26 Apr - 1 Jun 2021

São Paulo Declaration on Planetary Health Global Consultation

Nina Grinman • 22 April 2021

Welcome to the consultation!

Research and education, policy, the private sector, and the public will play key roles in making rapid, deep, structural changes in human activity that are required for the fundamental shifts needed in the Great Transition. The questions below refer to actions the following stakeholders can take to influence these sectors with the overall goal to achieve the Great Transition.

Your comments below will be incorporated into the São Paulo Declaration on Planetary Health

Click here to read the DRAFT Declaration


Please answer the questions below:

Please refrain from suggesting specific text edits to the draft Declaration. Instead, please focus on recommending action items for the questions and stakeholders listed below to be included in Section 3 of the Declaration


  1. What actions can the below stakeholders take to influence research and education to achieve the Great Transition?
  2. What actions can the below stakeholders take to influence policy changes to achieve the Great Transition?
  3.  What actions can the below stakeholders take to influence the private sector to achieve the Great Transition?
  4. What actions can the below stakeholders take to influence the public to achieve the Great Transition?

In your answers, please be specific to which stakeholders you are referring to.

The list of stakeholders include:

  1. Agriculture Sector
  2. Artists, Poets, Writers, Musicians
  3. Businesses
  4. Economists
  5. Funders
  6. Governments
  7. Health Practitioners
  8. Health Sector
  9. International Organizations
  10. Jurist and Lawmakers
  11. Media
  12. Researchers
  13. Spiritual leaders of all faiths
  14. Technology Professionals
  15. Universities and other Educational Institutions
  16. Youth representatives



Comments (76)

Planetary Health Alliance Moderator

A synthesis of comments from moderator Enrique Falceto De Barros:

"We had 32 contributors to the Sao Paulo Declaration from April 25th to May 10th, with many significant and useful comments and suggestions. Here highlight a few from April 25th to May 5th:

a) Education: include pre-scholar and schools;

b) Funders: consider new criteria on Planetary Health;

c) this Declaration may be seen as PH roadmap to 2030;

d) what is new in this Declaration in comparison to previous declarations from other sources?;

e) consider describing what has been achieved by the PH framework so far;

f) consider incorporating the April 28th "Nobel Summit statement – a call for action";

g) set an agenda for mindset transformation;

h) urban planners and architects are essential for the great transition, as well as all other professionals;

i) consider reframing agriculture into food systems ( as highlighted in the literature);

j) artists can inspire what it should look and feel like after the great transformation.

We do hope contributions continue with the same creative energy and inspiration to improve our declaration´s comprehensiveness and impact towards the necessary transformations.

Best wishes,



This week's moderator is Antonio Mauro Saraiva, chair of the 2021 Planetary Health Annual Meeting and Festival!


Yasna Palmeiro Silva

Hi everybody, 

First of all, thank you very much for all the work you've done. It's amazing.

I couldn't add information to the previous discussion group, so I guess it's OK if I add it here. 

I'm attaching a word document where I've added some thoughts and ideas to the declaration. Some general thoughts: Sometimes, we refer to "our" world when in reality it's not "our". It's the planet or Earth and it belongs to every single species in the world - This follows what Indigenous people would say. 

I'm not sure whether we need to include a call for vaccines patents. It's a very specific point and I guess a declaration is a general statement. 

When we call for specific sectors, then I think the first sentence should be highlighted. It's what stakeholders will read at first sight. 

I hope these suggestions and changes would make sense. 

Finally, some actions for:

5. Funders

- Include new evaluation criteria, such as “Impact on planetary health (research outcomes and policy outcomes)”, “Degree of engagement with people working on planetary health”

8. Health Sector

- Reframe health systems and practice including the planetary health approach

15. Universities and other Educational Institutions

- Incorporate planetary health into the educational curricula at different levels: pre-scholar, school (primary and secondary), universities.


Thank you very much again, 

Best wishes



I think if we speak about patents it should be broader- no patents on crops, drugs, knowledge;... Knowledge  should benefit the planet as a whole... 

Enrique Falceto De Barros Moderator

Dear Yasna,

thanks for your comments.

concerning your thoughts on "our world" expression:

i am not sure where we mention "our world", could you point it out? could it not be interpreted as not necessarily excluding our relatives from other species - who also "own our world"?


your practical sugestions for actors 5, 8 and 15 seem useful to me. We do need to consider them.

Planetary Health Alliance Moderator

Hello and welcome!

We are at a critical juncture in history with COVID-19 as the latest in a string of consequences resulting from excessive pressures we put on the planet. Planetary health science is clear: we can no longer safeguard human health and wellbeing and the health of the planet into the future unless we change course.

With these urgent challenges comes a unique opportunity to move society towards the Great Transition, a fundamental shift in how we live on Earth. The São Paulo Declaration on Planetary Health is our moment to come together as one voice, loud and clear, to state what actions are necessary to achieve the Great Transition. This Declaration invites all communities, geographies, cultures, and generations to act to safeguard the health of people and the planet.

Thank you for bringing your perspective, experience, and wisdom to this consultation. Your inputs are extremely valuable and will feed into the recommendations outlined in the São Paulo Declaration on Planetary Health that will be shared with the global community.

We ask that you focus on actions planetary health stakeholders can take rather than specific text edits. Remember that this document must be understandable to a broad audience and cannot be too specific on any one issue, no matter how important it may be.

We want your help to develop solutions. We need positivity, and most of all, we need hope.

Thank you!

Leslie Solomonian

I speak as a healthcare provider, educator, and advocate.  

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

- embed ecological and social justice into heathcare education

- acknowledge the significant influence of social and ecological determinants of health and demand shifting of resources to that focus

- this requires the de-deification of the "hierarchy of evidence," which influences bias in funding, publication and implementation

- emphasis on whole systems research

- remove barriers to education and research opportunities for historically and currently marginalized voices

- elevate community-based participatory methods into research methodology

- promote interprofessional and interdisciplinary education and research, move away from silos in education, research, and provision of healthcare

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

- deconstruction of the biomedical, reductionistic approach to healthcare; elevate systems thinking, integrative/traditional/interprofessional healthcare teams

- include other healthcare providers at policy tables other than medical doctors

- more emphasis on funding and public health initiatives to promote health of people and communities rather than funding of reactionary care (including policing)

- advocate for decommodication of healthcare services and resources necessary for good health; food, shelter, medicine, choice in healthcare as a human right; when these services are commodified, some profit from them and make them inaccessible to many

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

- socially innovated strategies to promote conditions for health; partnerships with developers to offer community gardens, affordable housing; advocacy to employers for fair wages and encouragement of cooperative ownership

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

- as has been pointed out, healthcare providers are a trusted voice; but there is too much emphasis on biomedical/reductionistic/RCT-informed "healthcare"; this must be brought back into balance, elevate the voices of those with a more holistic paradigm; reshape what is meant by "healthcare"; place reactionary medicine where it belongs and expand the voices of those who promote well-being; those with power and influence must use it to raise the perspective of those professions who have been marginalized

Also general comments on the draft declaration:

- first paragraph, last sentence ... I would encourage it to be more strongly stated:   "A global transition is urgently required to radically
restructure human societies in order to preserve the well-being of the living world in which they are embedded." (as opposed to it sounding like caring for the living world is secondary or a convenient co-benefit)

- second paragraph ... the consequences of climate devastation tends to impact socially/politically/economically vulnerable geographic regions first ... we know that the impacts are now closer to the seats of global power ... worth pointing out the melting of glaciers, and permafrost in the polar regions?  Rising levels of the seas and great lakes?  Massive forest fires in the US and Canada as well?

- generally advise to avoid the use of the word "change" when we mean destruction, devastation, collapse, ecocide ...

