3.4 PLANETARY HEALTH & CLIMATE CHANGE
ALEXANDRA L PHELAN Alexandra L Phelan is an associate professor at the Johns Hopkins Bloomberg School of Public Health, a faculty director (policy) at the Johns Hopkins Institute for Planetary Health and a senior scholar at the Johns Hopkins Center for Health Security, which she represents as a relevant stakeholder in the World Health Organization’s Pandemic Agreement negotiations. She researches, teaches and practises international law and environmental change impacts on global public health, in particular infectious diseases. @alexandraphelan.bsky.social
Developments in other global spaces have also reflected planetary health approaches that move away from traditionally siloed human health. At the 78th World Health Assembly this year, WHO member states adopted the Pandemic Agreement after more than three years of negotiations. This landmark treaty seeks to prevent, prepare for and respond to pandemics, and enshrines the principle of One Health – that human, animal and environmental health are interconnected – into a legally binding treaty for the first time. This interconnection is further realised through the express incorporation of obligations to take measures to identify and address the upstream drivers of infectious disease at the human, animal and environmental interfaces. The agreement also recognises the role of environmental and climatic factors in increasing the risk of pandemics, with parties endeavouring to include these considerations in national, regional and international policymaking. CRITICAL CHALLENGES, CRUCIAL MILESTONES The agreement has some time before taking legal effect, with opening the agreement for signature conditional on the successful negotiation of an annex for pathogen access and benefits sharing currently underway. Then, countries will be faced with the choice of whether to sign, ratify and become parties to this new legally binding instrument. That choice before political leaders will determine the health of all of us in the next pandemic. These two 2025 global governance milestones have a clear message: health is a political choice. This is a significant shift from the traditional and
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siloed approaches to planetary health issues. It is a movement towards laws and policies that better reflect a complex but not unnavigable scientific reality. However, critical challenges remain. These legal victories need to be translated into tangible action, with clear policy and budgetary commitments, particularly at the national level. Solidarity across countries will be integral to protecting civil society, healthcare and legal professionals, and scientists operating in oppressive settings. Pollyannaism and defeatism are equally destructive to demanding and achieving accountability for political choices that harm health. Planetary health reminds us to choose cooperation over fragmentation, long-term sustainability over short-term gains and evidence-informed action over disinformation. Despite significant obstacles to leaders making planetary health choices in the future, good governance, the enforcement of laws and policy accountability are critical tools for advocates and professionals. It is precisely during its contravention that upholding the principle of the rule of law is most vital, and safeguarding health is the only viable political choice. ▪
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”
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HEALTH - A POLITICAL CHOICE Health: A Political Choice – The Future of Health in a Fractured World
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