PHM-Exch> New Lancet Manifesto

[Claudio Schuftan]

From: Stig Wall <stig.wall at epiph.umu.se>


Dear Friends,

We published this in Lancet yesterday and it is available at
www.thelancet.com  for endorsement.

Best

Stig



>From public to planetary health: a manifesto

This manifesto for transforming public health calls for a social movement
to support collective public health action at all levels of
society—personal, community, national, regional, global, and planetary. Our
aim is to respond to the threats we face: threats to human health and
wellbeing, threats to the sustainability of our civilisation, and threats
to the natural and human-made systems that support us. Our vision is for a
planet that nourishes and sustains the diversity of life with which we
coexist and on which we depend. Our goal is to create a movement for
planetary health.

Our audience includes health professionals and public health practitioners,
politicians and policy makers, international civil servants working across
the UN and in development agencies, and academics working on behalf of
communities. Above all, our audience includes every person who has an
interest in their own health, in the health of their fellow human beings,
and in the health of future generations.

The discipline of public health is critical to this vision because of its
values of social justice and fairness for all, and its focus on the
collective actions of interdependent and empowered peoples and their
communities. Our objectives are to protect and promote health and
wellbeing, to prevent disease and disability, to eliminate conditions that
harm health and wellbeing, and to foster resilience and adaptation. In
achieving these objectives, our actions must respond to the fragility of
our planet and our obligation to safeguard the physical and human
environments within which we exist.

Planetary health is an attitude towards life and a philosophy for living.
It emphasises people, not diseases, and equity, not the creation of unjust
societies. We seek to minimise differences in health according to wealth,
education, gender, and place. We support knowledge as one source of social
transformation, and the right to realise, progressively, the highest
attainable levels of health and wellbeing.

Our patterns of overconsumption are unsustainable and will ultimately cause
the collapse of our civilisation. The harms we continue to inflict on our
planetary systems are a threat to our very existence as a species. The
gains made in health and wellbeing over recent centuries, including through
public health actions, are not irreversible; they can easily be lost, a
lesson we have failed to learn from

previous civilisations. We have created an unjust global economic system
that favours a small, wealthy elite over the many who have so little.

The idea of unconstrained progress is a dangerous human illusion: success
brings new and potentially even more dangerous threats. Our tolerance of
neoliberalism and transnational forces dedicated to ends far removed from
the needs of the vast majority of people, and especially the most deprived
and vulnerable, is only deepening the crisis we face. We live in a world
where the trust between us, our institutions, and our leaders, is falling
to levels incompatible with peaceful and just societies, thus contributing
to widespread disillusionment with democracy and the political process.

An urgent transformation is required in our values and our practices based
on recognition of our interdependence and the interconnectedness of the
risks we face. We need a new vision of cooperative and democratic action at
all levels of society and a new principle of planetism and wellbeing for
every person on this Earth—a principle that asserts that we must conserve,
sustain, and make resilient the planetary and human systems on which health
depends by giving priority to the wellbeing of all. All too often
governments make commitments but fail to act on them; independent
accountability is essential to ensure the monitoring and review of these
commitments, together with the appropriate remedial action.

The voice of public health and medicine as the independent conscience of
planetary health has a special part to play in achieving this vision.
Together with empowered communities, we can confront entrenched interests
and forces that jeopardise our future. A powerful social movement based on
collective action at every level of society will deliver planetary health
and, at the same time, support sustainable human development.

*Richard Horton, Robert Beaglehole, Ruth Bonita,

John Raeburn, Martin McKee, Stig Wall
The Lancet, London NW1 7BY, UK (RH); University of Auckland, Auckland, New
Zealand (RBe, RBo); Department of Public Health, AUT University, Auckland,
New Zealand (JR); Department of Health Services Research and Policy, London
School of Hygiene & Tropical Medicine, London, UK (MM); and Department of
Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (SW)

We declare that we have no competing interests. RBe and RBo gratefully
acknowledge their Rockefeller Foundation, Bellagio joint residency.

www.thelancet.com Vol383 March8,2014

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