and processing, illness seeded by underlying, long-standing, and restricted food transport including environmental injustice, health disparities, and imports, exports, and food assistance. These gender inequities. In urban settings, lack of bit.ly/still-only-one-earth 3 COVID-19 and Planetary Health: How a Pandemic Could Pave the Way for a Green Recovery simultaneous shocks have led to an estimated zoonoses and more than 75% of those are 80–130 million additional food insecure people. from wildlife. Loss of biodiversity and ecosystem integrity weakens health systems and changes our International Recognition exposure to pathogens. At the community level, of the Environment-Health ecosystem degradation limits the availability Nexus of natural medicines and the sustainability of traditional knowledge, as well as opportunities The Stockholm Declaration and Action to identify new drugs to treat cancer, viral Plan adopted at the 1972 United Nations infections, neurological and brain disorders, Conference on the Human Environment and other elusive diseases. Antimicrobial was the first intergovernmental conference resistance, influenced by unregulated and non- outcome to recognize the right to a harmonized use of antimicrobial drugs across healthy environment. It further recognized the veterinary, livestock, and human health environmental disturbance and destruction sectors, threatens the long-term effectiveness as “harmful to the physical, mental and social of antimicrobial drugs and the ability to treat health of man.” The global conversation bacterial infections and diseases. Studies highlighted the need for integrated show biodiversity loss seems to increase environment and development policies at a emergence and exposure to new strains