- paragraph 4 ... would suggest what we need first and foremost is a redefinition of values ... what is important, what is "good," what is just?  This will inform the restructuring as described 

- I agree that demanding depatentization of COVID vaccines may be too specific for this declaration ... but I definition would advocate for decommodification of ALL health-promoting services, including drugs, vaccines, food, traditional medicines, medical care, public health initiatives, etc.



Lis Leão

Hi everyone,

First of all I would like to congratulate PHA and Brazilian team for the amazing event and also for this initiative.
I speak as a researcher in the field of nature & health and as a postgraduate professor at Hospital Israelita Albert Einstein, in São Paulo. I want to share my perspective  based on my professional education, but also as a wildlife photographer and, therefore, as a conservationist. Thank you for allowing this contribution.

The following are specific actions the below stakeholders can take to influence these sectors with the overall goal to achieve the Great Transition:

Agriculture Sector

Regular meetings of agribusiness leaders with specialists in climate change and health to evaluate and develop solutions together.


Artists, Poets, Writers, Musicians

Return to including nature in cultural production (because in the past it existed more), be it in music, poetry, novels, photography, children's books, in order to contribute to the construction and strengthening of the bond with nature. Culture and nature preservation must go together.



New businesses that focus on biocentrism, such as sustainable tourism “in” and “with” nature.

New health services based on experiences of immersion in nature to wellbeing and health promotion.



Inclusion of the planetary health theme in specific grants for research, not only from government agencies but also from philanthropists, and other companies who can contribute to the development of evidence and its applicability in the real world.



Development of public policies built in dialogue with all areas of impact, such as the Environment, Health, Public Security, Transport for access to natural areas, Social (for greater equity).


Health Practitioners

Health professionals need to seek additional training, since planetary health is not yet found in the traditional curricula of academic training courses.


Health Sector

Health sector leaders can develop new ways for health organizations to relate to nature beyond the issues of sustainability and hospital waste management, including new preventive health programs that have a connection with nature as one of the foundations for implementation in population health.

Create paths to combine the ancestral knowledge of the indigenous people with the medicine of the non-indigenous people.


International Organizations

Develop joint actions, whether educational, informative, evaluative, or research, with local leaders from all regions. Contribute to the identification and development of leaders from the least favored countries to meet the motto of Sustainable Development Objectives – “not to leave anyone behind”.


Jurist and Lawmakers

Harden the penalties related to environmental crimes, as well as expand and strengthen legislation that protects biodiversity (and consequently humanity), while also developing appropriate enforcement mechanisms.



Present a positive communication agenda with the general population so that climate change is not seen with fatalism, but with a focus on the possibilities of engagement so that we achieve planetary health.



Develop research on the theme in its various aspects and mixed research methods, generate evidence, act strongly in scientific dissemination not only among peers, but with the general population.

Create programs to visit schools to raise awareness and bring children closer to scientific discourse and its importance for planetary health.

Provide scientific evidence for nature-based interventions in health in association with biodiversity conservation


Technology Professionals

Develop technologies that bring people closer to nature.


Universities and other Educational Institutions

Foster and encourage research lines in the area of ​​planetary health.

Insert programmatic content in a transversal way in undergraduate courses in the area of ​​health, architecture and in other areas that can train professionals with an interdisciplinary vision and necessary for future professional performance.

Create outreach programs in planetary health

Create specific disciplines on nature and health, planetary health, indigenous ancestral knowledge for undergraduate health courses and also postgraduate courses involving these topics.

Develop online and free courses on open access platforms for the dissemination of knowledge about planetary health and related topics to a wider scope, mainly in a continental country such as Brazil.


Youth representatives

Develop specific forums to identify and strengthen young people to act in planetary health as agents of transformation.

Susana Paixao

The curricula of undergraduate degrees in Environmental Health address most of the themes of Planetary Health.

Enrique Falceto De Barros Moderator

Dear Lis Leão,


Muito obrigado por suas contribuições!


you maybe interested in this course launched by the PHA:

Registration Period: 01/18/2021 to 12/19/2021

Course Period: 01/18/2021 to 12/31/2021

Target Audience: Undergraduate students and higher level health professionals. The course is also open to the community and any individuals who are interested in the topic.




Lis Leão

Enrique Falceto De Barros 

Dear Enrique, thanks for the information. I attended a presentation at the event and already made my registration! :) very cool this free initiative! We have a grant from Fundação Boticario and we are developing two courses, online and free too, which will be on Einstein's open platform. We will deal more specifically with nature connectedness and health. One aimed to health professionals and another to managers of natural areas. Let's add the efforts! We will have an international symposium this year also online and with simultaneous translation (I INTERNATIONAL SYMPOSIUM ON NATURE & HEALTH: Building bridges between human well-being and conservation)

I'm talking to Sam Myers for his participation (hopefully it will work!). In the coming days we will already have a hot site with scientific programming in English, too.


Lis Leão

Susana Paixao 

Yes I know. I thought of specific forums outside the niches where this already happens. (so as not to be preaching only to those already converted) rsrs :)

Ralf Klemens Stappen


Lis Leão 

this is an interesting topic, but still a fringe area of science - in our academic society some events were held on this in the past. The leading head here is Gunnar Tellnes, University Oslo - attached a link for  a book on forests and health, (bases on a conference) but where the whole topic of nature-health was discussed in principle. It´s very important topic if we se this for 7.7 billon peoples ! Also Susan Prescott, Australia  INVIVO work on this question -more form the arts, I like her approach very much. Here a nice art-video.

Lis Leão

Ralf Klemens Stappen 

Dear Ralf,
thank you very much for the references. I'm going to know them. I agree that in the academic society we still have some obstacles. I”ve lived  this in the field of complementary terapies for many years (since 90s). In 2013 at Einstein I was co-founder of  specialization in integrative health that now in 2021 evolved into a new postgraduate course in integrative health: advanced studies, in which I have a discipline on nature and health.  One of my master's students in science is an ambassador for planetary health in the program instituted by USP. Gradually we gaining more space, although in Brazil I feel that we are still crawling. But let's go on!

Ralf Klemens Stappen

Dear Lis  

the Nobel Summit last week, made this interesting statement (as representative of the mainstream science): We need to reinvent our relationship with planet Earth

We could also see the question extended - We need to reinvent our relationship "with nature". The problem is simply that the reductionist, mechanistic scientific logic - which was very effective to analyze parts up to quanta and bisons - but in the end does not understand nature as a whole anymore. This has been discussed for more than 50 years.  But this logic is deeply anchored everywhere, in the universities, curricula, in the minds and therefore we have a hard time with a paradigm shift here. Although the reductionist approach is basically considered to be completely inadequate because (to understand nature) of the implications of quantum theory. Indigenous peoples are closer to this than modern science (excluded the avangarde!). In Planetary Health this was only touched upon e.g. in the introduction of Howard Frumkin and Samuel Myers book to Planetary Health regarding deep ecology, "system thinking (ODUM)" .

If we want to rethink nature in medicine and healing - you have to rethink the concepts of life, body and soul.  A really interesting scientific system approach is the book by Fritjo Capra and Pier Luigu Luisi "The System view of Life" (Cambridge University Press).

Concerning your nature photography, in Planetary Health we should reintegrate the great (but lost ....) natural science tradition of Alexander von Humboldt - as a scientific method for understanding. Humboldt spent hours and days painting landscapes, animals, birds, etc. in the Amzonas. That's hundreds of pictures. The added value, was that Humboldt found a very deep, holistic view of nature through the long looking and close observation. We should reinvent natur photography as a scientific method of "integrative understanding" in PH..

