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By guest contributors Renzo R. Guinto (Section Editor for PLOS Global Public Health’s Planetary and Environmental Health Section), Revati Phalkey, Upasona Ghosh, Shibaji Bose
For many years, climate has not been a key focus for international health policy research (HPSR). During the 5th Global Symposium on Health Systems Research, Health Systems Global (HSG) in Liverpool in 2018, only one abstract out of thousands mentioned the phrase “climate change.” But there is no denying that the climate emergency is already posing an existential threat – while COVID-19 is wreaking its own havoc – to population health and health systems worldwide, as summarized in the “code red” assessment of the recent reports of the UN Intergovernmental Panel on Climate Change (IPCC)The Lancet Countdown. Therefore, the HPSR community must not turn a blind eye towards this pressing planetary health issue.
But the HPSR community is now taking a leadership role. This year, we, a group of scholars and practitioners deeply concerned about the nexus of climate change and health systems, started a new Thematic Working Group in HSG – TWG on Climate-Resilient and Sustainable Health SystemsThe UN Climate Change Conference (COP26), in Glasgow, officially launched the. In the coming years, we hope to facilitate learning and knowledge exchange, advance frameworks and research methods, and build technical capacity especially among the next generation of scholars and practitioners – all for the advancement of scholarship and practice around the climate change and health systems interface. Our TWG organized a panel discussion to jumpstart this work on November 27, 2021, at the face–to-face training of The. Emerging Voices for Global Health, which is one of HSG’s flagship programs. Here are five key messages from the discussion.
First, climate change is already affecting every part of the world – whether poor or rich. It is not only a problem for low and middle-income countries, such as India being struck by severe typhoons and India suffering from worsening undernutrition. Even high-income countries are already being impacted by climate change today, such as Canada being struck by heat waves or Germany being affected by extreme flooding which is unprecedented in the country’s history. Thus, HPSR researchers can work with practitioners from rich and poor countries to create a climate-health systems nexus. This allows knowledge, expertise and solutions to flow in both directions. Renzo, for example, is launching a joint venture between the University of California San Francisco in the Philippines and the University of the Philippines in building. climate-resilient local health systems – both the Philippines and United States have something to learn from each other in this novel arena.
Second, the climate-health system nexus requires that we not only focus on the health systems but also the wider environment. The boundaries of investigation become blurred and the scope for inquiry expands. This interface requires that we study not only the health systems, but also the social and ecological systems as well as their interconnections. In HPSR we always say we embrace transdisciplinarity – but studying climate change means we need to work with unconventional allies such as climatologists, ecologists, and geologists, among others. The international consortium is one example of how HPSR practitioners have partnered with other disciplinary experts like natural scientists, environmentalists and gender scholars. TAPESTRY, which focuses upon climate change transformation in marginalized areas in India and Bangladesh. Upasona has been working with this consortium which investigates the experiences of different actors in dealing with climate change and how the co-produced knowledge can help transform a community’s wellbeing in the face of the climate crisis.
Third, climate change has a direct impact on communities by affecting their health system functions and operating through their context-specific socio determinants of wellbeing. Therefore, HPSR work on climate can’t ignore communities that are at the frontlines of climate change and that are often overlooked in traditional health system frameworks that tend to focus on “building blocks” or “control knobs.” Special attention must be given to meaningful and respectful engagement with indigenous communities. For instance, in the Indian part of Sundarbans which is one of the world’s climate change hotspots, the space for community participation in health decision-making is limited. Shibaji & Upasona used action research. photovoice, to provide mothers of young children with a platform to express their collective voices about how climate change is impacting their children’s health. Participating as co-researchers, women negotiated with local policymakers in order to reach mutually acceptable actions at the community and level.
Fourth, climate change is something that everyday people are already experiencing. Its impacts cannot be simply represented in numbers or transcripts of interviews. The climate-health systems nexus provides an opportunity to use a wide range innovative communication and research techniques. The photovoice project in Indian Sundarbans, for instance, was previously described. documented in filmCommunicating the interplay between shared contextual and differing vulnerabilities of children and how they exacerbate their experience with climate change. The film version of Renzo’s doctoral dissertation on climate-smart local health systemsIn the Philippines, he captured not only the expert voice but also the voices of the frontline communities. His films have been used to teach and viewed worldwide by tens or thousands. Participatory visual actions research methods can also be used to uncover knowledge about uncertainty in health systems and to empower communities to become active agents of knowledge making, shifting politics of research.
Fifth, climate change is an issue that is not just urgent but also has a strict deadline and hard limits that are of lasting consequence to humanity – keeping the global average temperature increase below 1.5 degrees Celsius by 2030 as articulated in the Paris Agreement and reinforced by the Glasgow Pact.Lives are at stake – not just of people in the present but of the future children of the world. Therefore, climate-health system nexus requires more than rigorous scholarship. It also requires bold activism and movement building. The COVID-19 pandemic and the vaccine inequity it generated compelled many global health and HPSR researchers and practitioners to embrace activism – the same must happen in relation to the evolving climate emergency. The slow pace at which climate action is taking place must be a source of frustration for the HPSR community. This has long-term detrimental consequences for health equity and resilience as well as health system resilience. It is crucial that newly generated knowledge about this nexus be quickly translated and distributed to policymakers, practitioners, as well as the general public.
COP26 more than 50 countriesIn the next few years, they have committed to building climate-resilient and low carbon national health systems. The HPSR community must take advantage of this political development and harness its capacities to help the world’s countries succeed in this collective goal. In the coming years, we hope to see more colleagues from the HPSR community, especially emerging voices, scholars, and practitioners, to be part of this growing movement – to build health systems that do no harm to the planet and are adaptive to the challenges brought about by a rapidly changing climate. Join us!
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About the Authors
Renzo R. Guinto The Vice Chair of Thematic Working Group (TWG), on Climate-Resilient & Sustainable Health Systems of Health Systems Global, is he. He is the Chief Planetary Health Scientist of the Sunway Centre for Planetary Health in Malaysia and the Inaugural Director of the Planetary and Global Health Program of the St. Luke’s Medical Center College of Medicine in the Philippines. His Twitter handle is @RenzoGuinto
Revati PhalkeyChair of the TWG on Climate Resilient & Sustainable Health Systems of Health Systems Global. She is the Head, Climate Change and Health Unit at the UK Health Security Agency and Honorary Associate Professor of Global Health at Heidelberg University.
Upasona GhoshThe Coordinator of the TWG for Climate-Resilient Sustainable Health Systems of Health Systems Global. She is an assistant professor in environmental health, social and behavioural sciences at Public Health Foundation of India.
Shibaji BoseThe Communications Lead of TWG for Climate-Resilient Health Systems of Health Systems Global. He is a former journalist and has co-curated photo voice and directed films about climate change. His work has been featured in the Wellcome Trust’s Cannes Film Festival and HSG symposiums.
