From economics to pollution, human activity is creating new health challenges, but the protection of biodiversity may provide the answer
By Cristiana Paşca Palmer executive secretary, UN Biodiversity
We often neglect the intimate links between ourselves and nature, yet to a large extent our health and well-being depend on the environment in which we live.
Biodiversity – at the genetic, species and ecosystem levels – is central to human survival. Without it, our immune systems would falter, local livelihoods and economic development would suffer, life-sustaining ecological functions would be hindered, social and ecological resilience would be compromised, and we would lose the health benefits and cultural values afforded by our landscapes, seascapes and the life that shares our ecosystems.
Biodiversity and healthy ecosystems are key determinants of human health. They sustain essential ecological processes and functions, such as soil formation, nutrient cycling and carbon sequestration, essential to all life on earth. They also regulate the quantity and quality of freshwater, pollinate our crops; protect against floods, storm surges, pests and disease; and increase resilience in the face of climate change and disaster risk.
Biodiversity is also the source of essential nutrients, vaccines, energy, shelter, livelihoods, cultural heritage and spiritual enrichment. It provides the basis for both biomedical discovery and traditional medicine. As non-communicable diseases such as diabetes and obesity continue to escalate across rapidly urbanising landscapes, the conservation and restoration of our ecosystems can also provide an essential lifeline for healthy lifestyles.
Nature filters the air we breathe, supports key immuno-regulatory functions of our gut microbiota, and provides green spaces to support physical and mental health.
Biodiversity is not a luxury, but a fundamental prerequisite of well-being. The aggregate value of ecosystem services provided by nature has been estimated at $125 trillion annually. We cannot afford to overlook nature’s contribution to people as the bedrock of equitable and resilient health systems and societies.
Working toward twin goals: biodiversity conservation and universal health coverage
The recently released United Nations Global Assessment on Biodiversity and Ecosystem Services provided us with an alarmingly clear picture of the magnitude of the ongoing damage inflicted on our life support systems. As our natural infrastructure erodes, it weakens the social safeguards that universal health coverage ultimately seeks to extend, namely that people and communities everywhere have access to essential, high-quality health care, without fear of financial hardship. These twin challenges can, and must, be approached together.
Public health policy must consider the root causes of ill health, including its upstream environmental and economic drivers. According to the World Health Organization, approximately 12.6 million deaths were attributable to modifiable environmental factors in 2012. The stark proportion of environmentally mediated mortality is even higher among children under five years and the elderly, in low- and middle-income countries. Ecosystem degradation and climate change are also increasing overall healthcare costs, making universal health coverage a more daunting political, economic and social challenge.
To help bridge these challenges, the Convention on Biological Diversity and WHO have doubled their efforts across multiple stakeholder groups since establishing their joint work programme in 2012. Regional and subregional capacity-building workshops, sustained cross-sectoral dialogues, efforts to support education and awareness raising, and a comprehensive review of the state of knowledge have supported evidence-based policy making. All this has led to the establishment of a dedicated interagency liaison group, fostered new diplomatic overtures and generated international policy guidance.
These efforts provided the basis for bold commitments on biodiversity and health agreed by 196 countries at the 2018 UN Biodiversity Conference. Here governments endorsed the comprehensive biodiversity-inclusive One Health guidance to strengthen the capacity for prevention, early warning, risk reduction, and the management of national and global health risks exacerbated by degraded ecosystems, land-use change, pollution, anti-microbial resistance and unhealthy environments.
Countries also called on the CBD, WHO and other stakeholders to develop a global plan of action on biodiversity and health, to ensure common drivers of degradation and ill health are taken up in a coordinated and purposeful manner, coherent with the common goals of the 2030 Agenda for Sustainable Development.
These developments reflect the recognition that health is not solely the responsibility of the health sector. Strong and resilient public health systems demand much more than just financing and services. Addressing the multi-sectoral nature of health determinants and root causes of ill health requires holistic, whole-of-government, whole-of-society approaches.
It also requires bold political, economic and social commitment to prevent and create health-promoting environments.
The task ahead: integrating biodiversity conservation and universal health coverage for all
Inequity remains a central challenge to global health and sustainable development. Those with the least access to social protection mechanisms and health care are also disproportionately affected by the steadfast degradation of our natural world. Indeed, the right to health is our most basic human right. Yet more than half of the world’s population does not have access to essential health services, especially in low- and middle-income countries.
At the same time, the pressures of prevailing economic structures and anthropogenic activity on planetary processes are giving rise to a new set of global health and development challenges. Meeting these requires bold transformative actions that effectively reconcile the three pillars of sustainable development. Governments are already starting to develop an ambitious post-2020 global framework for biodiversity that is transformational, achievable and closely aligned with the aims of the Sustainable Development Goals. The engagement of all stakeholders will be central to its successful implementation.
To ensure that pursuing SDG 3 (ensuring healthy lives and promoting well-being for all, at all ages) and SDGs 14 and 15 (life under water and life on land) will truly leave no one behind, we need concerted, inclusive, cross-sectoral engagement, commitment and action.
Universal health coverage can be truly universal only if it jointly considers the health of people and the health of our planet and if it galvanises the political will to advance an agenda based on equity and sustainability.
Healthy ecosystems will reduce the costs of public health provision, making universal health coverage more affordable across developed and developing states. There will be a unique opportunity at the 2019 G20 Osaka Summit in Japan and again at the 2019 G7 Biarritz Summit in France to advance policy options that can reflect these essential relationships.