Implementation of policies to protect planetary health
Authors: Rosalie Schultz
Journal: The Lancet Planetary Health (2018)

Subhrendu Pattanayak and Andy Haines's important Comment1Pattanayak S Haines A Implementation of policies to protect planetary health.Lancet Planet Health. 2017; 1: e255-e256Summary Full Text Full Text PDF PubMed Scopus (14) Google Scholar 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. Missing from the Comment was consideration of transference of evidence from low and middle-income settings to high-income ones in efforts to attain sustainable development. Action by all countries is needed to reach the Sustainable Development Goals, and some low and middle-income countries are leading in promotion of sustainable development. Examples are Bhutan, Costa Rica, Maldives, and Tuvalu in their progress towards being carbon neutral, and Ecuador whose new constitution includes the rights of nature and fostering of a good life with harmony between people and nature.2Department of Economic and Social Affairs UNSWorld economic and social survey 2013: sustainable development challenges. United Nations, New York2013Google Scholar The need to transfer evidence from low and middle-income settings to high-income settings is an important omission from the Comment. Without this consideration the opportunities for development towards planetary health are limited. Within the health sector the notion of reverse innovation, from low and middle-income countries, is emerging, and challenging the discourse that high-income countries alone lead innovation.3Ahmed F Ahmed N Briggs T et al.Can reverse innovation catalyse better value health care?.Lancet Global Health. 2017; 5: e967-e968Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar RS is a recipient of a research entry scholarship from the Vincent Fairfax Family Foundation, administered by the Royal Australasian College of Physicians. Implementation of policies to protect planetary health – Authors’ replyWe 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.1 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. 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