GDT Nature Photographer of the Year 2021

Atteached there is a manifesto for the "new thinking" - ,see also here:


We have to think how we can bring the sentence in the draft : "It will also require a revival in how we understand our relationship to Nature and to each other." into action also with stakeholder, education and reserach !


Enrique Falceto De Barros Moderator



excellent glocal example!

have you read Videiras de Cristal?

forte abraço,



Enrique Falceto De Barros 

In spite of the vital planetary interconnection of each ground clod, and it seems that international opinion matters little the resistance of a traditional "hunsrich" community in this singular and forgotten foreign immigration bioregion of the extreme south of Brazil - target of repeated cowardly attacks. of world-wide consortia of the so-called "clean energy" (reported in an article to be published soon * Konrath, J. The World Network Biosphere Reserve landscape managente in extreme south Brazil ...), I believe we can communicate in the local language.

"Sim, li quase todo romance histórico-ficcional do Assis Brasil, mas ando atrás de outro mais intimista e prosaico do Prof. João Wendling (A História do Walachai).  A propósito, para o bem da ecologia comunitária do Teewald recomendo fortemente que dediqueis um tempinho a leitura do Relatório PDA192MA (2007) linkado na mensagem anterior, pra entender o quanto uma altimetria de menos de 500 metros, há menos de 80 km da ecotoposfera tóxica da megacidade de Porto Alegre, tem a ver com a saúde ambiental da região com maior densidade populacional do estado". 






Jennifer Cole

The inclusion of actions targeted to specific stakeholders is extremely welcome and will help to ensure planetary health can become operationalised. 

I do feel, however, that there is a group who are being consistently overlooked - lower socioeconomic groups in affluent countries. Peter Hotez has written about "blue marble" health, how the worst health outcomes can be suffered by the poor and marginalised in pockets that sit in the midst of wealth - the homeless, or the displaced - and I think this needs to be tied to "blue marble economics", ensuring we do not place planetary health out of the reach of the economically vulnerable. The poor cannot afford to shop at the organic deli, to be the early adopters of electric vehicles; they are not home owners who have the luxury of choosing to install solar panels; they do not have a garden to plant, Planetary health must not marginalise them and must not overlook them while seeking to support others further afield. The inner cities may not be pretty but they need to be helped to bloom. 

I would therefore focus on an action for Government:

Support and subsidise, where necessary, planetary health initiatives for the urban poor, from community gardens and allotments, to active transport and social housing close to places of meaningful work. Encourage communities to be stewards of their own green spaces, no matter how small, and support their long-term health by improving air quality; availability of, access to and affordability of fresh food not only though markets but also community cafes and kitchen for those who struggle to find time to cook for themselves. Promise a place in planetary health to all, not only those who can afford the best view. 

And also: political terms are short, but the words of great politician live on. The greatest politician of the last century vowed that we would fight them on the beaches. This century, we need to fight for the beaches. We need to fight for the air. Stand for what you think is right, and people will stand with you. 

And for media:

The pen is mightier than the sword. Speak with the emotion that will grab headlines, and be the voice that others do not always have. Question, and probe, and hold to account, and leave no stone unturned. Always speak the truth but speak with a new truth backed by evidence that dissenters cannot challenge. Speak to everyone, and for everyone, wherever a voice is needed.

For the health sector:

Measure health in terms of the absence of disease, not only the quantity of life. We must move away from a metric that identifies success only on longevity to question what constitutes healthy life, and healthy populations, across the life course. Ask hard questions about which was most to blame: SARS Cov-2 or obesity, and address the underlying drivers of vulnerability. Look beyond the walls of hospitals to playing fields that keep children active, to community kitchens where everyone can eat healthily and with friends, look at what makes a community health, not only a body, and heal society as well as individuals. Sending a 'healed' individual back into an unhealthy environment is inefficient and ineffective - create communities inducive to good health. Key to this is community healthcare, local healthcare workers who live within a community, know its members and work to prevent ill-health more than to treat it.  (see chapter attached, from Health in the Anthropocene' edited by Katharine Zwyert and Stephen Quilley. 

Ralf Klemens Stappen

Hello friends,

after all, there are hundreds of such declarations, usually hardly anyone outside is interested in them. They can have a great significance for inside, the planetary health community and I think also for the scientific community, reserach funding and universities. What I would personally like to see is  this is our PH Roadmap to 2030. What we want to achive  and what we hope to get support for. It makes a lot of sense to develop the declaration in perspective - as a vision, mission with a small action program. In my opion, it will take until 2030 anyway for Planetary Health to be truly 100% operationally ready.  We should be very clear about our own goals.

We have a huge  international discussion about the Great Transition (scince 2001 https://greattransition.org/gt-essay  and also very important reports about it from WBGU (up from 2011)https://www.wbgu.de/en/publications/flagship-reports, which are very detailed in all questions, which are mentioned above (see report). We should not go behind ! We also have many documents of the international community, starting with AGENDA 21, AGENDA 2030, etc., where similar demands are made. The core question is what is the new, the special mission/message of the Planetary Health Community is doing to heal our Planety. As far as I remember the community of nations is talking about GREAT TRANSFORMATION (Agenda 2030).

I would say frist something about the history of Planetary Health, about the vision, about what has been achieved by 2021 and what is the new approach of Planetary Health.



Thank you very much I agree we should not just have another declaration that is only another piece of paper being read and circulated in the same networks. we could however have some health arguments reinforced through the COVID outbreak whose origins lie in the destructive way life is organized. and the fact that the disease is not yet "under control" shows that techno- quick fix solutions are not possible

Enrique Falceto De Barros Moderator

Dear Ralf,

your insights make a lot of sense to me.



Ralf Klemens Stappen


The international term (in UN documents and science....) is transform or transformation:

Transforming our world: the 2030 Agenda for
Sustainable Development 

To make a difference (and for new add ons) we could speak concerning " for a need for a:

"Great Health Transition" or

"Great Health Transformation"

that would also fit very well because of Covid-19. Transformation is much stronger (in terms of ambition) than transition - that's more of a scenario logic term.

Ralf Klemens Stappen

Concerning the central questions /task:

"Instead, please focus on recommending action items for the questions and stakeholders listed below..."

we could it make very effective and easy. There will be a very strong statement from the



on Thursday 28 a "Nobel Summit statement – a call for action" where the Declaration could be oriented, from Planetary Health's perspective. This will likely be evidence-based on the latest international scientific discussion, led by world-class institutions and scientist in the field. An interlink could strengthen the Sao Paula Declaration. Richard Horton is participating there as a speaker (I am a normal participant).

They will give a precise answer what actions are relevant now in 2021 and the task here would be to find a link to Planetary Health and the stakeholders.


Look this video from Johan Rockström.....

10 Years to Transform the Future of Humanity—Or Destabilize the Planet


There will be a very strong and outstanding statement, signed from some Nobel Lauretes - also Planetary Health ist mentioned.


Enrique Falceto De Barros Moderator

Dear Ralph,


i do agree the term "transformation" is very appropriate and powerful.

"Transition" was meant to resonate with the title of the meeting.



Carin-Lee Masters

Please do not make the same mistake as many others by excluding mental health and conscious/unconscious awareness initiatives, without a deep sense of awareness of the unconscious and self in context, including dealing with feelings of envy, hatred and aggression (instinctive feelings), we will continue to act these out, project them onto others, and be intent on destroying those we regard as different, insignificant, and 'other', including nature. 

Enrique Falceto De Barros Moderator

Dear Carin-Lee,

As a family doctor, i am very interested in "mindsets".

i am actually developing a paper on how family doctors could address this issue with patients, when appropriate.



Carin-Lee Masters


Enrique Falceto De Barros Great. Considering mental health links need to always be on the 'agenda', as many health professionals are fortunately realising more and more that body and mind (and spirit) are inextricably linked, that we are all inextricably linked too, to each other, nature and our ailing planet.

