The Helsinki Declaration 2020: Europe that protects
Authors: Jaana I Halonen, Marina Erhola, Eeva Furman, Tari Haahtela, Pekka Jousilahti, Robert Barouki, Åke Bergman, Nils E Billo, Richard Fuller, Andrew Haines, Manolis Kogevinas, Marike Kolossa-Gehring, Kinga Krauze, Timo Lanki, Joana Lobo Vicente, Peter Messerli, Mark Nieuwenhuijsen, Riikka Paloniemi, Annette Peters, Karl-Heinz Posch, Pekka Timonen, Roel Vermeulen, Suvi M Virtanen, Jean Bousquet, Josep M Antó
Journal: The Lancet Planetary Health (2020)

The concept of planetary health in the Rockefeller Foundation–Lancet Commission1Whitmee 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 (769) Google Scholar is based on the understanding that human health and human civilisation depend on flourishing and balanced natural systems and the wise stewardship of those ecosystems. How to deploy the planetary health approach in the EU, particularly in relation to the new growth strategy of the European Green Deal,2European CommissionThe European Green Deal.https://ec.europa.eu/info/publications/communication-european-green-deal_enDate: 2019Date accessed: October 2, 2020Google Scholar was discussed by researchers, policy makers, and regulators in a conference entitled Europe that Protects: Safeguarding our Planet, Safeguarding our Health. The conference was organised in Helsinki in December, 2019, under the auspices of Finland's presidency of the EU. As a result of the conference, participants agreed upon a declaration that calls for action to support planetary health during the 2020s. In this Comment, we discuss the core aspects of the Helsinki Declaration.3Finnish Institute for Health and WelfareFinnish Environment InstituteHelsinki Declaration to protect human and planetary health for 2020s.http://www.julkari.fi/handle/10024/139144Date: 2020Date accessed: October 2, 2020Google Scholar The conference was infused with a strong sense of urgency around actions to reduce climate change-related disruptions in environment and health, biodiversity loss due to changed land-use, and pollution and chemicalisation. The Helsinki Declaration emphasises this urgency and stresses the topics that are shown in the panel.PanelThe Helsinki Declaration emphasises the urgency of actingH: Human health depends on our ability to sustain planetary health. Awareness of the strong interlinkage between human and planetary health must be raised.E: Equity is the guiding principle to ensure societal balance, which is a prerequisite for any successful action. Nature conservation and restoration do not succeed without social justice.L: Long-term goals are to take priority over short-term political victories or economic gains.S: Short-term actions, like reducing air pollution, chemical contamination, and ending smoking, have fast and radical impacts on health and should be actively promoted, as they also sustain planetary health.I: Interventions among and planned with communities and citizens produce relevant results for political decisions and models for societal learning.N: Nature is us, we are nature. Nature is both inside and outside of us, and well functioning, sustainable, and biodiverse natural systems are essential for human health and survival.K: Knowledge emerges from scientific insights and innovations proceed to action only when co-created by scientists, citizens, and policy makers.I: Impact-oriented actions for planetary health must be continuously evaluated and adjusted accordingly. H: Human health depends on our ability to sustain planetary health. Awareness of the strong interlinkage between human and planetary health must be raised. E: Equity is the guiding principle to ensure societal balance, which is a prerequisite for any successful action. Nature conservation and restoration do not succeed without social justice. L: Long-term goals are to take priority over short-term political victories or economic gains. S: Short-term actions, like reducing air pollution, chemical contamination, and ending smoking, have fast and radical impacts on health and should be actively promoted, as they also sustain planetary health. I: Interventions among and planned with communities and citizens produce relevant results for political decisions and models for societal learning. N: Nature is us, we are nature. Nature is both inside and outside of us, and well functioning, sustainable, and biodiverse natural systems are essential for human health and survival. K: Knowledge emerges from scientific insights and innovations proceed to action only when co-created by scientists, citizens, and policy makers. I: Impact-oriented actions for planetary health must be continuously evaluated and adjusted accordingly. The first declaration is to raise awareness of the strong interlinkage between human and planetary health. It is important that the health of both humans and our environment are considered by governments and decision makers. What is at stake is not just our health, but the health and even the existence of the youngest and future generations. Wide communication, education, and counselling are essential to raising the critical mass that is needed for change. The second point stresses that social justice is a prerequisite for nature conservation and restoration. When policies are planned and decided upon, their effects on social and cultural fairness should be identified, assessed, and taken into consideration throughout the process. A systems approach whereby several aspects of planetary health are planned together creates a good opportunity to pay attention to equity in all of its dimensions. These comprise individual, business, community, gender-related, territorial, social, and cultural issues. Fairness empowers people to work towards common goals, whereas inequity has been shown to hamper sustainable economic growth. The importance of long-term goals being prioritised over short-term political victories or economical gains forms the third declaration. Strategic choices should aim for long-term practical action plans with predefined priorities and goals, by various sectors. Improved cooperation is needed between the public