[closed] What actions can planetary health stakeholders take to achieve the Great Transition?

I have concentrated much of my efforts trying to stimulate people reimagine the way we are interdependent on the planet. That is why will start with (2) artists and (15) Educational Institutions.

(2) i feel Artists are under represented in the movement for a healthier planet. Without artists our creative power is significantly reduced. Therefore i would ask  artist's organizations to identify barriers to their commitment to planetary health, and call on them to lead our imagination challenge.

(15) as a professor, i feel Universities are too fragmented into silos, which gets in the way of identifying and tackeling complex issues in planetary health. i would ask Universities and Educational institutions to identify challenging and complex issues and foster transdisciplinary teams to address, research and respond adequately in an systemic way.

1. What actions can the below stakeholders take to influence research and education to achieve the Great Transition?  As educators, this is where I believe that we can have the great impact. As a proponent of planetary health (using an Indigenous lens), we are able to showcase how connection to land and country are not only important for our health and well-being but traditional knowledge also takes into consideration, other beings as important. This is different from the more common anthropocentric lens that focuses on human health and well-being. Working in health professions education, fortunately, there are many woke individuals who appreciated the impact of health on the environment and so advocate for more sustainable practices. 7. 8 and 15.
2. What actions can the below stakeholders take to influence policy changes to achieve the Great Transition? Again in education, we can influence policies at our institutions, which are often slow to take up challenges such as the ecological ones we are facing. Similarly for the health care sector and professionals. 7, 8, 15
3. What actions can the below stakeholders take to influence the private sector to achieve the Great Transition? By disinvesting in unsustainable practices like the fossil fuels. By switching to greener alternatives. Lobbying supermarkets to replace some items with greener options. 1-15 can do this in their private capacity. 
4. What actions can the below stakeholders take to influence the public to achieve the Great Transition? 7 and 8 can educate patients about their footprint. The arts (2) are highly influential for creating awareness through posters, songs, movies, etc. 

Hello and welcome!

I guess it is very clear to all of us that we are living a dramatically important time in our lives, and in humankind history. 

That is why we think that it is time to have a document that alerts and invites people from all communities, geographies, and generations, to act, NOW, to safeguard our planet, our health and wellbeing, and safeguard humankind. Planetary health provides an incredibly comprehensive, inclusive and scientifically solid framework to guide us and all stakeholders in that journey.

That document, The São Paulo Declaration on Planetary Health, will be a call-to-action co-created with the participants of the 2021 Planetary Health Annual Meeting, an event that will take place in a couple of weeks. That virtual and free event (planetaryhealthannualmeeting.com) will bring voices from all over the planet discussing key aspects that we need to address to promote a change. 

So, thank you for joining, for bringing your perspective, experience and wisdom. 

Remember that the document must be understandable to the widest audience possible. It cannot be too long, too specific, or too detailed, nor can it focus too much in any specific issue, no matter how important it might be, which is the case of COVID19.

I also ask you to be positive, to help point to solutions, because we need hope as much as possible. 
Thank you!

Thank you, Enrique and Michelle for your thoughts! They make a lot of sense to me.

Particularly, I would encourage others to follow Michelle's approach to add comments, starting with the questions (1 to 4) and adding the stakeholder group to her text. It makes it clear now, and will also help us compile the contributions at the end.
 

I would like to make 3 specific comments on the draft:

Media - need to tell the full truth about the climate and ecological crises - they need to ensure full, consistent and comprehensive coverage on all platforms every day - like they have done with covid pandemic

Governments and global bodies - need to support, and listen to the outputs and recommendations from the Global Assembly (www.globalassembly.org ) when it reports later this year. They need to embrace deliberative democracy locally, nationally and internationally to ensure better decision making for a safer, more sustainable future

Business and agriculture - need to support biodiversity and food security by not patenting seed varieties and not preventing local farmers from using and sharing their traditional seed varieties 

Dear colleagues,

Welcome to the second week of this global consultation of the Sao Paulo Declaration, the outcome document of the Annual Planetary Health Alliance meeting.

We are very much looking forward to your concrete recommendations for specific stakeholders. What are we missing?