Mathilde Pascal


Thanks for this very nice initiative. Here are some initial toughts after reading the first draft: 

General: defining planetary health should be a starting point, do not consider that everyone understands it. Also, as a community, how will you make sure that the values of planetary health will be sincere, and not instrumentalized in a kind of greenwashing, as, I feel, it’s the case for One health? (e.g. now with the pandemic old programs are relabeled one health without any changes in their content).

Also, I feel the whole document is a lot about discussion, advocacy... and not really about action. The first pledge should be a pledge to act, not in a general fashion, but in a very specific way. For instance, I pledge to dedicate some of my time to caring for the wildlife of my neighborhood, and this in turns make me evolve as a human being and as a researcher. 

Economists: link with the ideas of planetary economics? cf https://www.kateraworth.com

For international organization => everything here is also true for national organizations

For universities => acknowledge the norms of moderation, and the implicit values of sciences which led to a self-censoring, develop mental health support for the researchers who are observing the destructions of the world, engage with other actors of the society.

I miss a section on public health, it is briefly in the health sector section with prevention and equity, but I think a specific section on public health discussing prevention, the need to collaborate with other professionals (e.g. environmentalists, urban planners), to reduce inequities, develop literacy, empower the most vulnerable, assess the environmental impacts of public health policies, and the health impacts of environmental policies, discuss balance of risk and benefits … would be highly valuable.

I also miss a section on intellectual leaders who are not spiritual leaders, e.g. philosophers. Or maybe they implicitly are under researchers?





Jan Dieterle

Dear all.

First of all, I appreciate the discussions and the different backgrounds of the participants. Thank you for all the work that has already been done!

As a Landscape Architect I would like to suggest to add another category of stakeholder:

  • Urban Planners, Landscape Architects and Architects.

When designing sustainable spaces, we always need an integrated perspective to achieve interactive and liveable environments. We create vibrant living environments with people - for people. I would like to emphasise new synergies of the planning disciplines with the health sector, and others, because an ecologically sound environment is directly related to human health. (see also SDG 11)

Also, it will be important to establish interdisciplinary teaching approaches in building mutual understanding.

All the best


Ralf Klemens Stappen

Some remarks and questions...

I think we have an overlap in the content of section 2 and section 3. Actions are already listed in section 2 - why is this duplication necessary? Section 1 should perhaps be aligned with the vision of the Planetary Health Memorandum  2014 and also the "Call for Action" of the first Lancet Report. We should also not fall behind these documents. Better an answer - what has been achieved ? Where are still important fields of action today (see Lancet Report)? What new mission and message can we formulate in 2021 for 2030? What should the Planetary Health Movement achieve longterm? What are the central mechanisms for the message? 

Part of the declaration could be a kind of new memorandum from 2014.

The Berlin Principles One Health (where some here have contributed) are definitely a guide for the formulation. What is the difference? Where are the similarities ? What can be achieved together with One Health, Global Health Movement, etc. ?

Elena Cromeyer

This is a great start so far. I agree with one of the other comments that we need to break out/be more specific with "health sector." It's a pretty broad sector with several sub-sectors and focus areas. Public health should be an area unto itself and I think it's important to stress that the field of public health should prioritize aligning population, animal and environmental health more effectively. It's a field that tends to really segment these areas singularly. The inverse relationship of environmental effects on human health should be explored and integrated in the field of public health more. This is my research area in my doctoral degree. Most areas of human health are so closely interrelated with the health of the environment and animals. 

Also, I would add the "Food Industry" to the list of stakeholders as I don't think it is fully encapsulated in the agriculture industry. I'm thinking restaurants, grocery stores and other food establishments or places that make, distribute or sell food. These include a very large section of the food industry. 


Enrique Falceto De Barros Moderator

Dear Elena,


We definetly should consider the FOOD SYSTEMS, which is consistently poping up in the literature.



Stakeholder: Goverments.

Intention: Calling for Planetary Urban Transition Drive!

Forgive my poor English.  The call for the St. Paulo's Declaration of Planetary Health is very timely, challenging and panoptical. Certainly, I would have much more to say, but in the face of the emergency action that the time requires, I will  focus on a single point. Althougth the key message of the São Paulo Declaration on Planetary Health recognizes the Agriculture Sector actions as the center of planetary health shift, in terms of our footprint on natural systems,  it is unthinkable to ignore the growing urban environmental footprint resulting from the population influx, which at the turn of the millennium is directed to more than 50% of the population living in large cities, reaching 80% by the end of the 21st century. Knowing that in addition to the generation of atmospheric greenhouse emissions, cement is currently the most consumed product globally. Whereas in addition to natural ecosystems converted into human settlements, other areas of land and water are also subtracted from a number of infrastructures to support the urban way of life, such as highways, waterways, power generation, waste dump, mining, etc.,  it is incomprehensible that public managers are UNAWARE of the basic truth of the need to replace each square meter of natural or semi-natural ecosystems subtracted for urban development by protected natural areas (from the same biome), in the municipality itself or political-administrative macro-region - in the form of a "territorial sustainability duty" to future generations. If that were the case, there would be no need for the parting of mythical, unmanageable and extensive lands of conservation units elsewhere.  

Grateful for the opportunity.

Enrique Falceto De Barros Moderator

Dear Julio,

i feel your english is not worse than mine!


as i stated above, we do need urban planners to prioritize planetary health.

Muito obrigado!


Cristian Leal

Olá! Felicitações a todxs!

Como ator social do setor saúde, com expertise na área ambiental, mais especificamente resíduos de serviços de saúde, minha contribuição se concentrará neste tópico.

Acredito que o setor saúde tem que aderir ao Projeto Hospitais Saudáveis, uma iniciativa da organização Saúde Sem Dano (https://www.hospitaissaudaveis.org/), cujo objetivo é promover a sustentabilidade do setor saúde ao redor do mundo. aqui no Brasil especificamente, vários  membros, representados por hospitais e outros serviços, além de sistemas de saúde aderiram ao PHS. acredito ser um ótimo começo. então vamos promover a adesão dos sistemas de saúde brasileiros a esta iniciativa.

Espero ter contribuído, modestamente, mas efetivamente.




Enrique Falceto De Barros Moderator

Dear Cristian,

thanks for your input.

Health without harm is working closely with us.

They are awesome indeed!



Ralf Klemens Stappen

Enclosed for your inspiration is this statement published today....

Nobel Prize Laureates and Other Experts Issue Urgent Call for Action After ‘Our Planet, Our Future’ Summit (29. April).

Read the full: Statement

Here are some excerpts. .

"We need to reinvent our relationship with planet Earth. The future of all life on this planet, humans and our societies included, requires us to become effective stewards of the global commons — the climate, ice, land, ocean, freshwater, forests, soils, and rich diversity of life that regulate the state of the planet, and combine to create a unique and harmonious life-support system. There is now an existential need to build economies and societies that support Earth system harmony rather than disrupt it."

Planetary health

The health of nature, our planet, and people is tightly connected. Pandemic risk is one of many global health risks in the Anthropocene. The risks of pandemics are now greater due to destruction of natural habitats, highly networked societies, and misinformation....The poorest and most marginalized in societies remain the most vulnerable. The scale of this catastrophe could have been greatly reduced through preventive measures, greater openness, early detection systems, and faster emergency responses.

Our Future

A decade of action

Time is running out to prevent irreversible changes.... How do we lock this in? The following seven proposals provide a foundation for effective planetary stewardship.

