A pangolin, the world’s most trafficked mammal, at a conservation site in Ninh Binh, Vietnam, September 14, 2020. Vietnam has vowed to crack down on the illegal wildlife trade often blamed for the COVID-19 pandemic.  Image: Manan Vatsyayana/AFP/Getty

‘Different faces of a single threat’: Global Health Must Play a Bigger Role in Planetary Health

The pandemic has led to a scramble to fund new infectious disease prevention measures aimed at averting future pandemics.

As the global death toll topped 4 million, in mid-July a G-20 panel called for $75 billion in financing over the next 5 years to develop flexible, responsive health systems that provide early detection of and faster response to disease outbreaks.

While these capabilities are critical in responding to outbreaks, they will ultimately fail to prevent another pandemic. This is because we’ve been viewing global health security through the narrow lens of human health. Instead, we need a comprehensive new approach.

Here’s why: Some 75% of emerging infectious diseases come from animals. And the way we are treating the planet vastly increases the chances of zoonotic spillover. Destroying forests for development or farming, intensified livestock production, and wildlife trade greatly increase the chance that pathogens will spill over to humans. 

A changing climate increases disease risk as well. A hotter planet means mosquitoes can survive in more temperate areas and at higher altitudes, which puts an additional 4.7 billion people at risk of contracting dengue or malaria through 2070, according to a Lancet Planetary Health study. Climate change also drives drought and extreme weather events and fuels malnutrition and social instability—all tinder for disease outbreaks, particularly among the world’s most vulnerable populations.

What’s needed:

An integrated approach to get ahead of outbreaks

Global health security currently focuses on containing existing disease outbreaks, but we must stop them from happening in the first place. One Health, which looks at the itersection of animal, plant and human life, has been a valuable concept, but planetary health solutions look back even farther at a chain of effects to consider how humans affect greenhouse gasses and animal populations.

One example: The nonprofit Health in Harmony, working with public health specialists, ecologists, and environmental scientists, addressed logging in Borneo to conserve animal habitats and improve human health. Residents in several villages received discounted health services and job training in exchange for reducing logging. A decade into the program, 21,000 hectares of forest had regrown. Infant mortality fell 67% in the population of about 100,000 people, and there were significant declines in malaria, tuberculosis, and diabetes.

Planetary health approaches are more economical, too. A 2020 Science study found that the annual cost of preventing future zoonotic outbreaks by stopping deforestation and regulating the wildlife trade is ~$22 billion. The economic fallout of the COVID-19 pandemic may reach $18 trillion by 2022.

A broader role for global health leadership

As a 2020 commentary in BMJ Global Health pointed out, global health NGOs are important members of a One Health or Planetary Health solution. Beyond lending epidemiological and health systems expertise, we can convene international multisectoral collaborators, sharing our umbrella with nonprofits in the environmental, climate ecosystem, and wildlife conservation sectors, and engage with governments to support disease surveillance systems.

Policymakers must begin exploring cross-departmental and intra-agency approaches and coordination to address planetary health goals. We also need to change the way funding is allocated, thinking about how disease-specific programs may also benefit from addressing environmental equity and sustainability.

Progress is already being made

 Preventing Pandemics at the Source—a coalition of public health and environmental groups—is calling for dedicated funds and coordinated multisectoral action to stop pathogen spillover. The GEO Health Community of Practice, which includes representatives from NASA, the United Nations Office for Outer Space Affairs, and WHO, promotes geological modeling and prediction technology to inform public health policy, including pandemic response.

Research is branching out as well

The National Institute of Environmental Health Sciences is looking at how poor air quality and heat waves may drive the spread of and deaths due to COVID-19.

As we ponder how to approach huge challenges like climate change, infectious diseases, and loss of biodiversity, it’s time to realize that they are, in fact, different faces of a single threat that demands a unified approach. The field of global health must adapt to a warming world and evolving scientific knowledge and help lead efforts to create a truly healthy planet.

Ashley Arabasadi is a Senior External Affairs Manager with nonprofit global health organization Management Sciences for Health and co-chair of the Global Health Security Roundtable, hosted by the Global Health Council.

 

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A pangolin, the world’s most trafficked mammal, at a conservation site in Ninh Binh, Vietnam, September 14, 2020. Vietnam has vowed to crack down on the illegal wildlife trade often blamed for the COVID-19 pandemic. Image: Manan Vatsyayana/AFP/Getty