THE FUTURE OF PLANETARY HEALTH: TOWARD THE “GREAT TRANSITION”
A path without borders of research, care, and regeneration for the Planet.
The Planetary Health Annual Meeting was recently held in Rotterdam, the Netherlands, helping us to better understand what Planetary Health is, how it has evolved over its first ten years of activity, and why we need it in the world of scientific research and in our societies (we discussed it here). In addition to summarizing the new scientific evidence, the concrete solutions implemented so far, and the tools being developed, the meeting highlighted the main challenges and directions that Planetary Health must now take to respond to the urgent health needs at the planetary level. If we want the next decade of Planetary Health to be dedicated to dismantling the system that hinders its development, what direction should we take?
Integrating Evidence: The Synergy Between Planetary Health and Planetary Boundaries
During the meeting, the topic of planetary boundaries was discussed. These are thresholds relating to nine planetary processes, quantified and periodically analyzed by scientists at the Potsdam Institute, within which we must remain to ensure a safer future on the Planet. These nine processes (climate change, biodiversity integrity, biogeochemical cycles of nitrogen and phosphorus, novel entities, land system change, freshwater change, ocean acidification, ozone depletion, and atmospheric aerosol loading) serve to maintain the stability and resilience of the Planet’s natural systems. Exceeding the planetary boundaries risks triggering radical, sudden or irreversible changes in these systems.
So far, we have already crossed seven of these critical thresholds (that is, all of them except aerosol loading and ozone depletion). The latest report, from the end of September 2025, announced the crossing of a seventh threshold—ocean acidification—which could lead to harmful consequences for marine ecosystems, especially the most vulnerable ones such as coral reefs.
Why is it important to reconcile planetary boundaries with Planetary Health? By compromising ecosystems, the crossing of planetary boundaries represents a major threat to human health as well, which is closely interconnected with that of other living beings and natural phenomena. There is already considerable evidence on this: we know that all nine processes are linked to human health, that exceeding planetary boundaries could amplify the direct effects on health, and—by destabilizing our societies—also the social risk factors. However, there is still no precise quantification of the “global burden of disease” linked to the crossing of planetary boundaries. We could define the health burden linked to climate change as an “invisible pandemic,” since the effects on human health are numerous, spreading rapidly, and still poorly understood. What we can currently measure and analyze, in terms of health effects, is only a small part of the countless reciprocal influences that connect our health to the condition of the Planet.
Source: The Lancet
The research community is working to adopt a comprehensive approach that studies planetary boundaries from multiple perspectives, integrating health and social well-being metrics into the analysis to obtain a complete picture of the environmental and socio-health impact linked to planetary boundaries. The idea would be to create a monitoring dashboard that collects all these variables, with updates over time to assess their evolution and guide political choices and climate financing. Such a project will require constant collaboration among different disciplines and the harmonization of their metrics and methodologies. It is therefore an ambitious project but one of vital importance, strongly aligned with the fundamental principles of Planetary Health, which defines itself as a transdisciplinary science oriented toward post-disciplinarity—that is, overcoming traditional disciplinary boundaries to make room for new forms of collaboration that are more flexible and accessible within our societies.
The current framework also fails to highlight existing inequalities related to the planetary boundaries and their consequences. A first attempt to integrate the principle of justice into the analysis was made by creating the model of “Safe and Just Earth system boundaries,” which examined five of the nine planetary boundaries including parameters of intra-generational, inter-generational, and inter-species justice. A further development will be the differentiation and mapping of the impacts of planetary boundaries at the level of geographical regions, countries, and societies, in order to provide an analysis report that also reflects the dynamics of climate and social injustice. Greater attention will also be paid to the synergies between planetary boundaries—that is, the impacts associated with the transgression of two or more of these limits (which are all interdependent)—and the potential benefits that could result from reversing these trends, namely restoring the nine processes within their planetary boundaries. Among these benefits, the economic savings resulting from reduced natural exploitation and the protection of planetary systems will also be highlighted, including major savings in social and health spending—an aspect rarely considered in such economic balances. Promoting human health, with all benefits linked to it, is a powerful lever that could help us change course, motivating systemic and urgent actions in our societies.
