By Wendy Anson
Spurred by the 2015 report of The Rockefeller Foundation-Lancet Commission on Planetary Health, a number of initiatives are opening new research frontiers in global environmental health. Data from earth observations and global health surveillance increasingly suggest that serious human health problems are arising from multiple global environmental processes and their complex interactions. The core premise, summed up by Sam Myers, M.D., Planetary Health Alliance director and senior research scientist at the Harvard T.H. Chan School of Public Health, “is that human activity is disrupting most of our planet’s natural systems."
An important next step, according to Myers and others concerned with the health consequences of global environmental changes, is to re-frame the issue itself. “What’s needed is to extend the global [environmental] health issue focus from simply ‘climate and health’ into a broader planetary health perspective,” Myers holds. “This framing best addresses the human health implications of accelerating anthropogenic changes in the structure and function of Earth’s natural systems.”
The Planetary Health Alliance, supported by the Rockefeller Foundation, had its inaugural meeting April 28-30, 2017, at the Harvard Chan School in Boston. The purpose of the meeting was to help develop a new “community of science”-based approach, bringing together a group of international, multidisciplinary researchers.
The April meeting counted among its attendees a cohort of natural scientists, a group not often found in a human health context. In conducting their own specialized work, the researchers came logically and unequivocally up against issues of human health. “Current technology and analytics emerging from our multidisciplinary focus leads to a helpful new way of conceptualizing and calculating anthropogenic disruption to the environment and its associated human health impacts. When you think about the divergent ecological drivers each requiring different expertise,” emphasized Myers, “that’s precisely where a community of specialized and multidisciplinary researchers will contribute to both a deep understanding of the challenges and subsequently how to build specific solutions.”
“Planetary health builds on the One Health framework that holds the study of local domestic and wild animals as paramount to a comprehensive understanding of health and ecosystem interactions. In going beyond these roots, planetary health puts more emphasis on environmental interactions and embraces a global point of view,” NIEHS Senior Advisor for Public Health John M. Balbus, M.D., explains. “And while the scope and level of interdisciplinary coordination of the Planetary Health Alliance is new, some of the foundational concepts are very much embedded in NIEHS’ approach to environmental health.”
NIEHS has long supported investigations on land and sea, delving into pollutants’ effects on human and wildlife health across the globe. As one example, the Centers for Oceans and Human Health initiatives include monitoring contaminants in local wildlife to study the health effects of eating seafood that harbors toxins like polychlorinated biphenyls (PCBs) and mercury.
A Stronger Focus on Ecological Interactions
“Ecological change drives a lot of the disease emergence,” says Peter Daszak, Ph.D., president of EcoHealth Alliance, a global nongovernmental organization “dedicated to protecting wildlife and public health” from the emergence of disease. “We have papers evidencing the damaging ecological effects coming out of specific agricultural land use changes and intensification.”
Myers notes that while climate change is an important part of the problem, interventions that address other parts of the ecological cascade may be more effective at protecting health because they are more tractable at the local level. He warns that an exclusive focus on climate change can fail to offer the multifactorial view linking to specific actions that can solve both environmental and health problems.
“What’s really striking,” Myers continues, “is a circle of multiple ecological drivers that interact in often unexpected ways resulting in frequently health-averse consequences. These drivers include accelerating climatic disruption, changes in land use and land cover, growing resource scarcity, fisheries degradation, altered biogeochemical cycles, biodiversity loss, and global pollution.”
To illustrate, Myers outlined how a constellation of biodiversity loss; air, soil, and water pollution; growing scarcity of arable land and water; and climatic disruption are all interacting with each other and simultaneously having profound impacts on the quality and quantity of the global food supply.
NIEHS and Global Collaborations
NIEHS has been engaged for several years on another initiative focused on the intersection of human, animal, and environment health. The International Conference on One Medicine One Science (iCOMOS) is an effort led by the University of Minnesota that focuses on “a practical understanding of human and animal health that is international, interdisciplinary and cross-sectoral.” The conference engages scientists, policymakers, and others from more than 35 countries in sharing emerging One Health research, frameworks, and collaborations for global solutions.
The next iCOMOS is slated for April 2018 in Minneapolis, and will feature Nobel laureates, heads of research and health organizations, including the NIEHS director and the World Health Organization’s Department of Public Health and Environment director, and experts from across the world. As part of the conference, NIEHS’ Kimberly Thigpen Tart, J.D., M.P.H., and Heather Henry, Ph.D., are developing a joint workshop with the National Institute of Allergy and Infectious Diseases that will highlight how the two NIH institutes integrate One Health into their work and provide practical information about project funding, data management, and partnership building.
Thigpen Tart said that NIEHS brings practical expertise on identifying and understanding environmental exposures, as well as studying animals as surrogates for disease impacts in humans. She noted that many of the findings gleaned from participating in international research projects are applicable to health problems in the United States as well. “We realize that many environmental health problems are trans-boundary in nature,” Thigpen Tart said, “and that lessons learned in one area of the world can be used to improve the health of people across the globe.” As an example, she described NIEHS research in response to arsenic poisoning in Bangladesh that resulted from drinking water from contaminated tube wells, “We learned about arsenic’s underlying biological mechanisms in humans in Bangladesh. We’re also able to apply that knowledge here in the United States where many states, including North Carolina, have natural arsenic in groundwater.”
Working collaboratively to find global health solutions is a tenet of long-standing and new global environmental health groups alike. “Translating strong ecosystem health science into actionable information for health policy makers”, EcoHealth Alliance collaborates with health, agriculture, and wildlife government agencies to develop, among other projects, human and animal disease risk surveillance infrastructures. Specialized researchers associated with Future Earth, a platform with hubs in five cities worldwide, form Knowledge-Action Networks, which collectively investigate global sustainability.
Balbus reflected, “Our NIEHS institute has for decades through its work provided a lot of the scientific foundation for this integrated thinking. At the same time, the Global Environmental Health program is now, and will be continuing, to shape the future agenda of these new initiatives.”