It’s Human Civilization that is at stake

This year’s Consortium of Universities for Global Health (CUGH) conference in San Francisco opened with a powerful keynote delivered on planetary health by Richard Horton, The Lancet’s editor-in-chief, declaring we have been mortgaging the health of future generations to pay for today’s wants.  This came as a wake up call for many of the audience members, many of whom train, deliver and work in the health care field. With a call for the construction of a “realistic utopia,” Horton further emphasized that an exclusive focus on health will fail. We need to forge a new global identity with planetary health as the unifying idea. An idea where we begin to focus on the environment and natural systems that are essential to the overall health of human civilization.

Reviewing the Lancet Commission’s report, Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health, it becomes clear that we have not been employing the wise stewardship that our earth needs.

Fernando Mena-Carrasco, MSW, BSN, RN, Intern, Center for Global Initiatives, Johns Hopkins School of Nursing
Fernando Mena-Carrasco, MSW, BSN, RN, Intern, Center for Global Initiatives, Johns Hopkins School of Nursing

So the question now becomes, what do we do about it?  

If we use planetary health as a unifying idea, all of our actions need to be based on the understanding that the continuation of the human civilization, foundationally built on human health, rests on the vitality, strength and resiliency of our natural systems.[1] As nurses and midwives, we, along with all health care professionals, have a crucial role to play in achieving this “realistic utopia.” Understanding the health of the populations that we serve is intrinsically linked to the environments that we inhabit we must begin to work across sectors to integrate policies that safeguard the environment. Incorporating sustainable policies while enhancing the current health systems we might be on our way to safeguarding our health and well-being.

The CUGH conference brought together professionals across disciplines highlighting the need to change our thinking to inform our future actions. Brookings Institute’s John McArthur stated that, while the world is short of where it needs to be regarding health, the Sustainable Development Goals (SDGs) provide tools to change the trajectory for development and health. Further, as Dr. Ndola Prata from the Bixby Center for Population, Health and Sustainability pointed out, meeting the needs for modern family planning is the most cost-effective public health intervention and can improve health in the short term (e.g. from reduced maternal mortality and reduced pressures on the environment and infrastructure).

Ashley Gresh, MA, BSN, RN, Intern, Center for Global Initiatives, Johns Hopkins School of Nursing
Ashley Gresh, MA, BSN, RN, Intern, Center for Global Initiatives, Johns Hopkins School of Nursing

But perhaps the most important message to remember as we operationalize a realistic utopia in our fields of study and practice is the power and influence we hold as individuals who can and do create change. Most of us have been socialized to believe that those who are charged with protecting the enduring vitality of our planet are environmental activists, like Al Gore and Harrison Ford. But we are now aware that the collective barriers we face can only be addressed with the human capital we share. And one of the avenues for achieving this goal with our colleagues living in the U.S. and abroad is by using low-bandwidth, open-access technological tools that allow for productive dialogue between communities of research, policy, and practice; translating theoretical frameworks into practical tools that may be used in the frontlines.

What then is the role of universities and those training the next generation of health care leaders?

Acknowledging that our human civilization now faces threats that may be characterized by surprise and uncertainty, we must be equipped in emergency preparedness and innovation.[2] Universities, along with public health systems, need to be prepared to not only train students in health care preparedness but also to respond and collaborate in the setting of global health crises, including climate change, migration, and war. Jason Cone, executive director of Médecins Sans Frontières (MSF) pointed out that during the Ebola outbreak in West Africa, some faculty and staff at universities were blocked from joining the fight. The future demands of new and emerging diseases will require that we remain agile, flexible and innovative; continually meeting the urgent needs of global health threats. As International Rescue Committee (IRC) leader, David Miliband, noted this will call for us to reframe the way we think and shift from “hard to reach people” to a broader systems thinking of “hard to reach systems.”

Teresa Pfaff, Manager, Center for Global Initiatives, Johns Hopkins School of Nursing
Teresa Pfaff, MSN, RN, APHN-BC, CPH, Manager, Center for Global Initiatives, Johns Hopkins School of Nursing

The longer we hold off action to effectively integrate planetary health concepts into the curriculum of the next generations, the more costly and difficult it will become to successfully mitigate the challenges of our human civilization. We must provide training not only in the specific technical knowledge base of our disciplines, but also on how to persuasively convey salient points to policy makers and colleagues across other disciplines. In other words, universities and other educational institutions must be able to produce professionals who are not only competent in their field but can successfully engage in exchanges that help narrow the gap between research, policy, and practice.

“Medicine is a social science, and politics is medicine at a large scale.” Rudolf Virchow


[1] Whitmee et al., 2016

[2] Whitmee et al., 2016

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