health, environment, energy, agriculture, and transport sectors, as well as chemical and other industries. Failure of knowledge transfer between sectors is one of the overarching challenges in planetary health, and there is an urgent need for multidisciplinary and interdisciplinary research. The new EU research framework, Horizon Europe, with its crosscutting missions offers a unique opportunity to shift traditional environmental health research towards a more comprehensive interdisciplinary approach, thereby bringing together the health of humans with ecosystem sustainability. Such shifts from fragmented research, policy, and practice towards systematic actions are the way to promote human and planetary health in the longer term. The fourth point advocates for the promotion of short-term actions such as reducing air pollution and chemical contamination, and ending smoking. Due to the magnitude and pace of degradation of natural systems, we urgently need near-term actions that are based on existing scientific evidence. These actions often have the potential for co-benefits of health improvements, while also reducing the growing health and environmental risks from climate change, pollution, or biodiversity loss. The European Green Deal2European CommissionThe European Green Deal.https://ec.europa.eu/info/publications/communication-european-green-deal_enDate: 2019Date accessed: October 2, 2020Google Scholar has the potential to achieve such co-benefits in the near term, if implemented successfully.4Haines A Scheelbeek P European Green Deal: a major opportunity for health improvement.Lancet. 2020; 395: 1327-1329Summary Full Text Full Text PDF Scopus (19) Google Scholar The value of the health benefits of climate change mitigation can offset the costs, such as when abating air pollution by replacing fossil fuels with clean renewable energy across sectors. In the fifth aim, the focus is on interventions that produce results for political decisions and models for societal learning. City planning needs to be revisited to ensure the successful application of nature-based solutions, such as the availability of walkable and cyclist-friendly areas in cities where about two-thirds of the current population in Europe lives. Long-term and near-term goals for human and planetary health should also take place at the legislative level. Community-based interventions and digital solutions can be essentially speeded up by innovative legislation. Well functioning, sustainable, and biodiverse natural systems are highlighted in the sixth declaration. During the past decades, the changes of lifestyle, environment, and nature have caused increases in morbidity and in related costs. The epidemic of non-communicable diseases could be stopped by such changes as a healthy diet, declaring the endgame for smoking, supporting physical activities, and ensuring equal access to green areas in all cities. The seventh declaration emphasis the need for scientific knowledge and innovation as the basis of actions. While existing knowledge should induce urgent near-term actions, more research is needed on several topics. An EU project, Health and Environment Research Agenda, has identified research priorities grouped into the following strategic goals: mitigating and adapting to global change; reducing harmful environmental exposures; promoting healthy living and public health; supporting transformative approaches; and developing critical technologies and tools.5Health Environment Research Agenda for EuropeEU research agenda for the environment, climate and health 2020–2030: interim document.https://www.heraresearcheu.eu/hera-2030-agendaDate: 2020Date accessed: October 2, 2020Google Scholar Wide networks of stakeholders focusing on these research priorities could produce solutions that are ready to be implemented and scaled up. Finally, the eight point calls for the evaluation and adjustment of these actions to scale up successes. Actions based on new research knowledge need to be evaluated for the best real-world impacts regarding human and planetary health as well as economics. Courage and open-mindedness are needed to make changes to actions that are found to be ineffective. The COVID-19 pandemic has dramatically changed the context in which the conference took place and has put the EU at an unprecedented crossroads for future action. As with preventing the spread of COVID-19, it is time to unite individuals, communities, and societies in shared action to support the greater good that is planetary health. The planetary health approach can inform actions supporting recovery from the COVID-19 pandemic, as it is for the EU Green Deal. There is substantial evidence and knowledge for the EU to initiate a European strategy for planetary health in support of the European Green Deal.2European CommissionThe European Green Deal.https://ec.europa.eu/info/publications/communication-european-green-deal_enDate: 2019Date accessed: October 2, 2020Google Scholar This strategy could help to achieve not only the aims of the Green Deal, but also the Sustainable Development Goals. Such a strategy would also endorse the spirit of the WHO Global Strategy on Health, Environment, and Climate Change6WHOWHO global strategy on health, environment and climate change: the transformation needed to improve lives and well-being sustainably through healthy environments.https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72%289%29-en.pdfDate: 2020Date accessed: October 2, 2020Google Scholar and the Health in All Policies approach.7WHOHealth in all policies: Helsinki statement: framework for country action.https://apps.who.int/iris/bitstream/handle/10665/112636/9789241506908_eng.pdf?sequence=1Date: 2014Date accessed: October 2, 2020Google Scholar The planetary health perspective—which considers the health of human civilisation and the state of natural systems on which it depends—should become a key consideration in all policies. We declare no competing interests. The conference was organised and supported by the European Commission, Finnish Institute for Health and Welfare, and the Finnish Environment Institute.