By Liz Grant and Liz Willetts 

In early September, two hundred medical journal editors raised the voice of the health sector as one in a call to action heading into the Glasgow Climate Change Conference. It was sharp. It was charged. And it pointed to the groundswell of interest in the health sector to engage in the health-environment policy nexus.

From front-line clinicians, to public health and academic experts, to nursing and medical student associations, health professionals are taking advantage of the metaphorical microphone COVID-19 has thrust at them. It’s overdue. It has been six years since the SDGs and integrated development targets were developed and six years since the Lancet introduced the field of planetary health. It has sunk in that ecological degradation drives illnesses like infectious disease, malnutrition, respiratory and heart diseases, cancers, and depression. Experts on both sides of the nexus increasingly see the need for a bridge. Taking climate as an environmental example, health alarm bells have moved from sharp warnings—such as in the 1990 IPCC reports—to a worldwide orchestrated crescendo in the pre-COP 26 medical editorial.

Now what? How do we harness this momentum and turn the enormous human, technical, and financial capacity of the health sector into cohesive, strategic engagement that advances the health-environment nexus? It is readily apparent this sector is ready.

It is time to move from expression to action. “Cross-sectoral engagement.” “Multi-sectoral health governance.” “Systems thinking.” What does this mean in practical terms? How does one do “integrated thinking” and where do you start “interlinking”? What would an expert environmental lawyer and a veteran physician talk about to affect policy change—and would they even share the same language of ideas?

Major health philanthropies have put health-environment nexus ideas at the forefront of their agendas, such as studying the human microbiome and biotechnology. The UN Environment Assembly and the World Health Assembly have adopted resolutions mobilizing the attention, finance, and capacity of decades-old agencies and industries to reconsider how to include the health sector in planning, and ultimately—and whether community health outcomes are part of environmental assessments. Industry leaders are writing on World Economic Forum blogs about the lack of environment and health considerations in trade policies. Prominent thought leadership circles, such as the Edinburgh Futures Conversations, host economists noting dramatic shifts in economic thinking: mainstreaming of ESG tools, inclusive GDP, considering an economy that could deliver wellbeing, and “replanting the entire system” away from fossil fuels and toward a circular economy. The G20 is talking about the social and environmental determinants of health, while the UN just made the right to a safe, healthy, sustainable environment a human right.

This is a unique time for stakeholders to drive governance, and in turn, influence the future of the private sector.

The health sector is not only a stakeholder sharing in the knowledge that societies thrive when everyone in society thrives, it can and must participate in this shift. In an upcoming publication, IISD and the Global Health Academy will explore how we break down these silos and connect expertise—across global environmental agreements, across policy architectures, and across technical issues. As we watch COP 26, we must consider the value if:

• We speak the same language: Health professionals need to understand the architecture of global environmental agreements before they can influence how to change and enhance them, and likewise environmental agents can transform the footprint of health and health systems and change health outcomes
• Clinicians are expert stakeholders: Most decision-making does not happen at the COPs; find, or make, doors to the intersessional bodies where substantive issues are discussed and prioritized and technical expertise is sorely needed
• National implementation is global implementation: A binding global treaty is only effective if countries fulfill its mandate; local health data is an indicator for monitoring effectiveness

Our full analysis, Bringing Health into the Global Environmental Agenda 2021-2022: a guide for policy makers, will be available in December 2021.

Liz Grant, is Assistant Principal (Global Health) and Director of the Global Health Academy at the University of Edinburgh. Liz Willetts, is a primary care clinician and consultant at the International Institute for Sustainable Development. This project is funded by the Wellcome Trust.