In 2023, a disturbing milestone was reached: six out of nine planetary boundaries were crossed, signalling an unprecedented threat to Earth’s stability.1 Simultaneously, the world grappled with a relentless series of disease outbreaks—Ebola, dengue, Zika, covid-19, Mpox, and Nipah. This convergence of crises is not coincidental. As Tulio de Oliveira, a leading genomics expert, warns, “Over half of known pathogen outbreaks will increase due to climate change.”2 The message is clear: our planet’s health and human health are inextricably linked, demanding an urgent, integrated response.
Recent years have seen tentative steps towards recognising this interconnection. The COP28 climate talks featured an official health day3 and the World Health Assembly adopted a climate and health resolution.3 The CEPI Global Pandemic Preparedness Summit in Brazil highlighted the cascading effects of climate change on infectious diseases, even impacting marine mammals like sea lions.4
However, these initiatives fall short of the substantial shift that is required. Three critical gaps hinder meaningful progress:
1. The absence of a clearly articulated goal and agenda for joint action.
2. Insufficient political commitment from governments at national and international levels.
3. A lack of governance mechanisms to advance an integrated planetary agenda.
The ongoing struggles in crafting a pandemic agreement, even after the global impact of covid-19, exemplify these gaps. Notably, the concept of One Health—which recognises the interconnections between human, animal, and environmental health—has proven one of the most challenging areas of negotiation.5
The root of our ineffective response lies in our fragmented, anthropocentric worldview. As Blake and Gilman argue, we must widen our perspective to integrate the interactions of geophysical systems and living beings, both human and non-human. Our lodestar should be “thriving ecosystems in a stable biosphere supporting human lives and non-human life.”6
This shift requires more than simply “factoring in” climate considerations to health policies. It demands a fundamental reimagining of our relationship with the planet. The recent H5N1 avian influenza outbreak in South America, which has devastated local bird populations and threatens to spill over into humans, starkly illustrates the consequences of ignoring these interconnections.7
There is an increasing recognition of the interface between health and climate.
Achieving this planetary mindset necessitates leveraging “new technologies of perception.”6 These go beyond traditional public health surveillance, integrating data from diverse sources to provide a holistic view of planetary health.
For instance, the NASA Earth System Observatory combines satellite data on climate, land use, and ecosystem changes with ground-based sensors and AI analysis. This system could revolutionize our ability to predict and respond to emerging health threats.8
Similarly, the concept of “pandemic intelligence” now encompasses not just pathogen genomics, but also environmental monitoring, animal health surveillance, and social media analysis to detect early signs of outbreaks.9
The challenges we face transcend national borders, yet our governance structures remain rooted in the nation-state model. Even existential threats—whether from pandemics or climate change—have failed to generate sufficient cooperation. For pandemics “the safe operating space for humanity” is endangered every time a public health emergency of international concern (PHEIC) is declared.
Covid-19 laid bare the weakness of the global architecture on pandemic preparedness and response—greed, national interest, and geo-political concerns had been put before equity, solidarity, and support of life. The ongoing negotiations for a “pandemic agreement” under the World Health Organization illustrate both the potential and limitations of our current approach. While it represents a step forward, the process risks focusing too narrowly on “solving the last pandemic” rather than creating a flexible, forward-looking governance structure.10
We propose a more ambitious approach: the convergence of climate and pandemic governance mechanisms. This could take the form of joint Conferences of the Parties (COPs), bringing together expertise from multiple domains to tackle the interlinked challenges of climate change and global health and to work out how to jointly create “thriving ecosystems in a stable biosphere supporting human lives and non-human life.”6 We require mechanisms to “govern for the planet” not just bits and pieces of it.
During the covid-19 pandemic, WHO Director-General Tedros Adhanom Ghebreyesus reminded us that “no one is safe until everyone is safe.”11 We must now expand this concept: There is no possibility of human thriving unless the ecosystems we are part of thrive. This realisation demands immediate action, including the establishment of an Intergovernmental Panel on Planetary Health to provide policymakers with regular scientific assessments and the development of integrated health and climate impact assessments for all major policy decisions.
The challenges we face are unprecedented, but so too is our capacity for collective action and innovation. By embracing a truly planetary mindset, we can forge a path towards a healthier, more resilient future for all life on Earth.
Footnotes
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Competing interests: none
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Provenance and peer review: commissioned, not externally peer reviewed.
