An agenda for action on planetary health

As physicians, nurses, and other health professionals, we are already seeing the devastating impacts of the climate and ecological crises in our offices, in hospitals, and in communities ravaged by forest fires, crop failure, habitat loss, and water scarcity. In addition to the deadly heat dome, which caused the premature death of at least 595 people in our province, we saw patients with wildfire-related respiratory and cardiovascular distress, and we are seeing patients from all walks of life experiencing signs and symptoms of depression and anxiety related to the climate emergency. And now, of course, we are seeing the health impacts of the recent devastating rains and floods across much of B.C.

Moreover, we recognize that the harms resulting from these changes “disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities, and those with underlying health problems,” as well as people in low-income countries and – in B.C. and around the world – Indigenous peoples. Indigenous communities are of particular importance because they are both affected by the damage and destruction wreaked on their ancestral lands, and by the loss of those lands to colonial powers, and yet, as the UN recognizes, they are also important stewards of the land who carry invaluable traditional knowledge.

We have taken the Planetary Health Pledge to protect the health of people, their communities, and the planet. We maintain the utmost respect for human life and the diversity of life on Earth. We are dedicated to the health, longevity, and wellbeing of the people of B.C. and people everywhere and take these warnings seriously. However, we are also heartened by the potential health benefits of the transition to a society in which human well-being, in balance with nature, is the focus. 

The heat dome caused the premature death of at least 595 people in our province.

The B.C. government must take equally seriously the threats of climate and ecological changes and the potential health benefits of transitioning to a sustainable, just, and healthy society that is at peace with nature. 

• It must declare a Climate and Ecological Emergency and establish a transformative emergency plan that embeds equity, anti-racism, and social justice at its core and recognizes the interconnectedness of the climate, ecological, and social crises.
• That plan must include action on climate change and action to protect and restore nature. More broadly, we call for broad transformative change that puts human well-being in balance with nature at the heart of all policies and ensures a just transition to a healthy, just and sustainable society. Moreover, the plan must be collaboratively developed with B.C.’s First Nations and Indigenous peoples.

Yet on the climate front B.C. is still pushing for new fossil fuel extraction and export, is still providing tax breaks and other forms of support to the fossil fuel industry and has yet to declare a climate emergency.

• We call on the B.C. government to address these deficiencies by undertaking a comprehensive health impact assessment for all forms of energy created or used in B.C., so that B.C. can create energy policy based on a full understanding of the impacts of different energy systems on well-being, both locally and globally. 
• Other key steps are to end fossil fuel subsidies; stop all new fossil fuel infrastructure projects and rapidly phase out fossil fuel production and exports; set legally binding emissions targets based on evolving climate science, and invest in a regenerative zero emissions economy.

But this is not just about action on the climate emergency, important as that is. As the UN Environment Program (UNEP) recognized in February, the world faces at the same time a crisis of biodiversity loss, a crisis of pollution, and other human-driven ecological crises. For the sake of humanity, doctors are asking for governments to do as the UNEP says, and make peace with nature.

• Thus we call on the B.C. government to protect terrestrial and marine ecosystems, including in particular old-growth forests; return to its commitment to bring in a Species at Risk Act and/or bring in an overarching biodiversity law to prioritize ecosystem health and biodiversity conservation across all sectors, and recognize the right to a healthy environment and the rights of nature.

Beyond even that, we need to create broad transformative change focused on human well-being in balance with nature.

• Important steps include bringing in an alternative to GDP that truly reflects social and ecological well-being and progress; bringing in a Well-being Budget, as the government in Aotearoa/New Zealand  has done, and creating a Commissioner for Future Generations and a Well-being of Future Generations Act, as Wales has done.

A transition to a new green economy will need to incorporate a broad reimagining of cities, transportation systems, food production and distribution, financial markets, health-care, and educational systems.

• We must invest in organic, local, and regenerative agricultural systems, prioritize public transit and active transportation, accelerate the transition to zero-emissions vehicles, and require all new buildings to be zero-emissions by 2025, with a plan to support rapid retrofitting of all existing buildings.

Finally, we recognize the potential for the transition to a green economy to create inequitable health impacts upon fossil fuel workers, resource-dependent communities, and Indigenous communities that are impacted by fossil fuel production.

• Accordingly, a just transition must be designed in partnership with those most affected, to ensure they are protected.

Some useful links and resources

• A brief Agenda for Action.
• Doctors for Planetary Health – West Coast
• Code Red BC
• Canadian Association of Physicians for the Environment (CAPE)
• Canadian Association of Nurses for the Environment (CANE)
• Canadian Coalition for Green Health Care
• Lancet Planetary Health
• Planetary Health Pledge
• Editorial published in September 2021 in more than 200 leading medical journals – “Call for emergency action to limit global temperature increases, restore biodiversity, and protect health”
• WHO’s COP26 Health Programme
• COP26 Special Report on Climate Change and Health
• 2021 Global Conference on Health and Climate Change at COP26
• United Nations Environment Programme (2021). Making Peace with Nature: A scientific blueprint to tackle the climate, biodiversity and pollution emergencies. UNEP. Nairobi.