  • POLICY: Complement GDP as a metric of economic success with measures of true well-being of people and nature. Recognize that increasing disparities between rich and poor feed resentment and distrust, undermining the social contract necessary for difficult, long-term collective decision-making. Recognize that the deteriorating resilience of ecosystems undermines the future of humanity on Earth.
  • MISSION-DRIVEN INNOVATION: Economic dynamism is needed for rapid transformation. Governments have been at the forefront of funding transformational innovation in the last 100 years. The scale of today’s challenges will require large-scale collaboration between researchers, government, and business — with a focus on global sustainability.
  • EDUCATION: Education at all ages should include a strong emphasis on the nature of evidence, the scientific method, and scientific consensus to ensure future populations have the grounding necessary to drive political and economic change. Universities should embed concepts of planetary stewardship in all curricula as a matter of urgency. In a transformative, turbulent century, we should invest in life-long learning, and fact-based worldviews.
  • INFORMATION TECHNOLOGY: Special interest groups and highly partisan media can amplify misinformation and accelerate its spread through social media and other digital means of communication. In this way, these technologies can be deployed to frustrate a common purpose and erode public trust. Societies must urgently act to counter the industrialization of misinformation and find ways to enhance global communication systems in the service of sustainable futures.
  • FINANCE AND BUSINESS: Investors and companies must adopt principles of recirculation and regeneration of materials and apply science-based targets for all global commons and essential ecosystem services. Economic, environmental, and social externalities should be fairly priced.
  • SCIENTIFIC COLLABORATION: Greater investment is needed in international networks of scientific institutions to allow sustained collaboration on interdisciplinary science for global sustainability as well as transdisciplinary science that integrates diverse knowledge systems, including local, indigenous, and traditional knowledge.
  • KNOWLEDGE: The pandemic has demonstrated the value of basic research to policymakers and the public. Commitment to sustained investment in basic research is essential. In addition, we must develop new business models for the free sharing of all scientific knowledge.

What stands out is the time factor (SPEED) - 10 years left to us. Planetary Health is also defined more broadly, also in connection with COVID 19. In total, Health is mentioned often. The statement speaks more often of transformation towards sustainability, etc..

Which would certainly make sense if we prefaced the declaration with a short preamble (with vision, values, a short history, state of the movement...).


I have attached an example

    Enrique Falceto De Barros Moderator

    Dear Ralf,


    Nobel Prize Laureates  are highly relevant to the scientific community.

    their call definetly must inform the Sao Paulo Deaclaration.

    thanks again,


    Alana Lea

    Please consider the addition of the following statement in the Agricultural sector: 

    We fully support the "4 per 1000: Soils for Food Security and Climate" Initiative,” knowing that over 33% of the world’s soils are threatened by soil degradation while climate change is accelerating this process. An increase in soil carbon stock through an increase of soil organic matter could reverse this process and promote adaptation to climate change with multiple co-benefits. We recognize the role that forests, agroforestry and trees in the landscape play in the build up and conservation of soil carbon. We recall that farming practices, soil health management systems and landscape development that enhance soil carbon, such as agroecology, contribute to the preservation of natural resources and biodiversity. 

    Enrique Falceto De Barros Moderator

    Dear Alana,

    deforestation is indeed a key issue.

    please look at Health in Harmony, an important partner, and their work in raising this issue.

    FOOD SYSTEMS are a priority.


    Alana Lea

    Enrique Falceto De Barros I completely agree with you regarding the importance of Food Systems. As a member of the 4p1000 Consortium which was formed at the Paris COP21, I have come to have a deeper understanding of the necessity to focus on SOIL health for FOOD and HUMAN health. It is completely interconnected. It would be wonderful to see more organizations join efforts, it's not a competition -- all win if we can get the existing systems to change. Like PHA, 4p1000 is comprised of educational institutions, scientific bodies, NGOs and FARMERS who work toward the same goal. My experiences in Brazil over the last decade were quite disheartening in so many ways until tapping into the network of people doing agroforestry. Instead of clearing forests to make way for GMO soy (now being used to replace meat), we can preserve and restore forests WHILE growing food that is actually nourishing. 

    Alana Lea

    Please consider the addition of the following statement in the Artists, Poets, Writers and Musicians sector: 

    Inspire the public to participate in the transition to a truly regenerative future, by showing them what this looks and feels like, while adding concrete actions people at all levels can take without further delay.

    Since this is my main area of focus and involvement, I'm adding the link to a video that is featured in the PHA Festival, on the schedule for April 30: https://youtu.be/BwD3xo2vcjI

    Enrique Falceto De Barros Moderator

    Dear Alan,

    we will consider your suggestion.

    i am an enthusiast of the role of art in leading the cultural changes needed.

    best wishes,


    Anna Maria Stewart Ibarra

    Science/research funding agencies

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

    Design innovative calls for grants through a consultative process with stakeholders that includes diverse stakeholders from a global community.

    Allocate funding for the transdisciplinary science needed to support planetary health, including long term funding needed to support monitoring/surveillance of global change processes, funding to support policy and stakeholder engagement processes.

    Decolonize science by designing calls for grants where the science is driven by local communities/end users through co-design and other processes.

    Include open science/open data clauses in grant agreements to promote sharing of knowledge.

    Place planetary health as a cross-cutting priority area on the global science funding agenda.

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

    Require funded projects to be solutions driven, with policy makers/end users involved in the project development and co-design processes.

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

    Fund private-public partnerships. Involve the private sector in planetary health collaborations by requiring co-funding. Include private sector partners in co-design processes. 

    Engage with the private sector when developing grant call text, to ensure that funding priorities align with private sector needs/perceptions. 

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

    Engage with the public when developing grant call text, to ensure that funding priorities align with local needs/perceptions. 

    Require funded projects to conduct outreach and to design communication toolkits, especially for schools and children in areas where the work is ongoing. 

    Jessica LeClair

    Thank you for your work on this draft!

    My comment is for the health sector, researchers, and higher education,

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

    Refer to the Planetary Health Education Framework that offers a guide for planetary health education and scholarship, centering humanity's Interconnection within Nature. The Declaration on Planetary Health must also center this interconnection and move away from its anthropocentric focus. If we prioritize only human health, then any strategies we create for the Great Transition will be partial and ineffective. Let's introduce students and colleagues to kincentric approaches to planetary health education that support diverse ways of knowing and support healthy relations between humans and more-than-human worlds. 

    Marya Zlatnik

    Thank you for the opportunity to add my voice.  As a healthcare provider and health professions educator, I heartily agree with points made above by Leslie Solomonian and others regarding #7 and #8.  I would add that those of us in mainstream healthcare should lean into efforts to "Care Wisely" or "Choose Wisely" as promoted by the ABIM (https://www.choosingwisely.org/ ) or by agencies such as USPSTF or NICE. As individuals, we can decrease the carbon footprint of the healthcare that we provide by not engaging in care (ordering labs, radiology studies, medications, surgeries, or treatments) that does not improve health and increase health costs both financially and in terms of planetary health. Furthermore, we can teach this thinking to trainees and to patients.

    Giselle Mesiara

    Dear all,

    As a native Brazilian from Sao Paulo and  Global Health and Sustainability professional, I would like to contribute with the attached recommendation letter, to be analyzed and included in Section 3 of the Sao Paulo Declaration on Planetary Health for All.

    Thank you for this opportunity,

    Kind regards,

    Giselle Medeiros Mesiara.



    Ralf Klemens Stappen

    Thank you for your strong statement! I agree with many and understand you. We really need more manual work, complex PH interventions. Science has produced thousands of tons of studies in the last years - the diagnosis is clear, what we need are millions of intelligent PH interventions - evidence based. This is the core of Planetary Health, the focus on practice (see also the excellent book by Frumkin and Sam Myers). Therefore I like this approach.

