Sustaining planetary health in the Anthropocene

The inextricable link between global environmental change and human health has gained attention as we witness increasingly catastrophic weather events and widespread environmental degradation wrought by pollution and biodiversity loss and respond to an ongoing COVID pandemic of zoonotic origins [1,2]. In 2014, Richard Horton et al. called for a collective manifesto to transform public health to planetary health [3], which drew a range of responses [4-6]. Planetary health was defined as the health of human civilisation and the state of the natural systems on which it depends [3]. Soon after that, the 2015 report of the Rockefeller Foundation – Lancet Commission on planetary health clearly indicated that we have been mortgaging the health of future generations to realise short-term economic and development gains in the present [7]. Human civilisation has largely flourished by unsustainably exploiting nature's resources, but now confronts substantial health risks from the degradation of nature's life support systems as a direct result of human activities. Health risks from large-scale environmental changes such as climatic change, ocean acidification, land degradation, water scarcity, overexploitation of fisheries, and biodiversity loss pose serious challenges to global health and are likely to increase over the coming decades because of growing populations, accelerating demand for resources (such as land, food, and energy), and inappropriate use of technology (such as the nuclear armament race). The World Health Organization (WHO) recently estimated that more than 13 million deaths annually occur due to avoidable environmental causes, including climate change, air pollution, and other exposures [8].