Beyond political choice: A legal mandate for planetary health in a fractured world As political cooperation falls short, legal frameworks are emerging to uphold planetary health and human rights. From the ICJ’s climate ruling to the new Pandemic Agreement, international law offers a path to accountability, cooperation and justice
T he future state of our planet, and the health of all its living beings, depends on the political choices made by humanity, from the local to the global levels. Profound geopolitical tensions are hampering the international cooperation necessary to protect planetary health, exacerbated by countries – including but not only the United States – retreating from multilateralism, retreating from norms based on shared values of justice, equity and dignity, and retreating from evidence-informed policymaking. These political choices are a formula for instability through conflict, economic uncertainty and disruptions to the Earth’s natural systems. This instability has profound effects on human health, and the resulting fragmentation and isolation are fundamentally incompatible with the urgent cooperation needed to safeguard planetary health. A planetary health approach to law and governance seeks to distil such cooperation through agreed rules, norms and practices, including in binding law such as treaties, in non-binding but politically persuasive declarations, and even through the interpretation of existing legal obligations, as occurred in the International Court of Justice’s Advisory Opinion on climate change issued this year. The pervasive impacts of anthropogenic global environmental change on human health are not only scientific realities but also matters of global equity and justice, demanding reform. Infectious disease outbreaks, extreme weather events, heat and conflict are experienced disproportionately across the globe: within countries, systemic discrimination exacerbates environmental health impacts on marginalised populations; and between
countries, low- and middle-income countries bear the greatest health burdens while high-income countries continue to benefit from the exploitation of resources contributing to environmental harms. As stated in the report of The Rockefeller Foundation– Lancet Commission on planetary health, these disproportionate injustices are also not temporally constant, with the health of future generations “mortgaged … to realise economic and development gains in the present”. A LEGAL FRAMEWORK FOR ACTION Amidst the many planetary health challenges we face, the ICJ affirmed that climate change is “an existential problem of planetary proportions that imperils all forms of life”, underscoring the World Health Organization’s statement that it is the greatest threat to global health in the 21st century. In advising on the nature of legal obligations with respect to climate change, the ICJ identified international human rights law, including the rights to health and life, as well as the right to a clean, healthy and sustainable environment, noting their inextricable interdependence on each other and the state of the Earth’s climate and ecosystems. Although not legally binding, the impact of the ICJ advisory opinion is likely to be profound. By clarifying international legal obligations, it can empower civil society, advocates and communities to hold countries accountable to their international legal commitments. It has the potential to be highly persuasive in domestic litigation in several contexts, while providing momentum for political action at international forums such as the 30th Conference of Parties to the United Nations Framework Convention on Climate Change in Brazil in November 2025.
Alexandra L Phelan, professor, Johns Hopkins
Bloomberg School of Public Health, and senior scholar, Johns Hopkins Center for Health Security
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HEALTH - A POLITICAL CHOICE Health: A Political Choice – The Future of Health in a Fractured World
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