    What became clear to me after your statement - we need to show a DIFFERENCE, and for that we should definitely integrate new healthy META PARADIGMAS  like natural-based solutions, circualr economy, sustainable healthy cities (WHO,C40, ICLEI), organic food (IFOAM), economy for the common good, integral ecology (Laudato Si), etc. - which already have comprehensive solutions  and connect with them. We don't have to reinvent the world.I think we should acknowledge that.

    What I like very much is e.g. The new paradigm HALF-EARTH by Edward O.Wilson - to devote half the surface of Earth to nature.....

    Many stakeholders and professionals are already working actively on healthy solutions for the Earth. I would also count myself among them - we really have many very strong and effective approaches (therapies) and in part goes far beyond what is currently on the political agenda or mainstream. E.g. organic food is as far as I remember not part of the SDGs and Agenda 2030! 

    Let's discuss this all in detail.



    Giselle Mesiara

    Ralf Klemens Stappen  FYI, I just reviewed my recommendation and made small adjustments. Thanks for the shared material, very interesting!  It is great to see so many people with the intention to heal our planet and so do I.  About your comment regarding organic food and the SDGs, I believe it is somehow under goal number 2 End Hunger, once its statements mention "Achieve food security, and improved nutrition and promote sustainable agriculture".  And big "YES", it is necessary to have much more investments in planetary health projects implementation. As you mentioned, I also see tons of published papers and researchers presenting in conferences to other researchers their work. But how about implementation?  I'm a hands-on interventionist, a Health Planetary project implementer and I see no available work or investments for action in my area. It is very frustrating and unfair!

    Ralf Klemens Stappen

    Giselle Mesiara 

    Sustainable agriculture was already a big topic in Agenda 21, 1992 - there is already a very, very big difference to organic agriculture. Even agrobusiness call there farming sustainable....

    As far as the second point is concerned, we might need a Planetary Health Professional / Operation or Implementation Framework, analogous to the Planetary Health Educational Framework, where it would be a matter of creating new jobs and functions in all areas of the state, authorities, NGOs, foundations, etc. It makes no sense to train young people who cannot use their new knowledge later.The practice usually needs highly specialized experts, less generalists (even if this is important), we have to identify the qualifications, permanently educate and take care of qualified job development. I understand the frustration. In order to change this, we would have to proceed very professionally and strategically. So far, there are very few jobs, although the need for implementation is very great. Maybe we should start such a Framework in Hylo - what do you think ?


    Ralf Klemens Stappen

    Giselle Mesiara 

    I thought about it. It's all about transforming Planetary Health into concrete operations, interventions and decisions. That is the primacy of this approach. Research, education and practice must go hand in hand. At the moment the ratio of professional practitioners to research and education is maybe 1 to 100, there are first small approaches - but we are far away from saying that PH is operational. And if we are realistic, it will probably take another 10 years - that doesn't mean we don't need to start now. We really have to think very carefully about where the future fields of practice are, I have a whole series of fields that immediately come to mind. For example, last year there were many flood catastrophes in India, Central America, Southeast Asia, and Africa - we need new instruments to take effective precautions here, e.g. through climate adaptation, climate protection, local early warning systems, but also rapid emergency aid.  For the local level - but it also needs new regulations in the question of compensation (this is currently being discussed in the Warsaw Protocol!). There we are considering a project - where new PH instruments could be developed.  Another area is the transformation of cities and municipalities. But these are only two fields out of many. We have to approach this systematically. What we can do (here some suggestions) - until the next PH Assembly at Harvard is:

    1. Find like-minded people - who are interested. I form project in https://www.hylo.com - Are you already in it ?

    2. Identify future areas of operation, and what skills, tools, and training are needed to implement effective problem solving. Where are the current and future bottlenecks?

    3. Conduct demonstration projects around the world to practice the new practice.

    4. We need to develop, discuss, and build a broad consensus of the Planetary Health community on an operations roadmap.

    5 .........

    Let`s go on....wow, I even could create a new group. It would be good if you also became a moderator !

    Denise Galvin

    Thanks to everyone involved for the great work so far, but obviously we are only taking baby steps.  With this groundswell of acknowledgement that indeed we are in trouble the following could constitute a  KISS and sustainable first step -

    For Government - develop the space to engender truly collaborative dialogue with Civil Society to establish a set of Well-Being Indicators at national level.  These Indicators should be related to the achievement of the SDG 2030 Agenda and the dialogue must be on-going and two-way, viz put reliable monitoring and feedback mechanisms into place and review the process of collaboration and the Indicators perhaps initially on a bi-annual basis.


    These Indicators should be used to guide policy-making at all levels and form the basis of a Well-Being Charter of Agreement between a government and its citizens on how best to restore the Planet with sustainable actions and interventions at national, regional and local levels.  We did it with the Rio Declaration why can't we do it again?


    Many thanks again for the opportunity to contribute to this ground-breaking event.


    Ralf Klemens Stappen

    Thank you for your idea with the indicators -but this has been realized long ago, also with the civil society - I was involved myself (among others also as a delegate of the "Rio+20" -UN Conference on Sustainable Development). We have many SDG indicator systems from global, national to local level. Some examples.

    The SDG Index 

    SDG Index & Monitoring
    Tracking progress on the Sustainable Development Goals

    special look this: https://worldhappiness.report/ 

    and this

    That was a central idea of Jeffery Sachs, to metricize sustainable development incl. health - we are very advanced in that today.

    Denise Galvin

    Ralf Klemens Stappen thank you and I do notice that there is a recent addition -November, 2020 -  outlining the progress being made in 100 cities of Spain (where I live).  This is great stuff but unless we can actually find the way to embed a two way dialogue at national level then it seems like the desired change is still a distant aspiration. 

    For example, despite the efforts being made here to integrate SDG goals at national, regional and local level we now have another urgent obstacle in the form of how member states use the EU Covid-19 Recovery Funds.  According our Prime Minister the aim is to make Spain the recycling frontier of the EU and to advance us towards a Green Economy through exponential growth in Renewable Energy going into the national grid. 

    I can't comment on what is happening with recycling but I do know first hand that the funds directed to Green the Economy are being handed out to multi-nationals, national companies involved in Renewable Energy infrastructure provision and that what is happening is tantamount to Green Washing with Solar Parks springing up everywhere even in nature reserves.  On top of this the jobs to be created to achieve this objective in having Spain less reliant on nuclear energy and more renewables feeding into the grid are largely temporary.  Unless we can find the way to embed a two way dialogue between those who govern and those impacted and also to make the concept of Well-Being a fundamental plank of development of any kind - I am still not convinced about Happiness Indicators it seems like an esoteric concept for  ordinary citizens to understand - then it is not clear to me at least that we are the winning struggle to restore the Planet.

    Ralf Klemens Stappen

    Denise Galvin 

    Dear Denise,

    I'm beginning to understand what you're saying. You want more room for the citizens' participation in government, participation in policy-making. It frustrates you how the future is planned, perhaps gambled away. That is unfortunately the fate of representative democracy.

    There are very strong models like direct democracy in Switzerland, but also models like participatory democracy like in Bavaria - where citizens in municipalities can actively shape long-term politics.

    I can understand your frustration with dubious, perhaps irrational top-down decisions, you want more bottom-up.  If I'm honest, we may have to rethink the concept of states as a whole, how citizens and the state interact with each other. I also prefer the term citizen instead of civil society, because citizens are the sovereigns of the state - and civil society is important, but there are only a few organized citizens. I know only a few very few approaches here, interestingly one from a monarch, the Prince of Liechtenstein. He wrote an interesting book (The State in the 3 Millenium), with revolutionary ideas, also on direct democracy (in Liechtenstein they can even vote the monaachie out), with a very strong decentralized, community-focused approach.

