In a
previous blog I wrote the global health community should make the switch to the
‘planetary health’ era sooner rather than later.
I should
probably qualify this statement a bit. Nobody should ever listen to me, I just
make humble suggestions : )
More
importantly, though, with that statement, I referred to ‘planetary health’ the way Horton described it
earlier this year in an Offline contribution, after attending the annual
Planetary Health conference in Edinburgh ( see Offline:
Planetary health—worth everything )
As a
reminder, it’s worth to provide here Horton’s related paragraph in full:
“…Planetary health—the health of human
civilisations and the ecosystems on which they depend—has evolved into a
capacious interdisciplinary inquiry. Yet it is neither capacious nor
interdisciplinary enough. Planetary health, at least in its original
conception, was not meant to be a recalibrated version of environmental health,
as important as environmental health is to planetary health studies. Planetary
health was intended as an inquiry into our total world. The unity of life and
the forces that shape those lives. Our political systems and the headwinds
those systems face. The failure of technocratic liberalism, along with the
populism, xenophobia, racism, and nationalism left in its wake. The
intensification of market capitalism and the state's desire to sweep away all
obstacles to those markets. Power. The intimate and intricate effects of wealth
on the institutions of society. The failure of social mobility to compensate
for steep inequality. The decay of a tolerant, pluralistic, well informed
public discourse. The importance of taking an intersectional perspective. Rule of
law. Elites. The origins of war and the pursuit of peace. Problems of
economics—and economists. The study of nations—their histories, geographies,
ideas, and beliefs….
”
Defined in
this way, i.e. ‘in its original conception’, ‘planetary health’ has the right
feel for the challenges we face in this century.
(1) It certainly
has the right sense of urgency – cfr
Horton: “There is our task: to see the thunderstorm ahead of us. Many have
preferred to turn their heads away. It falls to planetary health to insist that
we face the thunderstorm.”
And (2) the
paradigm aims to connect all the dots,
going beyond silos, the way the SDG agenda is trying to do (while obviously,
not going far enough, as it makes too many compromises with the current (growth
focused) economic system). This is why I sometimes consider the ‘planetary
health’ paradigm as an “SDG agenda on
speed”: it involves a strong plea for a fair economic system, that works
for all, within planetary health boundaries. Only such a system will have truly
‘global citizens’, as compared to the (few) ‘winners’ and (too many) ‘losers’
in this economic system.
I admit it
sounds utopian, certainly given the way things are going currently on the
planet, but in my opinion, planetary health defined like this, is the right (global)
framing of the (interconnected) challenges we face now. (3) Planetary health along these lines would dare to ask the questions for a
radically different economic system. Deep down, for me, planetary health is
about finding the right balance between equity & a sustainable planet. With
both emphasized to the same extent. That requires daring to think beyond
capitalism, I think. Planetary health could ask these sorts of questions more
than the related environmental health, EcoHealth, GeoHealth, OneHealth, .. in
my opinion.
(4) Last
but not least, ‘planetary health’ also best
captures the sense ‘that we’re all in this together’ (California, as much as Delhi, the Sahel, …). It conveys this, in my opinion, also better
than “EcoHealth” et al. You could argue that 'global health' already does so, however there's a certain 'Northern dominated' feel about the latter term that is hard to get rid of.
The truth
is, however, for the moment, Planetary health doesn’t really do all of this, or at least
not nearly enough, even if it has the potential do so, as Horton rightly
emphasizes.
When I look
at the Planetary Health Alliance
website, for example, there’s very little on asking for a radically
different economic system, based on different (post-capitalist) values. Very little on how neoliberal globalization has
led to the current situation, on political determinants of the current global ‘perfect
storm’,…. Maybe it’s because ‘Planetary Health’ (as conceived by Horton) feels
too broad and encompassing for scientists – I agree it sounds a bit like a ‘Theory
of Everything’ -, maybe because it smacks too much of attacking the status quo?
The same goes for the website of the next Planetary Health meeting in
Stanford. It’s hard to imagine that post-growth thinkers (like Tim Jackson,
Jason Hickel, … and others) who dare to think of a truly different economic
system, will get a prominent place there. I hope I’m wrong, though. For the
time being, the ‘Planetary Health ‘community & the post-growth community
are still fairly separate communities; the ‘green growth’ paradigm still seems
much stronger within the Planetary Health community, than more radical
proposals.
By way of a
more concrete example of this claim, ask yourself the question: why is it that planetary
health “champions” like Macron and Bloomberg are not trusted by many ordinary
citizens (even if many very well understand that the planet is indeed in dire
shape)? Because, like the ‘yellow jackets’ (gilets
jaunes) in France now, they feel that it’ll always be common citizens
having to cough up the most for green measures (with some mitigating measures for the very poor,
the standard recipe of Macron and other “structural reformers” like him),
whereas the 1 % can continue to fly around the world, without being taxed much.
Macron
& Bloomberg want to ‘green’ the current economic system, instead of trying
to think of a new system based on post-capitalist values. They admit equity is
important, but Macron & Bloomberg will never find the right balance, I’m
afraid. Chances are their ‘planetary health agenda’ will thus not be
politically sustainable. From my point of view, it is thus a problem that they
are currently seen as ‘planetary health champions’.
Planetary
health, at least the way Horton conceives it, is not a “rebranding” of global
health. It’s acknowledging that ‘global health’ can only have partial answers
for the challenges the world currently faces, and that the values that (implicitly
& explicitly) ruled much of global health for the past few decades will not
lead to ‘Health for All’ in the 21st century. In fact, quite the
opposite seems true. See
some of the words Horton uses: ‘failure of technocratic liberalism; elites; …’ and
then ask yourself whether many of our current global health leaders feel more
confident talking to (and taking more into account) leaders of states (Macron),
billionaires (Bloomberg, Gates), people from the financial industry, or instead
to grassroots movements and people in the street.
If Horton’s
definition of ‘planetary health’ doesn’t become mainstream (and he’s certainly
not winning for the moment, unfortunately…), then ‘planetary health’ will
indeed turn out just another buzzword. And we might as well just forget about
it.
So the
challenge seems clear: ‘planetary health’, if it is to have a future, should
become ( a lot) more like what Horton had in mind. And then, once we agree on
this, comes the even more difficult part: how do we get to a ‘planetary health(y)’
world?
Something
in me says that we will need to look more at the likes of Ocasio-Cortez than to
Macron & Bloomberg for this.
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