Great progress has been made in addressing global undernutrition over the past several decades, in part because of large increases in food production from agricultural expansion and intensification. ...Food systems, however, face continued increases in demand and growing environmental pressures. Most prominently, human-caused climate change will influence the quality and quantity of food we produce and our ability to distribute it equitably. Our capacity to ensure food security and nutritional adequacy in the face of rapidly changing biophysical conditions will be a major determinant of the next century's global burden of disease. In this article, we review the main pathways by which climate change may affect our food production systems-agriculture, fisheries, and livestock-as well as the socioeconomic forces that may influence equitable distribution.
Antibiotic resistance is a global health crisis linked to increased, and often unrestricted, antibiotic use in humans and animals. As one of the world's largest producers and consumers of ...antibiotics, China is witness to some of the most acute symptoms of this crisis. Antibiotics and antibiotic resistance genes (ARGs) are widely distributed in surface water, sewage treatment plant effluent, soils and animal wastes. The emergence and increased prevalence of ARGs in the clinic/hospitals, especially carbapenem-resistant gram negative bacteria, has raised the concern of public health officials. It is important to understand the current state of antibiotic use in China and its relationship to ARG prevalence and diversity in the environment. Here we review these relationships and their relevance to antimicrobial resistance (AMR) trends witnessed in the clinical setting. This review highlights the issues of enrichment and dissemination of ARGs in the environment, and also future needs in mitigating the spread of antibiotic resistance in the environment, particularly under the ‘planetary health’ perspective, i.e., the systems that sustain or threaten human health.
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•Antibiotics and ARGs are widely distributed in environment media in China.•Antibiotic resistance varies geographically in China.•Strategies to mitigate the spread of antibiotic resistance are suggested.
The concept of planetary health acknowledges the links between ecosystems, biodiversity and human health and well-being. Soil, the critical component of the interconnected ecosystem, is the most ...biodiverse habitat on Earth, and soil microbiomes play a major role in human health and well-being through ecosystem services such as nutrient cycling, pollutant remediation and synthesis of bioactive compounds such as antimicrobials. Soil is also a natural source of antimicrobial resistance, which is often termed intrinsic resistance. However, increasing use and misuse of antimicrobials in humans and animals in recent decades has increased both the diversity and prevalence of antimicrobial resistance in soils, particularly in areas affected by human and animal wastes, such as organic manures and reclaimed wastewater, and also by air transmission. Antimicrobials and antimicrobial resistance are two sides of the sword, while antimicrobials are essential in health care; globally, antimicrobial resistance is jeopardizing the effectiveness of antimicrobial drugs, thus threatening human health. Soil is a crucial pathway through which humans are exposed to antimicrobial resistance determinants, including those harbored by human pathogens. In this review, we use the nexus of antimicrobials and antimicrobial resistance as a focus to discuss the role of soil in planetary health and illustrate the impacts of soil microbiomes on human health and well-being. This review examines the sources and dynamics of antimicrobial resistance in soils and uses the perspective of planetary health to track the movement of antimicrobial-resistance genes between environmental compartments, including soil, water, food and air.
•The review uses “One Health” perspective to track the movement of ARGs.•Soil and soil fauna microbiomes are the source of bioactive compounds.•Soil biota has the diverse and abundant intrinsic resistome.•Human activities are increasing antibiotic resistome at the global scale.•Management of soil biota is vitally important for safeguarding planetary health.
Nurses play a crucial role in addressing human health influenced by global forces such as pandemics, and political conflicts that displace millions; in leading efforts to promote planetary health; ...and in achieving the United Nations (UN) Sustainable Development Agenda. Academic nursing programs have a significant role in actualizing nursing's impact on global health (GH) and planetary health (PH). This paper describes how nursing programs can actualize their GH and PH nursing perspectives to benefit students and society, thereby increasing nursing's effectiveness and improving health outcomes in local and global settings. Numerous strategies to actualize GH and PH perspectives were derived from current literature and an assessment of eleven nursing program websites. Nursing programs may adopt program-wide strategies such as reflecting GH and PH in their mission statement; through education, in courses; and through faculty or student scholarship, policy endeavors, and/or partnerships. Now is the time to take such action, recommitting to GH and PH nursing and deepening nursing's impact. Academic nursing programs' leadership role in society, and their role in preparing nurses to lead, educate, discover, and advocate is essential for the health of populations and the planet long into the future.
•Nurses play a crucial role in addressing global and planetary health.•Emphasizing global and planetary health is imperative for academic nursing programs.•Cultivating global and planetary health perspectives strengthens nursing's impact.•Programs have numerous strategies to enact global and planetary health perspectives.•Nursing leadership for global and planetary health is essential for our future.
The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable ...healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to 'rapid, far-reaching and unprecedented changes' to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet.
The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals.
This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. 'Consensus' implies broad agreement amongst all individuals engaged in discussion on a specific issue, which in this instance, is agreement by all signatories of this Statement developed under the auspices of the Association for Medical Education in Europe (AMEE).
To ensure a shared understanding and to accurately convey information, we outline key terms in a glossary which accompanies this Consensus Statement (
Supplementary Appendix
1). We acknowledge, however, that terms evolve and that different terms resonate variably depending on factors such as setting and audience. We define education for sustainable healthcare as the process of equipping current and future health professionals with the knowledge, values, confidence and capacity to provide environmentally sustainable services through health professions education. We define a health professional as a person who has gained a professional qualification for work in the health system, whether in healthcare delivery, public health or a management or supporting role and education as 'the system comprising structures, curricula, faculty and activities contributing to a learning process'. This Statement is relevant to the full continuum of training - from undergraduate to postgraduate and continuing professional development.
Multiple global environmental changes (GECs) now under way, including climate change, biodiversity loss, freshwater depletion, tropical deforestation, overexploitation of fisheries, ocean ...acidification, and soil degradation, have substantial, but still imperfectly understood, implications for human health. Noncommunicable diseases (NCDs) make a major contribution to the global burden of disease. Many of the driving forces responsible for GEC also influence NCD risk through a range of mechanisms. This article provides an overview of pathways linking GEC and NCDs, focusing on five pathways: (
a
) energy, air pollution, and climate change; (
b
) urbanization; (
c
) food, nutrition, and agriculture; (
d
) the deposition of persistent chemicals in the environment; and (
e
) biodiversity loss.
For over 15-years, proponents of the One Health approach have worked to consistently interweave components that should never have been separated and now more than ever need to be re-connected: the ...health of humans, non-human animals, and ecosystems. We have failed to heed the warning signs. A One Health approach is paramount in directing our future health in this acutely and irrevocably changed world. COVID-19 has shown us the exorbitant cost of inaction. The time to act is now.
•The Berlin Principles update the Manhattan Principles from 2004, which first coined the term One Health for a broader public.•The Berlin Principles reconnect the health of humans, animals, and ecosystems in an economic and socio-political context.•Global environmental changes and the COVID-19 pandemic starkly remind the world of these foundational interconnections.•An urgent One Health call-to-action for cooperative, multilateral, and democratic engagement at all levels of society.
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