Imagination challenges in planetary health: re-conceptualising the human-environment relationship
Authors: Sabine Gabrysch
Journal: The Lancet Planetary Health (2018)

The new field of planetary health has identified three key challenges, concerning imagination, knowledge, and implementation.1Whitmee S Haines A Beyrer C et al.Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation-Lancet Commission on planetary health.Lancet. 2015; 386: 1973-2028Summary Full Text Full Text PDF PubMed Scopus (1125) Google Scholar We need research to increase our knowledge on how anthropogenic environmental change is affecting human health, through short-term (eg, air pollution) and long-term (eg, climate change), direct (eg, heat effects), and complex pathways (eg, biodiversity loss). We also need to improve our understanding of how we can implement sustainable solutions to stay within planetary boundaries, which will help to avoid catastrophic long-term consequences for human health and survival, as well as often also having immediate human health co-benefits (eg, improved cardiovascular health through active transport). We also need to fundamentally rethink our relationship with the planet, combining philosophical, ethical, literary, medical, and other perspectives, ideally creating a positive vision which can energise the so-called Great Transformation of human societies globally, which we so urgently need. This Comment aims to stimulate debate around such a re-conceptualisation. With increasing success in domesticating and controlling nature, humans have started to regard themselves as separate from nature. The environment is, however, also within us: we breathe the air, drink the water, eat other species, co-exist with millions of microorganisms on our external and internal surfaces, all of which are essential to our health and survival. Furthermore, now that we have entered the Anthropocene epoch, with humans as the major shaping force of the planet, there is no pure nature or untouched environment, so to speak, anymore; everything on this planet is influenced by human activities. Thus, the environment is part of us and we are part of the environment. James Lovelock and Lynn Margulis suggested in the 1970s that the Earth can be regarded as a superorganism, with self-regulatory feedback loops and emerging properties, ie, the whole being more than its parts, similar to a beehive that can keep its temperature stable over a certain range, although the individual insects cannot, without presupposing any intended purpose or consciousness.2Lovelock JE Gaia: a new look at life on earth. Oxford University Press, Oxford1979Google Scholar Lovelock and Margulis' idea was named Gaia theory, after the Greek earth goddess, a suggestion by Lovelock's neighbour, the writer William Golding. The theory implies that we are part of a larger entity, Gaia or, less poetic, the Earth system, that we are one component of a living planet, connected with all its other components, and totally dependent on it for our survival—a powerful image. What role do humans play today as part of the superorganism Earth? Our role has been compared to that of a cancer or a parasite infesting the Earth.3MacDougall AK Humans as cancer.http://www.brontaylor.com/courses/pdf/MacDougall--HumansCancer.pdfDate: 1996Date accessed: August 14, 2018Google Scholar The defining feature of cancer cells is that their growth is unregulated, ie, they do not react to feedback mechanisms, consequently using up a disproportionate amount of energy, invading other tissues, and eventually damaging vital organs and leading to death. Humans have emerged from the Earth, then gained some independence from nature by using technology. We liberated ourselves from constraints in food and energy supplies through using fossil fuels, and increased our population size and consumption exponentially. We are consuming vast natural resources and dumping toxic by-products into the air, water, and soil. As we gained independence from nature through technology, we also started disconnecting emotionally and ethically, dissociating ourselves from nature. We gave ourselves the right to exploit all other species as we please, seeing them as a pile of resources to be used for ourselves, the self-appointed pinnacle of evolution. It is clear now, however, that our success has become our biggest enemy. We cannot defeat nature as we are a part of it. Just like a cancer cannot defeat the body. The moment of a cancer's biggest success, the peak of its growth, is right before the collapse of the larger system. Albert Einstein famously pointed out that we cannot solve a problem with the same mindset that created it, that we need a new way of thinking if humanity is to survive. The first step towards solving our global environmental problems could be to rethink the human-environment relationship and realise that we are part of a living planet, but