Global Health in the Anthropocene? History and Planetary Health

Almost a year since delivering the 2018 Hagströmer Lecture at the Karolinska Institutet, it seems timely to reflect briefly on why I chose the topic of planetary health, and to touch on some subsequent developments.

Even as concerns about the health effects of climate change were growing in the 1990s, I was writing about histories of human acclimatisation and racial immunity in the colonial tropics, culminating eventually in my books, The Cultivation of Whiteness (2002) and Colonial Pathologies (2006). From 2004, I began research in the histories of disease ecology, largely a twentieth-century version of environmental health, resulting in publication of six or more articles. Accordingly, when Tony Capon, the world’s first ‘professor of planetary health’, asked me and my colleague Dr James Dunk to consider in 2016 the historicity implied in the new ‘planetary health’, we seized the opportunity. It was clear from the beginning that planetary health was, in part, a scaled-up and more systemic mode of understanding disease ecology, a novel framing of the relations of human health and planetary environments or ecosystems, the antecedents of which I had long been studying.

By the time I came to give the lecture in Stockholm, I regretted my use of the term ‘Anthropocene’ in its title. I realised that the epidemiologists and other public health experts expatiating since the late 1980s on the damage that global warming and environmental degradation were doing to human health had not needed the concept of the Anthropocene. One of the leading proponents of what came to be called planetary health, A.J. McMichael used the increasingly popular word only in his last, posthumously published book. Before then, systems ecology had provided sufficient analytic power to render the Anthropocene redundant in his arguments. Thus, I was glad I managed at the last minute at least to insert a query after the term, before the notice was distributed.

After presenting the lecture, I was provoked to write, along with Dunk, Capon, and Professor David S. Jones, a short historical essay for the New England Journal of Medicine (August 22, 2019), urging physicians to bring planetary environmental degradation back into their calculus of health and disease, and offering validation of political advocacy by the medical profession. During the previous few months, numerous international reports had documented the climate emergency that now confronts us. Scarcely a week goes by without epidemiologists and public health experts warning that we have all the evidence we need to compel action against global environmental degradation. Ever larger segments of the health profession therefore have been galvanized into overt political advocacy.

One might say that to lecture in 2018 on the past, present and future of planetary health itself was timely; but then again, in view of the gravity and constant intensification of climate change, and the ineffectiveness so far of any political responses, such events unfortunately might come to seem abiding, even timeless.