    Central to this, the citizen gets more rights - to help govern the state. Not simple statists.  He said the state should serve the people - not the people serve the state -look this video.

    He also founded an institute at Princeton University - it's about empowerment.

    To the end thought should we health and well-being generally - as a central basic principle in the constitution should anchor - in all states and cities, etc.. with indicators alone - we will not solve...these are very thick boards, no baby steps- but I think we really need to redesign the whole state philosophy, including Planetary Health - to solve this problem in Spain.


    Denise Galvin

    Ralf Klemens Stappen 

    All those examples are great however Spain has a population of 40+ million and Switzerland approx 9 million.  There is a certain amount of Spanish disdain towards the amount of money that Switzerland spends on referendums and this is probably related to the fact that Spanish citizens are not as affluent as their Swiss counterparts - which I link back to the concept of well-being - and there are more pressing problems here like high across the board unemployment rates.  In fact, I would think that citizens of Lichenstein and Bavaria would also rate as being more affluent than the average Spaniard.  This leads me back to well-being in all facets of life.  

    I do not have the answer because the role of the state is and always has been enshrined in a non-linear discourse. My aim was just to initiate debate.  I will end with this example: I remember in my undergrad course The Politics and Ethics of Environmentalism we were tossing around the idea that if you didn't have enough money for food  your urgency would be on how to feed yourself and you really wouldn't have the energy to engage in a debate about de-carbonisation or any of the other issues relevant to the health of the planet. Hence my focus on well-being harking back to Maslow's Hierarchy of Needs.

    Thanks for all of the good work here.

    Hiroto Ide

    I would first like to express my deep appreciation for your very great proposal!

    As a curriculum researcher and practitioner of primary and secondary education and higher education in Japan, I would like to make the following suggestions for this declaration.

    My opinion is directed to expressions for Stakeholder 15 "Universities and other educational institutions", 6 "Governments", 9 "International Organizations", and 12 "Researchers".


    I understand that this declaration focuses primarily on higher education. I basically agree with this choice.

    On the other hand, with regard to the reform of the curriculum for primary and secondary education, I would also like to recommend the addition of some wording to promote planetary health education.

    In primary and secondary education, an increasing number of learning programs are based on the design of integrated curricula, particularly in the areas of learning where children contribute to the SDGs. I am convinced that Planetary Health Education is compatible with the SDGs, and that access to Planetary Health from the primary education level is sufficiently possible if curriculum design and management are carefully considered and implemented.

    But I also understand that the reality of primary and secondary education is different in each country, region, city, and rural context. Some schools have the authority to organize curricula, while others have national curricula that are strongly binding on the state.

    I think the important thing is to boldly expand planetary health education, whatever the various circumstances, while adapting it to each context.

    In this regard, I would like to suggest the addition of a text that can be interpreted in a variety of ways and the promotion of starting some kind of action at the level of international organizations and governments (national and local).

    I also think it is important to research and develop a Planetary Health Education curriculum to train teachers who can connect primary and secondary education with higher education. Based on the characteristics of teacher education (training and on the job teacher training), which bridges the gap between subjects in schools and academia in universities and research institutions, I think it is important to build a sustainable system of succession for planetary health through education.

    Annie Mitchell

    my comments are recommendations/ suggestions for actions for  ( but not restricted to) health professionals and the health sector


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

    a) Draw on wide and diverse understandings of ethical values and priorities, beyond those of westernised disciplines, to explicitly include the particular values and priorities and interests of women, children, people with disabilities and  members of indigenous and marginalised communities.  Incorporate ethical responsibilities for planetary health in professional codes of conduct and ethics  - as  has been done (but we need to  go further)  for the British Psychological Society in 2018  https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20F… 

    which states  

    "The discipline of Psychology, both as
    a science and a profession, exists within the context of human society. Accordingly, a shared collective duty for the welfare of human and non-human beings, both within the societies in which Psychologists live and work, and beyond them, is acknowledged."


    b) As others have said very well, revise health programme curricula and intended learning outcomes ( and assessment criteria)  to strongly incorporate issues of planetary and ecological health and justice, complexity, power, threat and meaning, and inter-disciplinary partnership. . 


    c) Build attention to planetary health issues into all processes of health care provision governance, at personal and collective (policy) levels  

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

    Engage with social and politically progressive and environmentally aware activism,  and encourage learners to do so too.  Build planetary health awareness into conversations with colleagues and clients.  Use their vote.  Contribute to any opportunity to respond to policy consultations about climate and ecological concerns, and encourage others to do so too.  Push for demonstrable commitment and action from professional bodies and unions. Be  (visibly) strong values- based role models,  while not judging, but rather supporting and understanding, those who do not have the resources to make personal life style choices without systemic change happening first.  

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

    use their personal and collective financial powers eg to campaign for pensions and banking disinvestment; be discerning and strategic  about own spending. 

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

    Support processes of public engagement such as Citizens' Assemblies ; learn  about, and draw from knowledge of, processes of social change and follow the evidence about how to effectively engage with peoples' differing values and priorities, as exemplified for example in UK by the British Talks Climate research https://climateoutreach.org/reports/britain-talks-climate/ 

    Fabiana Schiavon


    Sou jornalista e estou tentando acompanhar a conversa. Mas para chegarmos na mídia, precisamos de dados, números de qualquer tipo. 

    Não identifiquei nada no material, mas se tiverem insights, ideias, mandem, por favor?



    Enrique Falceto De Barros Moderator

    Prezada Fabiana,

    a linguagem da declaração é mais no sentido de roadmap.

    dados nao faltam.

    caso queiras conversar, podes me mandar um email enriquequefbarros@gmail.com

    a mídia é fundamental.



    Elina Drakvik

    Thank you for this wonderful and important initiative! I focus here on the first two questions, at least for now (I am working in research management and science-to-policy interface).

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

    Research and research funding:

    Dedicated funding is required, understanding the scale of the challenges and promoting systems- and solutions-oriented approaches to these interconnected global problems including climate change, biodiversity loss and global environmental change, global pollution as well as inter-linkages with food systems and ecosystems health and how these all are affecting both human health and the environment, including animal and plant health. Funding agencies, cities, governments and international organisations should not only fund but also participate in these types of interdisciplinary research projects at various levels  (local, national, regional and international levels), and that would include not only researchers but a broad range of stakeholders, from academics to responsible businesses, health and various other relevant sectors, citizens and civil society, including vulnerable groups. This broad participation would help implementation and operationalisation of feasible solutions that have ownership, legitimacy and transparency embedded through participatory research, co-design and communication and awareness raising efforts.  

    However, it should be highlighted that only this type of research will not be sufficient. Broader scientific advances and scientific preparedness is needed in areas that support breakthroughs in fundamental research (basic research) in the fields of health and environment. Fundamental research and international collaboration have been critical to the response to COVID-19, and they will continue to be essential in helping to solve current and future threats both at local and global scale.

    Furthermore, more research and innovation funding should be directed to radical and transformative societal and technological innovations that support planetary health and that do not seek only incremental improvement but which are truly based on state of the art and beyond. Although incremental knowledge has a significant role to play, the problem becomes more tangible if/when incremental research projects have competitive edge only because they are compatible with the existing system and regulatory environment in the health and environment field, adding something only on top of it and hence, supporting “easy uptake” to policies – not questioning or altering the system itself even when it is flawed or outdated. So also here discussions with stakeholders, and between policymakers and researchers, are important to agree on direction and "degree" of changes required.

    Education system:

    Integrating and operationalising interdisciplinary and transdiciplinary education and skills on planetary health is necessary at all levels, including primary and secondary education. This includes involving broader education sector and co-designing teachers’ education and training materials as well as school materials that are appropriate for specific age groups and contexts. This could include also innovative immersive learning experiences via virtual reality and gaming that may be attractive channels for younger audiences.  

