Promoting planetary health justice

The dominant framing of planetary health (PH) has been significantly shaped by the Rockefeller Foundation-funded Lancet Commission on PH and associated initiatives, often prioritizing "win-win" solutions. For instance, the Pathfinder Commission, a high-profile follow-up to the Lancet Commission that aims to identify PH solutions with the most wide-ranging co-benefits, identified the transport sector as having significant potential for emissions reductions and health co-benefits. However, the PH equity implications and conflicts of transitioning to sustainable transport in high income countries are often overlooked. The promotion of electric vehicles in high-income cities can lead to inequitable export of older, polluting vehicles to Africa, exacerbating local air pollution and creating end-of-life waste challenges, among others. The second most promising solution identified by the Pathfinder Commission relates to sustainable diets, but a focus on individual lifestyles can reduce attention from the ways that unhealthy foodstuff consumption is linked to powerful corporate practices. Furthermore, few solutions from the Global South are included in the Pathfinder Commission due to limited evidence, and similarly the Lancet Countdown which tracks climate change impacts on health, focuses on ‘globally relevant’ metrics such as heat outcomes, with limited attention to localized climate sensitive diseases that impact marginalized groups, such as neglected tropical diseases (NTDs) that largely impact low-in and middle-income regions, creating tensions between global and local priorities. 

A focus on win win solutions over other more complex interventions is rooted in neoliberal approaches to health and sustainability, where certain solutions and forms of knowledge are foregrounded for their ability provide the most appealing and immediate ‘cost-benefits’ for policy makers. At the same time, many of these solutions and their potential contributions are never realized as attempts promote multi-sectoral co-benefits continue to fall flat with policy-makers outside the health sector, which can be seen in clear gaps for health in climate policy and finance. In addition, such win win solutions have been critiqued as often technoscientific, aiming to control nature with limited considerations of power, risking re-producing the same processes that contributed to ecological crises. 

This work will contribute to establishing the field of critical planetary health, focusing on examining the goal conflicts inherent in ‘win win’ solutions that are promoted by planetary health actors.