Sir Andy Haines is Professor of Public Health and Primary Care at the London School of Hygiene & Tropical Medicine and chair of the Rockefeller Foundation Lancet Commission on Planetary Health.
The Commission's new report, "Safeguarding human health in the Anthropocene era," reviews multiple environmental changes over the last few decades and the public health implications. "The effect on human health is enormous," he says, noting the global threat to food systems (land and sea), air pollution, infectious diseases, water-related diseases and the health burden of extreme weather events exacerbated by climate change.
"Our premise is humanity has benefited enormously from exploiting the environment. Our concern is we have done so by mortgaging the future. We have put at risk mostly poor people around the world and future generations who won't be able to exploit the environment as we have done because that exploitation is unsustainable."
What do you identify as the key findings of the report?
Sir Andy Haines: There is this array of health problems due to the exploitation of the environment. We can't think it's an environmental issue. Fundamentally, it's a human health issue.
Sir Andy Haines: We're thinking of strategies to benefit health, and the environment and the economy. For example, we look at diets with lower beef consumption. We look at sustainable cities, with more active travel and public transport that can also reduce urban heat islands. We outline a whole range of strategies and policies that can lower environmental impact and improve health."
What inspired you on your career path?
AH: I was a clinical doctor for many years, then trained as a researcher. As a family physician, I saw that many conditions I treated were caused or exacerbated by the environment. Then I moved more into public health and preventative work. I began to see links between changing climates and health. Back then it was unclear how bad thing were going to be, but I started to think about that and began work with The World Health Organization. I worked with Tony McMichael from Australia [a public health scientist] on research. He was a great thought leader and we collaborated on papers in the 1990s.
What are some external factors that drive your work?
AH: As a doctor, seeing the effects of the environment on health. We are seeing changes are becoming so dramatic now. There's an awful lot of interest now. We are seeing with fossil fuels what we saw in the tobacco industry. It's not easy to shift the patterns of investment. We have to establish partnerships with other sectors to facilitate change.
What are barriers you face in your work?
AH: We need to assess our government systems. we're subsidizing behaviours that are damaging the public health. Look at fossil fuel subsidies and air quality. We have to address these incentives and look to change. And we need to find a way for the more vulnerable to have a voice.
Tell us about a good discovery you've made at work.
AH: In clinical medicine, I did a fair amount of work on prevention, on showing family doctors could change people's behaviors. With more recent work that is in the environmental area, I'm proud of a collective effort in 2009 on articles that looked at health benefits in a range of sectors to reduce greenhouse gases and improve public health. People had looked at air pollution before then, but we tried to look at a range of sectors, including housing and agriculture, to see how we could improve health and also protect the environment. We tried to show the magnitude of benefits from policies to protect public health. It's taken some time to take off because it's beyond the health sector, but it's becoming easier. We use positive messages as opposed to gloom and doom. If one can develop strong evidence that a low-carbon society can be a healthier society, that motivates people to action.
A genie grants you two wishes to fight climate change. What do you ask for?
AH: First, a decarbonizing of energy and electricity sectors. That's the big priority and major. Also: sustainable cities. There's an enormous amount that can be done--and not just in our cities but in the ones that haven't been built yet, where population growth is so high. There a prospect to build these cities right and to provide a decent environment for people to live in while being sustainable.
Are you hopeful or pessimistic?
AH: Neither. I'm a realist. One has to take things one step at a time. It doesn't happen overnight, but I do think it's possible to change things over decades. The decisions this generation makes will influence the trajectory of history. We're at an important juncture. We've got problems with our government systems that don't take into account the full range and all the impacts. Unless we start including the costs in our economic decision-making it will be hard to change direction. We need to get rid of these subsidies [for fossil fuels]. We have fundamental rethinking to do--the way in which we govern and the financial signals we send need to change. But I see there's a rapidly growing realization that we're at an important juncture in history and I think young people are much more attuned to these problems.