have been behaving like a cancer and need to re-integrate ourselves into the planetary feedback loops. Such re-integration does not imply reverting to (cruel) natural regulation mechanisms through hunger and disease, as existed during the stone age, can be achieved through self-regulation using social and political mechanisms, such as family planning and carbon taxes. As Heinrich von Kleist wrote in his essay On the Marionette Theatre,4von Kleist H On the marionette theatre.http://southerncrossreview.org/9/kleist.htmDate accessed: July 1, 2018Google Scholar once humans have eaten from the tree of knowledge and been thrown out of paradise, there is no easy way back; but we have to make the journey around the world and see if we can find an entrance to paradise from the other end. Kleist describes the example of the professional dancer striving to regain the gracefulness of the puppet, and, in a similar way, humanity has to try and find ways of reconnecting with nature at a conscious level. With humans now interfering with almost all of the Earth's systems, we are steering into the Anthropocene epoch with vastly less stable and hospitable conditions for human societies than during the Holocene epoch. To stay within the safe operating space as defined by the planetary boundaries approach and not destabilise planetary systems beyond critical tipping points,5Steffen W Richardson K Rockström J et al.Planetary boundaries: guiding human development on a changing planet.Science. 2015; 347: 1259855Crossref PubMed Scopus (5075) Google Scholar we must learn how to organise ourselves differently. Similar to a beehive, humanity needs to act intelligently as a whole, as a global community. Can our political systems and institutions respond to this challenge in a timely fashion? Why have we been painfully slow at responding so far? Why are we failing to recognise the scale and urgency of the problem? A deeper understanding of ourselves and a transformation of our value system might be required to change our actions, as has been highlighted by some religious leaders.6Lama Dalai Ethics for the new millennium. Riverhead Books, New York1999Google Scholar, 7Francis Pope Encyclical letter Laudato si': on care for our common home. Vatican Press, 2015http://w2.vatican.va/content/francesco/en/encyclicals/documents/papa-francesco_20150524_enciclica-laudato-si.htmlDate accessed: July 1, 2018Google Scholar Besides improved regulatory mechanisms at societal and political levels, we might need ethical principles to guide and self-regulate our behaviour. As the Brazilian environmentalist José Lutzenberger pointed out, the environmental crisis is not primarily a technological challenge, but rather an ethical challenge, in that our current mainstream ethics are human-centred, exclude other living beings, and devaluate nature.8Lutzenberger JA Our suicidal ethics. Written for the World Ethics Congress, Kühlungsborn, Germany.http://www.fgaia.org.br/texts/e-worldethics.htmlDate: 2000Date accessed: July 1, 2018Google Scholar Albert Schweitzer's concept of Reverence for Life9Schweitzer A Reverence for life: the words of Albert Schweitzer. Maurice Basset, Anna Maria, FL2017Google Scholar and many indigenous value systems give nature its own intrinsic value, as well as foster an understanding that we are part of a living Earth, together with so many other beings, and not the only species on the planet that matters. We need to transform societal structures and individual minds from a focus on having to a focus on being, as highlighted already in the 1970s by Erich Fromm.10Fromm E To have or to be? A new blueprint for mankind. Harper & Row, New York1976Google Scholar Humans can be greedy and selfish, exploiting others and nature, like the Homo economicus in economists' models, but we can also choose to behave differently and cultivate generosity and compassion, realising our interconnectedness. In a world where spirituality has been lost and where unlimited growth has gained the status of a religion, this connectedness to other humans and other species, this feeling of being embedded into a bigger whole, having a purpose, and actively working towards the wellbeing of others and the planet could be a true and lasting source of happiness. Many thinkers, activists, communities, and social movements are working towards such a transformational change in our worldview and actions, in line with the statements in the Lancet's manifesto for planetary health.11Horton R Beaglehole R Bonita R Raeburn J McKee M Wall S From public to planetary health: a manifesto.Lancet. 2014; 383: 847Summary Full Text Full Text PDF PubMed Scopus (188) Google Scholar As health professionals, aware of the imminent collapse of our civilisation if we continue with business as usual, the formidable challenges ahead, but also the tremendous opportunities, we should be joining these forces. I declare no competing interests.