Our event already has almost three thousand participants from nearly 100 countries. It has never been more critical than now to bridge communities for transformative action.

Thank you for your contributions!

Hola,

Me parece que así como está mencionado el sector agropecuario en la Declaración (lo cual me parece acertado), también debería mencionarse al "sector energético (combustibles fósiles) y minero", por el fuerte impacto que tienen sobre los ecosistemas y la biodiversidad de manera directa (muchas veces irreversible), contribuyendo (al igual que el sector agropecuario) a la tala de árboles, alteración de hábitat naturales y cambio climático.

I would say, let's start.

Typically, in running a large project like this you need designated hitters at key partners. They don't need to be dedicated, think virtual team, they have other roles as scientists, business people, bankers, doctors, fisher, etc. 

Time to get them onboard, VTs are dynamic, people can come and go as they wish but as momentum builds so will the team. Ideally the team should include everybody, literally. Then you have your transformation/transition.

First thing I would do is send the draft to the great writers in our society. Yes, poets and philosophers but also academics, they love to write and do so beautifully. So publish the declaration as a paper in a journal!. Then the authors can get scientific credit. They like that too.

I edited the draft a bithttps://documentcloud.adobe.com/link/review?uri=urn:aaid:scds:US:09ca13c3-1180-4410-8f9c-eaaea2f587c2

Dear all,

thank you for your outstanding work and ongoing efforts for this cause. I have a few brief comments on the draft and offer a few general suggestions for stakeholders 7 and 8. I hope some of this will be of value.

Draft Section 1 (recommendations for changes in italics):

'Ultimately, these planetary emergencies are a result of people’s broken relationships with nature and each other.'

Something along these lines to more clearly point to the social causes of today’s environmental problems (large-scale agriculture, social and environmental exploitation, colonialism, racism, speciesism, extractive industries, capitalism and the economic growth paradigm)

The section needs to mention the need to reimagine economies and growth. e.g.: ‘how we consider and measure growth, progress and development’

Draft Section 2 (recommendations for changes in italics):

For Governments— 'Center planetary health …specifically in post COVID-19 plans and economic and environmental policies.'

For Businesses— replace ‘net zero’ with ‘zero’ or specify a time-frame for net-zero (e.g. 2040) and then a timeframe for zero (e.g. 2050). I am not convinced of the idea of circular economies and wonder whether we should really advocate for it here. I would recommend advocating for ‘diverse economic models’ instead.

For the Health Sector-- replace ‘net zero’ with ‘zero’ or specify a time-frame for net-zero (e.g. 2040) and then a timeframe for zero (e.g. 2050)

For Media — Tell the stories of those who are protecting Nature and fighting for justice and equity, investigate the connections between a safe environment, justice, equity and human health, and hold to account those who are damaging the planet’s natural systems and mistreating other people.

Draft Section 3 

I must say that I found draft section 2 quite action-oriented in itself and am unsure about the need to add more granular elements. For what its worth and with a lack of time to think about this further, here are some thoughts for health professionals and health sectors:

1) What actions can health practitioners /sector take to influence research and education to achieve the Great Transition? Planetary health research and education must become a standard element of all healthcare education.

2) What actions can health practitioners /sector take to influence policy changes to achieve the Great Transition? Understanding the political nature of being a healthcare professional, as well as the dependence of good health on good politics, and leverage the political power of the healthcare professions, also by getting directly involved in politics and policy making.

3) What actions can health practitioners /sector take to influence the private sector to achieve the Great Transition? Take clear stand regarding the Great Transition via role modelling, advocacy and political activism.

4) What actions can health practitioners /sector take to influence the public to achieve the Great Transition? Take clear stand regarding the Great Transition via role modelling, advocacy, public education and political activism.

Best regards and thank you for including me in this process.

Dear everyone,

Thank you so much for this amazing initiative and for the invitation to be part of it! Together with PlaHNet members, we just had a meeting to brainstorm ideas. We'll just consolidate them and send before April 21st. 

Stay safe!

Sincerely,

Pearl Ante-Testard and PlaHNet team

Great! Thank you for participating. Eager to see your comments. Hope to see you at the Conference, in a week.

Warm greetings to all, and thank you for the invitation to participate in this discussion. 

