Implementation of policies to protect planetary health – Authors’ reply
Authors: Subhrendu K Pattanayak, Andy Haines
Journal: The Lancet Planetary Health (2018)

We agree with Rosalie Schultz that innovation in the health-care sector could, in principle, be led by low-income and middle-income countries (LMICs) and that high-income countries can learn useful lessons from successful approaches to scaling up access to effective health care. Indeed one of us has argued that countries such as the UK should learn from the Brazilian experience of community health workers working in primary care teams.1Harris M Haines A The potential contribution of community health workers to improving health in UK primary care.J R Soc Med. 2012; 105: 330-335Crossref PubMed Scopus (12) Google Scholar However, recent evidence suggests that decision makers from high-income countries may reject evidence from health services in LMICs, often perceiving it to be of little relevance to their circumstances.2Harris M Marti J Watt H Bhatti Y Macinko J Darzi AW Explicit bias toward high-income country research: a randomized, blinded, crossover experiment of English clinicians.Health Affairs. 2017; 36: 1Crossref Scopus (53) Google Scholar Although there are some examples of so-called South–North transfers of innovations such as payments to land owners for the provision of ecosystem services (which in many senses originated in Costa Rica and other LMICs3Snider AG Pattanayak SK Sills EO Schuler JL Policy innovations for private forest management and conservation in Costa Rica.J Forestry. 2003; 101: 18-23Google Scholar, 4Ferraro PJ Lawlor K Mullan KL Pattanayak SK Forest figures: a review of ecosystem services valuation and policies in developing countries.Rev Environ Econ Policy. 2012; 6: 20-44Crossref Scopus (93) Google Scholar), in the case of planetary health the challenges of creating a sustainable economy, for example by decarbonising an industrialised economy, are different from those confronting many LMICs, particularly those that are not fully industrialised. This difference is because the former have extensive and complex economies based on the exploitation of fossil fuels and high consumption of resources; therefore they will need to transform not only their energy sectors but also transport, industry, and other key sectors. By contrast, LMICs might share common features, but they are not locked in the same degree to highly energy, carbon, and resource intensive patterns of development and consumer demand, in addition to having different governance, cultural and often eco-climatic settings. For these reasons we believe that South–South transfer of innovations may be more frequent than South–North transfers. We declare no competing interests. Implementation of policies to protect planetary healthSubhrendu Pattanayak and Andy Haines's important Comment1 outlined the inadequacy of progress towards planetary health, and noted the opportunity provided by the Sustainable Development Goals to confront challenges to planetary health. The authors argued that evidence from high-income settings cannot be directly transposed to low-income or middle-income settings, and this issue contributes to inadequate progress towards implementation of planetary health policies. Full-Text PDF Open AccessImplementation of policies to protect planetary healthExtensive evidence exists that human health and civilisation depends on flourishing natural systems.1 The Rockefeller–Lancet Commission on planetary health summarised how climate change, biodiversity loss, freshwater depletion, and air and water pollution threaten to reverse advances in human health and increase health inequities worldwide.2 For example, increasing carbon dioxide concentrations and declines in animal pollinators will exacerbate micronutrient deficiencies and risks of non-communicable disease. Full-Text PDF Open Access