    Quality education supports development of value and norm system as well as may inspire to behaviour change towards sustainable and healthy choices at individual, family and community level. Children and young people may also be more receptive to changing their behaviour, educating their own parents and peers. Furthermore, it may be useful to learn from other initiatives using participatory approaches to include children and young people in drafting and developing solutions that will have direct impact in their own lives and furthermore, and provide best practices and concrete examples how to communicate in ways that bring hope.

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

    The increasing health and environmental risks from climate change, environmental degradation, pollution and biodiversity loss need to be urgently tackled. The focus should not be on symptoms alone, but consider the drivers and inter-dependencies - how we organise our living, in cities, communities and societies at large, in a sustainable manner. Bold decisions will be needed from decision-makers, short-term wins should not prevail over long-term benefits. Involvement of citizens and various stakeholders will be necessary to discuss and debate in a transparent manner both costs and benefits and short- and long-term consequences, solutions as well as needed behavior (and value) changes towards sustainability and thriving, good life.

    Governments should take decisive international collective action and enhance cooperation on planetary health (as well as related initiatives on One Health, Eco Health, One Sustainable Health), and this more holistic/systemic approach should become mainstreamed in all policies, combining implications related to human health, environment and climate from a sustainability perspective and putting health and well-being (in a broad sense) at the centre of policies. This could mean e.g. developing and applying the “well-being economy” (https://wellbeingeconomy.org/ ).

    More practical examples could be e.g. adding sustainability related criteria to public procurements, as well as developing legislation towards “Safe and Sustainable by Design” in relation to materials and chemicals used in our everyday lives, and promoting their circularity (both through regulations and incentives).

    Best regards,

    Elina Drakvik 

    Kerstin Damerau

    First of all, thank you very much for your efforts on preparing this declaration!! 

    I skimmed over the numerous great comments, and here are my 2 cents:

    Regarding businesses, I think it would be great to edit this paragraph a bit and make it somewhat clearer that to reach planetary health we need businesses/corporations to take responsibility for their impacts globally. Often, corporations like to deflect by shifting blame to consumers or (foreign) governments, especially in regard to their internationally outsourced operations. This links to a previous comment on the role of low- and mid-income populations. We need systemic change as you underlined very well. To do so, we cannot expect vulnerable population groups to promote/generate this change, but rather those who keep them within current socio-economic conditions.

    E.g. with respect to greenhouse gas emissions, we (scientists/media/government) like to compare national GHG statistics as if their respective population were to blame rather than disclosing and comparing the largest emitting corporations, no matter where their emissions occur.



    Elina Drakvik

    Hi Kerstin!

    I agree, tricky indeed. Your comment is also topical in light of the recent Guardian article that discusses the power of a few dominating actors behind a third of carbon emissions: https://www.theguardian.com/environment/2019/oct/09/revealed-20-firms-third-carbon-emissions. We definitely need this type of research and investigative journalism (linked to role of media).

    Also, a recent study related to financial giants is highly interesting as their actions can play a significant role for climate stability. According to the study (see the link below), a handful of international investors influence the stability of some of the world’s largest forests and hence the global climate. Financial institutions have a key role to play, not only in terms of redirecting investments to renewable energy and low-carbon businesses, but also to bolster the resilience and stability of the Brazilian Amazon and boreal forests in Russia and Canada, two known ‘tipping elements’ in the Earth system. These ‘Sleeping Giants’, if awakened, can have pivotal impacts on the global climate by becoming large-scale emitters of carbon dioxide, as opposed to storing carbon in soil and vegetation. Here is the link to the news and the published article: http://www.gedb.se/news/publications/188309

    Best regards,

    Elina Drakvik


    Liudmila Liutsko

    For Educational purposes, I'd also suggest to work on it at ealrier stages, before universities, meaning incorporating in the content of the educational programms, in the kindergarden, primary and secondary schools; and, of course, linked to the relevant decision-making bodies - ministry of education, etc.

    Tara Tolhurst

    Some ideas for what actions Spiritual Leaders of All Faiths can take to influence the public particularly to achieve the Great Transition:

    • Incorporate and emphasise our interconnectedness to Nature and to each other, as well as environmental justice, into community discussions, activities and talks, helping people to relate and connect to Nature
    • Do theology on Nature and environmental justice, and find links in scriptures and holy writings to reflect on our relationship with Nature and others
    • Encourage and demonstrate practical actions for caring for Nature and each other in faith communities
    • Create and distribute resources for people of faith to engage with caring for and connecting to Nature and each other and for supporting the effort to achieve the Great Transition
    Ralf Klemens Stappen

    I agree in principle - but we should not forget the institutions either. There are tens of thousands of religious schools of all religions alone. The Catholic Church alone has one of the largest health care and educations systems in the world (the largest healthy system in the USA !) and there are over 500 Catholic universities. Regarding interconnectivity, there is partly a real paradigm shift with Laudato Si - Planetary Health is already on the agenda, at least in the Catholic Church.

    • World religions should use all their capacities to support Planetary Health on all levels.
    • Religious and spiritual communities should use their universities and schools for the education, training and study of Planetary Health.
    • They should be a planetary health leader for environmental and sustainability management systems in their institutions like hospitals, kindergarden,  etc..


    Saulo Barboza

    Dear all,

    Please consider adding one more stakeholder to the list: Sport and Physical Activity Community.

    Sports and physical activity can be powerful avenues for mainstreaming planetary health. Regular physical activity helps in the prevention and treatment of noncommunicable diseases (NCDs), improves mental health, quality of life and well-being. Societies that are more physically active can generate additional returns on investment including reduced use of fossil fuels, cleaner air and less congested, safer roads. Such benefits are highlighted in the WHO Global Action Plan on Physical Activity 2018—2030. This plan is in synchrony with the 2030 Agenda and its implementation can contribute to achieving 13 of the 17 sustainable development goals (SDGs).

    Further, sports and physical activity function as high-impact vehicles for humanitarian, population development, and peace-building efforts worldwide; and have been influencing research and education, policy changes, the private sector, and the public (question 1—4) throughout history in different ways. Bridging planetary health and the sport and physical activity community seems to be an important step towards the Great Transition.

    Those would be some initial thoughts to add such community as stakeholders in this Declaration. Happy to discuss this further.

    All the best,


    David Lopez-Carr
    • What actions can the below stakeholders take to influence research and education to achieve the Great Transition?

    Governments can catalyze funding Great Transition ideas by providing seed funds for doctoral dissertations on Planetary Health topics. Education policy should emphasize meeting the SDG for educating all children in K-12, especially girls. Health Ministry workers can have a ripple effect by training regional health workers to train local health workers.


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

    A united front is needed from all stakeholders to hold government accountable. Grassroots organizing, educational campaigns, and sending letters to congress are all important actions.


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

    The private sector needs to see that doing their part in the Great Transition is also good business and that showing their good works is the best advertising. To the extent their are news stories on these actions, the publicity is free. This is a win-win.


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

    The academic community must focus on critical and integrative thinking. Lawmakers must push a Great Transition Agenda. Healthworkers must spread the word wherever they work. The media must report responsibly.



    Flavia Virginio

    Dear all, firstly I would like to apologize my delay, and consequently it was impossible to me to read all the discussion. But if it is possible to contribute yet, I would like to suggest that we think about to submit a paper in the "Scientists warning" style.  

    Flavia Virginio

    In addition, I consider that it is important to add in the document as a whole, the message of the importance of a D&I (Diversity and Inclusion)  in the committees, groups, teams.. I say it because several studies have been highlighted that diversity improve any team. In other words, if we contemplate different ethnical, gender people, consequently different life experiences and think configuration. 

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