The draft Declaration is comprehensive and reflects good work. Here are my comments and suggestions on each section.

1. Introduction

Has there been a conversation on the selection of the term “Great Transition” in context of the now commonly used phrase “Transformative change” that circles at the UN level? If this topic has already been reviewed and decided then perhaps some of the logic in the new terminology could be included in the Introduction to indicate why it differs.   

2. Key Messages

I suggest the following amendment to the para on Economists, as follows (see italicized additions). Inclusive wealth implies both a shift in measurement GDP but also strategic approach. Support for ecosystem integrity means both meaningful preservation as well as regeneration in the case of damage. This amendment may additionally help to capture the concerns of Professor Tagles more generally.

_

For Economists--Promote planetary health by transitioning away from GDP growth as the primary metric for measuring economic success. Instead, emphasize metrics and investments that support preservation and regeneration of Nature, human wellbeing, equity, and happiness--the things we actually value. This would allow the economy to serve the living world in which it is embedded.

_

I suggest the following amendment to the message on the arts (see italicized text addition). I believe the Declaration could be strengthened by a reference to culture, and cultural traditions that reflect the environment-health linkage, therefore a text that reflects both new and historic narratives. 

For Artists, Poets, Writers, Musicians--Help humanity fashion new narratives about our relationship to Nature and to each other that reject the myth of human exceptionalism and emphasize our interdependence with Nature and each other. Revitalize and highlight cultural traditions and language that celebrate environment and health interlinkages.

3. Action Items

Language and communication are important parts of a transition and terminology is a building block for public uptake of new and interdisciplinary concepts like Planetary Health. Broadly speaking, across all stakeholders I suggest these actions:

• Shift from using “social” to “socioecological” determinants of health in public and global health discourse
• Ensure the terms "environment" and "health" are always mentioned together in reporting, analysis, proposals, case studies, titles, and policy-making, as well as any other form of media

Here are a few sector-specific comments:

7/8: Health practitioners/Health Sector

• As opposed to simply patient “health,” facilitate uptake of a "health and well-being" mindset in clinical practice, which strengthens the idea of harmonizing health with external factors
• Require health practitioners to learn the basic environmental status of the place of clinical practice, including:
  • sourcing of drinking water
  • chemicals that pose greatest local risk for exposure
  • state of biodiversity and ecosystem integrity
  • local plant-remedies and traditional use
  • general understanding of global environmental change impacts to the local area (i.e. vector disease patterns, weather change and natural disasters)
  • the general framework of the local food value chain (what/where is food produced and supplied)

11: Media

• work to remove politics from healthcare at all scales

I enjoy continuing the discussion on this work. 

If the goal of planetary health (PH) remains inproving human health alongside that of the environment; it is then significant to give priority to the governance aspect of  PH, especially to the actors that deals with health and environment as an entity. This approach can be achieved through transdisciplinary collaborations, utilizing approach that involves the SDGs.

Dear Abubuwa, thank you for your comments. I could not agree more on the importance of governance. By definition, knowledge is infinite but we have enough to promote significant change. Transdisciplinary is indeed an approach that we support as a community. If you have examples of success stories, do not hesitate to share more. See you at the PHAM 2021! 

Dear all,

Thank you for this opportunity to read the draft declaration and submit comments.

This important declaration is well-written and I look forward to seeing the end product!

In answer to your questions

What actions can the below stakeholders take to influence research and education to achieve the Great Transition?

• For stakeholders #12 (Researchers) and #15 (Universities and other Educational Institutions), I agree with Enrique that research should not be undertaken in silos. A multi-/trans-disciplinary approach is essential - both within universities and between universities, nationally and internationally. Research undertaken with the private sector will also be needed.
• Researchers #12 should aim to disseminate their findings through a variety of media including podcasts and blogs to increase awareness and reach of planetary health research.
• For Technology Professionals #14, accessibility should be at the forefront of design and decision-making. For example, no-one should be excluded through inaccessible technologies or educational content, and every effort should be made to remove barriers to accessing research/education (to this end, open access science is also needed).
• For #15 (Universities and other Educational Institutions), 'widening participation’ initiatives (briefing paper) should be pursued so that people from all backgrounds have improved access to education so they can become the leaders of tomorrow we need.
• #15 (Universities and other Educational Institutions) should avoid using non-sensical metrics to make decisions on academics’ progression / job security (e.g. see University of Liverpool doi:10.1136/bmj.n825). A huge spectrum of research will be important for the achievement of planetary health (as evidenced by the varied programme and abstracts submitted for the PHA Meeting) and not all will necessarily be widely cited, but may still be important for influencing policy-makers, for example.

