Pakistan may more readily embrace planetary health than other countries: Dr Capone

Islamabad
The government of Pakistan already recognises the health risks from climate change, and therefore, may more readily embrace planetary health than other countries. One important initial step that it can take is to begin a conversation about health, beyond a focus on treatment services.
There remarks were made by Prof. Dr. Anthony Capone, director of the International Institute for Global Health at United Nations University, Kuala Lumpur, during an exclusive interview with ‘The News.’
Anthony was in town in connection with the Pakistan launch of the Rockefeller Foundation-Lancet Report on Planetary Health, an event hosted by NGO think-tank Heartfile. Both Anthony and Heartfile’s president Dr. Sania Nishtar are among the 15 commissioners who authored the prestigious report.
Anthony is a public health physician and an authority on environmental health and health promotion, with research interests in urban sustainability and human health. He has over two decades of senior leadership and management experience in public health research, education and policy, and has consulted in many countries and for a wide variety of organisations. Anthony has also held National Health and Medical Research Council and World Health Organisation fellowships, as well as leadership roles with the Australasian Faculty of Public Health Medicine and the International Society for Urban Health.
Anthony’s short visit to Pakistan provided an ideal opportunity for an interaction on how Pakistan can move forward in its drive to implement the recommendations contained in the Commission on Planetary Health report, which analyses a range of ways in which health is interlinked with the environment. Excerpts from the interview follow:
Question: Planetary health is a relatively unexplored domain. For a country like Pakistan, which has thus far failed to integrate such critically inter-linked domains as population and health, how optimistic are you about the concept of planetary health being prioritised as a policy option by building linkages between environment and health?
Answer: While it is challenging to engage policymakers in any new concept, planetary health provides an integrative way of thinking about health in sustainable development. The government of Pakistan already recognises health risks from climate change and therefore may well more readily embrace planetary health than other countries.
Q: What role is the government of Pakistan expected to play in the implementation of the recommendations enshrined in the Commission report? What role is other stakeholders (international organisations, donor agencies, researchers, health professionals and civil society) expected to play?
A: In essence, the planetary health approach integrates understanding of ecological determinants of health with the current focus on social and economic determinants. All nations should consider the implications of this new report for strategic development planning at the country level. Climate change, biodiversity loss, toxic pollution and urbanisation all bring risks for health. Governments should consider the health implications of decision-making in all relevant portfolios, and identify opportunities for co-benefits for health.
All societal sectors have a role to play in planetary health. While the formal health system (i.e., hospitals, primary health services, etc.) needs to think about its own environmental footprint, planetary health requires inter-sectoral action for health.
Q: What mechanisms would one require at the country level to pave the way for action on the report’s recommendations?
A: One essential requirement is regular integrative assessment of the state of the environment to help highlight the interrelationships between policies and decisions across sectors, for example water, energy and food.
Q: How relevant are these recommendations for a country like Pakistan, where even basic health care facilities are not accessible to a majority? My fear is that the report will be shelved and forgotten within days of its launch.
A: While planetary health may seem like a somewhat abstract concept, in fact it is very relevant to Pakistan because planetary health addresses basic health needs including air and water quality, food security, housing, and stable climatic conditions. Fundamentally, human health depends on the health of planetary systems. While internationally there have been substantial gains in life expectancy and health in recent decades, the Rockefeller Foundation-Lancet Commissioners found that these have gains have often been at the cost of degraded environments.
Q: Environmental concerns are currently at the rock bottom of the government’s list of priorities. Poor public awareness of the effects of environmental degradation on health further compounds the challenge in hand. What role can the media play in highlighting the value of concerted action to prevent exacerbation of the health challenges of the future?
A: The media is well placed to bring these issues to the attention of the wider community. Importantly, the media can also highlight actions being taken to improve planetary health, for example, the uptake of renewable energy technologies which are much healthier than coal-fired power stations.
Q: Do you think it would help to institute a set of deadlines for fulfilment of some of the actions outlined in the report? Such global pressure may prove instrumental in pushing governments to institute some action.
A: Indeed, time-bound goals and targets can be helpful in achieving change. The planetary health approach aligns well with the proposed Sustainable Development Goals which we hope will be agreed by all nations at the UN Sustainable Development Summit in New York in September. As human health is relevant to all of the 17 SDGs, these new development goals will be a useful instrument for monitoring progress.
Q: The recommendations of the report cannot be fully achieved without cultivating strong linkages between the health and environment sectors. What initial steps, in your opinion, should the government of Pakistan take to level the ground for such a partnership?
A: One important step is to begin a conversation about health beyond a focus on treatment services. Planetary health is about safeguarding health. Environmental scientists, policymakers and practitioners should be recognised for their contribution to future health.
Q: The report calls for integrating environmental health into health budgeting and purchasing. It also recommends the creation of resilient health systems that can adapt quickly to meeting challenges and restore services. We in Pakistan haven’t seen this happening in decades. Yearly floods, even though a regular and predictable phenomenon, have swept the health infrastructure, wreaking havoc with human lives and environment, year after year. As such, the implementation of these recommendations in Pakistan’s context, appear a far cry. Your comment.
A: Health workers face considerable resource pressures and the day-to-day demands limit capacity for forward planning. However, health preparedness planning is increasingly recognized as an essential foundation in health service management. In-service training and capacity building can be helpful in this context.
Q: Will the Commission hold a follow-up meeting after the report’s regional launches to analyse country level responses to its recommendations?
A: As it happens, Dr. Sania Nishtar and I are very interested in follow-up work at the country level here in Pakistan. Stay tuned.