Despite the coronavirus pandemic, the climate crisis is still considered by 14 nations to be the biggest health threat to their citizens, according to a Pew Research Center study. But as we approach the fifth anniversary of the Paris Climate Agreement, on Dec. 12, and rejoice in the promise that the United States will recommit to the effort, it is painfully evident that much work still needs to be done to limit global heating.
Nature’s collapse and the climate crisis exist because humans are depleting natural resources, generating massive amounts of waste and toxic pollutants, causing large-scale biodiversity loss, and fundamentally changing landscapes, the composition of the atmosphere, and the health of oceans. Despite the hard-won public health gains of the past century, we are rapidly faced with the negative health impacts of higher temperatures, degraded air quality, threatened food production, new infectious disease outbreaks, decreasing access to fresh water, and more frequent natural disasters. Humanity is, consequently, more and more susceptible to malnutrition, mental health illness, injury, and disease. In other words, our health is at risk as we dismantle the natural ecological systems on which our health depends.
Yet public and global health practices have for decades focused on the individuals and populations of one species, Homo sapiens, to the neglect of our interdependence with nature and ecological determinants of health.
The good news is that there exists a health system built on this interdependence, and it is flourishing.
Locally designed solutions to deforestation have halted rampant logging in a 250,000-acre tropical rain forest in Borneo—a critical lung of the planet—while simultaneously improving people’s health and reducing poverty.
In Indonesian Borneo, there is a vital example of what is possible. Locally designed solutions to deforestation have halted rampant logging in a 250,000-acre tropical rain forest in Borneo — a critical lung of the planet — while simultaneously improving people’s health and reducing poverty. In a project that began in 2007, financial and technical resources from high-income countries have helped implement community-defined interventions. In order to stop logging, the community required access to affordable quality health care and training in organic farming and small-business management. Our organization, Health In Harmony, built a medical center staffed by Indonesians and facilitated training with expert organic farmers from the neighboring island of Java. This provided an alternative way to earn a living and eliminated the need to pay for costly chemical soil fertilizer and expensive transport to poor-quality, far-away health clinics. Villages received variable discounts on their health care based on changes in their rates of logging, but everyone could always access care with non-cash payment options like rain forest seedlings used for reforestation.
And this approach is working remarkably well. The Proceedings of the National Academy of Sciences of the United States of America just published Stanford University’s analysis of the 10-year impact of this program. Between 2007 and 2017, infant mortality decreased 67 percent in the population serviced by the medical center of 120,000 people, and there were significant declines in diagnosed cases of malaria, tuberculosis, neglected tropical diseases, chronic obstructive pulmonary disease, and diabetes. The number of logging households decreased 90 percent, the loss of ancient forest halted, and — significantly, where climate is concerned — $65.3 million worth of above-ground carbon was protected. Habitat for 3,000 critically endangered orangutans was also preserved.
Michele Barry, director of the Center for Innovation in Global Health at Stanford, said, “Health In Harmony’s innovative model has clear global health implications. Health and climate can and should be addressed in unison, and done in coordination with, and respect for, local communities.”
For generations, Indigenous and local peoples have been told how to manage their ancestral lands — despite having the closest connection to these ecosystems. We trusted their wisdom, and they naturally designed an approach that linked their health, household economy, occupation, and rain forest. They also created the beginnings of a regenerative health system — one that made them happier and healthier and also made their rain forest healthier.
Whether we live in Boston or Bangalore, recognizing our interdependence with nature and building smarter health systems is a prescription for protecting rain forests and slowing climate change.