What actions can the below stakeholders take to influence policy changes to achieve the Great Transition?

• I agree with Michelle that researchers #12 (and students/staff) should lobby their institutions #15 to commit to policies that are aligned with planetary health goals - this could include, for example, divesting from fossil fuels or avoiding unnecessary air travel.
• As Michelle says, health practitioners #7 should influence the health sector #8 to reorient towards planetary health.
• I also agree with Filip’s points on this question for #7 health practitioners

What actions can the below stakeholders take to influence the private sector to achieve the Great Transition?

• I agree with Michelle that all stakeholders #1-16 can influence the private sector in their personal lives through their purchasing power and campaigning etc.
• As I mention above, #12 (Researchers) and #15 (Universities and other Educational Institutions) should work together with the private sector, where feasible, for public good. An example is the collaboration between AstraZeneca and the University of Oxford in the production of their COVID-19 vaccine.

What actions can the below stakeholders take to influence the public to achieve the Great Transition?

• All stakeholders #1-16 should lead by example and support others as we together strive for the Great Transition.
• In particular, #7 health practitioners have a golden opportunity, as they are amongst the most trusted in society. They should encourage their patients and the wider public to make planetary health choices, such as reducing red meat consumption and active travel. This can also include green social prescribing.

It would be important and helpful as part of this consultation to seek out views from each type of stakeholder mentioned directly.

Regarding the draft

I wondered if the fishing industry should be included alongside agriculture?

I also wondered if ‘Cities’ (or City Mayors/Planners/Councils etc.) should be included as a key stakeholder?  “…how we construct and live in our cities” is included in Section 1, and I feel it is important to include cities in Sections 2/3 – e.g. see 'harnessing urbanisation for human wellbeing and planetary health', doi: 10.1016/S2542-5196(17)30005-0 Cities are / will be a key to achieving planetary health.

I agree with Hector about including "energy (fossil fuels) and mining sectors”.

Here are some additional comments on the draft:

• In Section 2, consider changing ‘For Governments’ to ‘For Governments and policy makers’.
• In Section 2, For Governments, I would consider highlighting that ‘health co-benefits’ and ‘health co-harms’ of policies should be considered and evaluated, e.g. see 'health co-benefits of climate action’, doi: 10.1016/S2542-5196(17)30003-7
• In Section 2, For Economists, I would change ‘GDP’ to ‘Gross Domestic Product (GDP)’.
• In Section 2, For International Organizations, I would add a comma between low- and middle-.
• In Section 2, For Businesses, I would consider changing ‘by 2050’ to ‘by 2050 if not before’ (or similar) and For the Health Sector, I would consider changing ‘by 2040’ in a similar way.
• In Section 2, For Spiritual leaders of all faiths, consider changing ‘relationship to Nature’ to ‘relationship with Nature’.
• In Section 2, should there be ‘key messages’ for Youth representatives?
• In the Conclusion, I would add a comma to ‘your Elders past, present and future’ – this sentence may benefit from semicolons.

Best wishes,

Chris

Dear Christopher, 

Your detailed comments are very helpful. We will gather all comments and improve the draft. In sum, you call for (among others):

1. No siloed research

2. Enhanced research dissemination to include a variety of media vehicles

3. Leadership by example. 

On stakeholders, you suggest including fisheries and cities. 

I hope to continue the dialogue here!

Thank you!

Hi all,

Many thanks for bringing this together, it's looking great. I have a few comments/suggestions:

In terms of Q4 on actions that actors can take to influence the public, I'd like to see a number of the groups (specifically, 6. Governments and 15. Universities but also groups such as 2. Artists, 7. Health Practitioners) doing more to put forward a positive vision of what a low carbon, resilient, health society looks like. Too much of the rhetoric is about what needs to be given-up to preserve the living world and not enough is focused on what we stand to gain from doing so and how that can inspire people to take action themselves and encourage their friends, family, elected officials, etc to act.

