Our Planet, Our Health Contents

6Governance for planetary health

Global Action

184.Whilst many of the impacts of planetary health transcend national boundaries, local action and governance can be effective. Professor Georgina Mace, UCL, noted that there was “not really any effective global governance of the environment at the moment”.312 She stated that the United Nations Framework Convention on Climate Change (UNFCCC) is “an important force” and reflected that this was because climate is “an interconnected global system”.313 However, Professor Mace said she was not convinced that international governance was needed:

We can do an awful lot with better national governance of local environmental problems. A lot of the things we have talked about—biodiversity, insect declines, water quality and air quality—can be managed nationally.314

185.The Government has announced an independent review of the link between biodiversity and economic growth, led by Professor Sir Partha Dasgupta. The review intends to report in 2020, ahead of the 15th meeting of the Conference of the Parties (COP15) to the Convention on Biological Diversity (CBD) in October 2020.315 This is an ideal opportunity for the UK to show international leadership on the protection and governance of biodiversity, and we urge Prof Gupta to consider the relationship between biodiversity and interconnected planetary health concerns, including food security and urban planning.

Leadership

186.The UK was the first Government to legislate for climate change targets in 2008,316 and is the first major economy to set legally binding net zero emissions targets.317 As UPSTREAM noted, the UK Government should “communicate clearly the threat posed to our society from climate change and planetary health”.318 The public should know about the dangers from environmental damage posed to their health and the environments that they live in and depend on for survival.

187.The prospect of the UK hosting the 2020 UN Climate Change Conference provides another opportunity for global leadership on this issue.319

188.To tackle the urgent concerns relating to public health, food security and the environment raised in this planetary health inquiry, strong national and international governance is required. Continuing the global leadership shown by legislating for net zero emissions by 2050, the UK Government should now highlight planetary health at forthcoming international meetings, including the 2020 Conference of the Parties to the Convention on Biological Diversity. As host of the 2020 UN Climate Change Conference (Conference of the Parties) the Government should ensure that planetary health is a key theme of the discussions.

Cross-departmental working

189.A theme of our inquiry has been the need for cross-departmental working. Professor Ian Boyd, Chief Scientific Adviser, DEFRA, used air quality, and DEFRA and the Department for Transport’s Joint Air Quality Unit, as an example of needing to be “very aware of other departmental interests”.320

190.In particular, the Ministry of Housing, Communities and Local Government (MHCLG), Department for Environment, Food & Rural Affairs (DEFRA), the Department of Health and Social Care, (DHSC) and Department for Transport (DfT) need to work together closely to ensure that the future of living in cities in the UK is healthier and more sustainable. We were therefore concerned to hear that there had been no Chief Scientific Adviser in the MHCLG for seven years, although an appointment has now been made.321

Operating in silos: health organisations

191.A major concern amongst witnesses has been the tendency for departments and decision-making organisations to work in silos. Dr Richard Horton, the Lancet, expressed frustration that even the healthcare bodies were not interacting with each other:

In terms of the vision across our health infrastructure just think about it. We have a dozen or so royal colleges. We have the British Medical Association. We have a CMO [Chief Medical Officer]. We have Public Health England. Are they working together in a coordinated fashion? The answer is “no”. The Chief Medical Officer does fantastic work but she is utterly disconnected from the work of Public Health England. Our colleges are utterly disconnected from public health. This is no way to run the health system.322

192.A lack of co-operation contributes to a fragmented, and therefore weakened voice from health organisations when advising the Government on issues such as planetary health.

Data sharing

193.The UK possesses a huge wealth of knowledge about the environment, but not enough of that data is available to health organisations or medical professionals. Professor Lora Fleming, University of Exeter Medical School, told us that:

There are huge amounts of environmental data out there—things like the Met Office, world famous, fabulous data—but how do you link that up with human health data and how do you train people to be able to work with these huge datasets linking up variables that traditionally are not analysed as such? There is almost a research and training gap there to prepare people to really be able to look at things on a planetary scale from an analysis point of view.323

194.There is a role for Government to play in ensuring that the data is shared appropriately. Professor Howard Frumkin, Wellcome Trust, told us that:

As a governance issue, what that may mean is directing or incentivising the owners of different databases to get those databases to be interoperable and then to perform the analytics that are needed.324

195.We heard evidence that the Government is using data for health-related work. Professor Charlotte Watts, Department for International Development (DfID), told us that it was “doing a range of activities to respond and to support countries to respond to what we foresee as the extreme impacts of climate change”,325 and that DfID was “using data to understand what might be future rainfalls, risks of flooding, what might be the flow of a river and what might be the next round of infectious disease spread and how we ensure that the programmes we are supporting are aware of what is coming ahead and are responding effectively”.326

196.We note that Government departments and agencies are increasingly seeking to share data and work together to tackle planetary health concerns. However, more needs to be done. Improving public health in the UK while improving the environment will require significantly improved data sharing and cross-departmental working in the future.

197.To ensure cross-government working we recommend that the Government ensures single point accountability for planetary health at both ministerial and senior civil service levels. The Government should also establish a forum or joint unit to manage planetary health across Government. To support these meetings, health leaders and organisations must be in attendance: the Chief Scientific Advisers, Public Health England and the Chief Medical Officer all have a major role to play in providing advice on this crucial matter.

198.We find it extraordinary that MHCLG had not had a Chief Scientific Adviser for 7 years, especially given that UK buildings are a source of significant harm to public health and make up nearly a third of the UK’s carbon footprint. We note the crucial importance of scientific advice in policy making and support the Chief Scientific Adviser network in their excellent work. We recommend that the Government Chief Scientific Adviser (GCSA) assumes responsibility for oversight of the Chief Scientific Adviser network to ensure that such personnel gaps do not happen again. The GCSA should also ensure that the Government’s digital service makes its data available to researchers to map hunger, obesity and poverty so they can be incorporated into emerging policy solutions. The next round of research funding should include an element of planetary health research to combine the strong evidence base and expertise in this area from the UK research community.