One way to support the point above is to do more to emphasise the co-benefits of climate action (e.g. better quality air, reducing health inequalities, longer life expectancy, homes we can afford to power) so that those less concerned with climate change/ecological destruction can still see the benefits that action on the issue brings to their lives and therefore to maximise the chance that policy actions maintain public support.

On a practical level and in relation to Q2, there is often more that can be done to encourage cross-departmental collaboration within government - particularly where one department pays the costs for climate action (e.g. a housing department investing in energy efficiency or a transport department investing in electric vehicle infrastructure) and another sees the financial benefits of climate action from improving health outcomes (e.g. the Dept of Health). In a paper we wrote on this topic, we called for an Office for Public Health and the Environment in the UK to bring together civil servants from across government departments with a shared budget in order to maximise the chance that the benefits of climate action could be taken advantage of: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(20)3016…. I suspect similar models already exist in other countries but also suspect similar challenges of departmental boundaries acting as barriers to greater action exist in many other countries too.

Best

Neil  

The joys of clean air and water. I can’t sleep sometimes because the pollution irritates my eyes, nose and throat. When I was a boy breathing felt like drinking clean water, and water tasted magnificent.

First, this community is to be congratulated on this far-reaching document, which seeks to raise collective awareness of interconnectivity and place a higher value on collaborative solutions. I agree with others who have commented on the importance to "emphasise the positives" in what we have to gain by changing our attitudes and approaches. It is already an excellent document and I have a few suggestions:

One omission that I suspect that many would feel is important to address, is the role of multinational corporations with regard to the NCD (noncommunicable disease) crisis and human health. The section on “for businesses” focuses largely on environmental impacts but does not address the production of unhealthy products for profit.  Under “for government” the document does mention corporate responsibility for human health with respect to equitable COVID vaccine access, which is extremely important. But what about the other side of the multinational corporation coin? What about policies that allow (and even facilitate) "access" to unhealthy food and beverages (and forces that target the less privileged and most vulnerable populations).

Further to that: The growing global pandemic of NCDs is a major barrier in the wellbeing of societythat is described throughout the Declaration. This is inextricably related to the health of environments, yet is not mentioned.  There is much weight given to the COVID-19, but the  growing global pandemic of NCDs is ongoing and much larger and very much related to planetary health on a multitude of levels. If we are truly talking about wellbeing this really should be mentioned.

As an artist, I am so very pleased to see this dimension included. I think that the significance and nature of this role has been understated.

Artists continue to hold up a mirror to societies, collecting and reflecting back the stories of the underserved, the injustices incurred by the voiceless. Display the  ways in which authoritarianism and power imbalances manifest in societies, those that otherwise maintain the unhealthy status quo, and compromise the aims of planetary health. At the same time, provide the global community with an optimistic vision of what the great transition, wellness across the planet and its systems, might look like.  

In other words, artists play a much more much more dynamic and integral role then implied in the document. They provide value not just in educating and fashioning new narratives but providing hope inspiration—speaking to people’s hearts and shared values which are known to promote self-awareness, and wellness at all scales.

Some other minor points

• Page 1, Paragraph 2: There are many “planetary emergencies” beyond COVID-19 and extreme weather. So rather than make it to narrow I would either avoid specificity or make a minor amendment to make this broader, such as “..ultimately, these and other planetary emergencies are a result of humanity’s broken relationship with Nature.”
•  Page 1, Paragraph 2: it is very good to be at articulating the importance of listening to voices from different groups. This may need to be reworded it does not ‘separate’ these groups or fail to recognise inherent overlaps. For example, Indigenous peoples have their own science and, as written, it implies that “scientists” are separate and have  more legitimate science. A minor point but speaks to perspective, attitudes, and how the message might be percieved.

Again, I hope that these suggestions are helpful in enhancing an already wonderful document.

Best wishes,

Susan

PS: A useful reference for the role of multinationals in planetary health (as it pertains to NCDs) is this Lancet paper by Rob Moodie:

Moodie et al. Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet 2013 Feb 23;381(9867):670-9

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)6208…

Hello everyone,

Thank you so much again for this brilliant work and for inviting us to contribute! As promised, below are the consolidated ideas and suggestions from PlaHNet members.

Contributors (no particular order): 

• Niilanjana Ganguli, Pearl Anne Ante-Testard, Katharine Palmer, Byomkesh Talukder, Maria Cristina Gonzales, Marisol Yglesias-Gonzales, Rose Wang, Yuria Celidwen 

Beside each suggested action point, we specified if this action would influence a, b, c, d.

a. Actions to influence research & education to achieve the Great Transition

b. Actions to influence policy changes

c. Actions to influence private sectors

d. Actions to influence the public

Suggested action points for each stakeholder:

Agriculture Sector

• Advocating for and practicing organic, safe, honest and responsible agricultural practices that respect human and animal health, and planetary health boundaries. (b,c,d)

Artists, Poets, Writers, Musicians

• Responsible and creative planetary health storytelling through art, poems, writing and songs. (a, b, c, d)
• Collaborating with researchers to transmit planetary health research findings in a simple and compelling manner. (a, b, c, d) 
• Demonstrate responsibility and protection of the natural environment in production practises and use of resources. (c)
• Acknowledge emerging artists addressing planetary health issues by creating opportunities and funding. (a, d)

Businesses

• Implementing sustainable economic and business models that respect the planetary boundaries. (b, c, d)
• Practicing honest and responsible product labelling. (b,c,d)
• Teaching sustainable economic and business models in business schools. (a, c, d)
• Use the $ power to persuade the government towards a just transition in public-private projects. (b) 
• Invest in learning, accepting and applying the unconventional economics into cost/benefit analysis at a company level. (a, b, c, d)

Economists

• Preach “ecological economics” in a digestible and relatable sense. “Ecological services” is still a mystery to most. (a, b, c, d)
• Making sure planetary health boundaries are honored and respected as part of economic evaluation and monitoring. (a, b, c, d)

Funders

• Fund more Planetary Health projects, initiatives and research (a,b,c,d)
• Leverage fundations and sustainable development goals. (a,b,c,d)

Governments

• Taking the initiative and responsibility in educating themselves of what is Planetary Health. (a,b,c,d)
• Attending seminars and conferences about Planetary Health. (a,b,c,d)
• Opting projects to have a cost-benefit analysis on their potential impact on the planet/ environment. (a,b,c,d) 
• Plan a paradigm shift towards proactive measures like robust monitoring systems. (c )
• Appoint an unbiased functional body (such as Ombudsman) for environmental and humanitarian crimes. ( c) 
• Support lobbying regulations, including calls for transparency. (b,c,d)
• Develop and implement plans aiming an economic decarbonization and energy transition as a measure for a green and healthy post covid-19 recovery. (b,c,d)

Health Practitioners

• Incorporating planetary health when giving health education to patients. (a,b,c,d)
• Being mindful of healthcare´s environmental impacts and take action on minimizing them as an individual and sector (i.e proper waste management, reduction of water and energy consumption, reduction of carbon footprint). (a,b,c,d)

Health Sector

• Having more establishment on health equity networks. (b,c,d)

International Organizations and NGOs

• Incorporating planetary health core values into their goals and mission. (b,c,d)
• Transdisciplinary and multidisciplinary approaches to global and planetary health challenges by collaborating with governments, civil societies, local communities, among others. (b,c,d)

Jurist and Lawmakers

• Putting accountability on countries, institutions or companies that emit carbon emissions beyond the recommended threshold. (a,b,c,d)

Media

• Using media responsibly to inspire and motivate people that change is possible rather than just eliciting fear of the consequences of planetary health challenges such as climate change, pandemic, etc. (a,b,c,d)
• Creating media contents of the different doable planetary health solutions that countries, groups and individuals could do and embrace. (a,b,c,d)
• Fight infodemias by communicating transparently and accurately as possible, information and data that are backed-up by high quality science. (a,b,c,d)

Researchers

• Communicating scientific findings to policymakers and other stakeholders in a simple and understandable manner. (a,b,c,d)
• Collaborating with artists and writers to transmit these messages to the public. (b,c,d)
• To influence policy, researchers need to talk the language of the policymakers (how will planetary health regulations/laws will benefit the country or economy). (a,b,c,d)
• Think global/” design” local. Know the difference between “what should be done?” and “ what can be done”. Context is crucial! (a) 
• Disseminate knowledge strategically by identifying key stakeholders and key industries. (b,c,d)
• “Knowing thy enemy” - Putting ourselves in the shoes of those who are still hesitant to believe before tackling them. (a)
• More “research-to-action” projects in behavioural science. (a)
• Target employment in major industries like mining and agriculture, that have the tools “Environmental Impact Assessments” but only use them as a “rubber stamp”. Use existing tools  to make a difference from within the system. (especially c but also a,b,d)

Moral/Spiritual leaders of all faiths

• Using their voice and influence in advocating for the planet.  (a,b,c,d)
• Engage the faith community in embracing sustainable lifestyles and community activities that can bring transition towards greener and healthier neighborhoods inspired by the values of stewardship and respect for creation. (a,b,c,d)

Technology Professionals

• Being planet- and ethically-responsible in using technology (a,b,c,d)
• Being planet- and ethically-responsible in developing new  technology (a,b,c,d) 

Universities and other Educational Institutions

• Aside from embedding planetary health curricula in all programs and faculties, meditation and spirituality should also be part of it to deepen the human experience of the interconnection between humans and the planet. Universities and educational institutions have the responsibility to nurture students holistically and not just at the level of the intellect. (a,b,c,d)

Youth representatives

• Joining planetary health groups or organizations (a,b,c,d)
• Advocating for planetary health (a,b,c,d)

Elders 

• Sharing wisdom of community resilience and intergenerational transmission of knowledge. (a,b,c,d)

Sincerely,

Pearl and PlaHNet members

Many thanks for sharing your draft, and for your great efforts for this extremely important cause. I agree with many of the great suggestions and comments already posted by others. But I've not had the chance to look through all other comments, so please just ignore any repetitions in my suggestions below.  
 

Section 1

The COVID-19 pandemic is the most recent in a series of catastrophic distress signals ringing around the world. (or catastrophic events)

Use well-being consistently. 

The planetary health science..

...rapid and deep structural changes..

...represent communities that are bridged across geographies..

.....in safeguarding the health of our planet and people
for future generations..
 

We call for urgent and decisive action that will save lives and
promote the health and well-being of people and planet,...

Section 2

..low- and middle-income countries..

..while strengthening health systems' resilience to tackle the health consequences..

Disease prevention, health promotion and health equity must be at the heart of..

...the adverse effects of our current dysfunctional relationship with our planet.

-Create and promote art work (e.g. poetry, visual arts, storytelling, music and theatre) that inspires and fosters greater planetary health awareness. 
 

...to embrace ancient teachings and wisdom....

Only by working together as a global community, we can
co-create and achieve the Great Transition.

Section 3

Researchers, educators, policy makers, the private sector and the general public will all play key roles in making the rapid and deep structural changes in human activity that will be required to achieve the
fundamental shifts needed to facilitate/actualize the Great Transition.

Hola a todos, valoro y aplaudo la iniciativa dirigida por ustedes en una materia tan importante y aún poco profundizada.

Como médico, me enfocaré en las propuestas de salud pública.

The Lancet, en su reporte del 2015, remarcaba al cambio climático como la mayor amenaza a la salud global del siglo 21. Sin embargo, tambien es una oportunidad para redefinir y trabajar sobre los determinantes sociales de la salud. Ese debe ser el enfoque que se debería trabajar al hablar de Cambio Climático y Salud. Se debe mencionar eso en el texto. La vulnerabilidad a los efectos del cambio climático es dispar entre paises, sociedades y poblaciones.

Es, en este sentido, que debemos fortalecer la atención primaria de la salud con enfásis en la educación a la comunidad sobre la adopción de actitudes y prácticas eco-amigables. El médico de atención primaria trabaja con la comunidad y junto al resto de personal de salud (enfermeras, psicologos, obstetras, etc) brindan consejería en materia de prevención de enfermedades. Si educamos al personal de atención primaria sobre el cambio climático y sus efectos en la salud e iniciamos programas de intervención y educación comunitarias; este sería un verdadero cambio.

Me despido, no sin antes agradecer la invitación.

Saludos cordiales,

Pool

Dear all, 

Thank you for the invitation to participate in the draft declaration. I will answer the specific numbers of stakeholders in the questionary. 

1.What actions can the below stakeholders take to influence research and education to achieve the Great Transition? Researchers, educational institutions, and some government organizations, for example, MoE who is setting standards would be influential stakeholders, so # 12, #15, #6,

2.What actions can the below stakeholders take to influence policy changes to achieve the Great Transition? #4, #6, #9, #11, #12

3.What actions can the below stakeholders take to influence the private sector to achieve the Great Transition? #4, #5, #1, #3, #6, #14,

4.What actions can the below stakeholders take to influence the public to achieve the Great Transition? #1,#2,#4, #8, #15, #16

Thanks again.

All the very best,

Irada

Caro Pool, 

Gracias por sus recomendaciones concentradas en "prácticas eco-amigables”, principalmente para  médicos de atención primaria trabaja junto al resto de personal de salud (enfermeras, psicólogos, obstetras, etc). Notamos la importancia de educar este sector sobre el cambio climático y sus efectos en la salud. Hay muchas iniciativas  en esta area pero concordo que tenemos que hacer esto principalmente en el Sur global.

Saludos cordiales,

Nicole

Dear all,

That is wonderful to see the Declaration taking shape. I congratulate your initiative and commend the contributions of the colleagues above.

As a general point, I would propose that all stakeholders should consider banning unnecessary single-use plastic material at their physical locations (e.g., disposable cups and cutlery). I understand that this has been accomplished somewhere; however, it is still a problematic issue faced by most in everyday life. Local actions like this can be a way to influence the people who visit or work at such places, regardless of their role or position (as categorised in questions 1–4).

Regarding question 1 (What actions can the below stakeholders take to influence research and education to achieve the Great Transition?), I would say that stakeholders #1, #3, #7, and #8 (and maybe others) can share real-world questions and challenges they face to implement/disseminate planetary health knowledge with stakeholders #12, #14, and #15; such questions and challenges can then be contemplated as research questions and/or problem-based education. The research and education process can involve the initial stakeholders themselves to test or even implement solutions that may be available somewhere else. That approach could lead to a cycle of problem/challenge and solution sharing.

Some thoughts for now.

All the best.

Saulo

Thousand thanks for the opportunity to read the draft and submit our reflections. As I read the comments above, I must say I am nowhere near with my experience and knowledge to be confident in suggestions about the policy side of planetary health action. However, as I have been working with community engagement in different settings, countries, and disciplines of action and I hope it is okay to share it here. 

6. Governments. 

Make sure that the decision making processes are decentralised and based on (as mentioned by Zoe) deliberative democracy which I consider a base for finding a common and shared solution. Decentralisation of fiscal resources could also help support and develop localy-based private sectors from agriculture, through fisheries, and other suppliers - promote whats regional and leads to long-term sustainable solutions. 

15.Universities and Educational Institutons.

Stat early. Do not wait until university in order to educate youth about environmental change and it's effect on human health. Conducting storytelling meetings, conversations with representatives of different disciplines, building a connection between kindergarten kids and nature by gardening time (as it is done in Denmark), meeting with professionals focusing on sustainability, etc.

16. Youth Represenatives.

As one, I would say thank you for including and giving us often an important say on the issues. However, it is necessary to acknowledge and include people above the age of 60 in the planetary health and environmental responsibility conversations. As you mentioned, we need to recognize the importance of all generations and unfortunately, I have noticed that the elder and younger generations are often not united but separated if not entirely excluded and blamed (-the elder generation). Hence, I would suggest to implement joint consulations, meetings, and action towards safegouring plenatary health by ALL generations involved at the same level - preferably in local and regional settings. But also end tokenism of youth. 

Kindly please, take my reflections through a prism and let me know if I should specify any of aforementioned points :)