Source: Earth Commission
Beyond Sustainability: The Concept of Regeneration
Planetary Health offers an innovative conceptual paradigm that goes beyond the concept of sustainability, the latter understood as the reduction or minimization of the negative impact of our actions on the environment. Limiting ourselves to sustainability holds us back from the ambitions of prosperity and wellbeing of Planetary Health, which instead aims at the restoration and regeneration of ecosystems. The Planetary Health paradigm is based on a positive definition of “health,” like that of the World Health Organization, namely “a state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity.” If we extend this definition of health not only to people but to the entire Planet, we find ourselves in a situation where we can no longer simply do the bare minimum to limit the worst damage to the Planet; we must commit to healing it completely, restoring and maintaining its health in the long term.
Source: Sphera
We can explain it better through a metaphor. If a loved one is sick, do we only want the severity of the illness to decrease, or do we hope that the person will fully recover and maintain that state of health over time without needing further medical interventions? The answer is obvious.
This mindset—of complete care, regeneration, and conservation—is what we should apply to the entire Planet. Simply reducing the negative impacts will never be enough to ensure long-term planetary wellbeing, one that includes both our health and that of ecosystems together. By reducing negative impacts—that is, by limiting ourselves to sustainability—we slow the process of the climate crisis and avoid the worst damages, but we do not consider the positive potential of our actions in regenerating ecosystems. We therefore need an evolution of our approach from sustainability to regenerativity. A regenerative future is one in which all systems, processes, entities, and beings thrive together, inherently reaching their full potential in collaboration with one another on an interconnected Planet.
The change in mindset that Planetary Health entails is so fundamental and comprehensive that we can truly speak of a conceptual revolution, from anthropocentrism—deeply rooted especially in Western societies—to ecocentrism. The latter already exists and is applied in certain sociocultural contexts, such as those of Indigenous peoples, who see humans as an integral part of ecosystems, in a relationship of connection and interdependence with other living beings and natural elements. Planetary Health integrates these values and the ancestral wisdom of Indigenous peoples into its body of knowledge to transform our mindset, moving it away from a profit-oriented outlook and encouraging a decolonization of our relationship with nature.
The Planet is not made of resources to exploit, but of living beings, elements, and natural systems—of which we are part and with which we need to live well together. To realize this conceptual revolution and translate it into concrete actions, it is necessary to talk about it more and more within our societies, and to talk about it in the right way. A new narrative is needed, one that communicates effectively, at all levels of society, that a path of care and regeneration for the Planet is the only path capable of ensuring a safer, more prosperous, peaceful, and healthy future for all people. It is a winning path, not one of sacrifice.
The “Great Transition”: How to Get There and What We Need
Finally, to implement the change that Planetary Health pursues, science and knowledge are fundamental but not sufficient; it is necessary to build a new operating system to carry out this “Great Transition” within our societies.
First and foremost, the transfer of knowledge from the scientific world to society must be free and transparent. Even though Planetary Health is committed to open, accessible, and inclusive science, its knowledge does not always get where it should, beyond the academic world. There are countries where scientifically accurate information on climate change, and its related effects, is censored in the name of political and economic interests. There are even countries where, in order to conceal the evidence, certain terms cannot be used. This is a major limitation to the transformation of our societies, but also an additional responsibility for those who do receive accurate information and can help to break, at least in part, the barriers of access.
It is possible to incorporate the teachings of Planetary Health into every sector of society, and this was demonstrated through numerous examples during the meeting. Planetary Health can be integrated at the level of political decision-making—local, national, and international. Malaysia has been recognized as the very first state to create a national operational program for Planetary Health (the National Planetary Health Action Plan), based on scientific evidence to protect human and Planetary Health while reconciling it with socioeconomic development, with contributions from scientists, politicians, industry representatives, and civil society. It is important to rethink our model of democracy, promoting participation and inclusivity—especially of minorities and of the most vulnerable communities, who are the main victims of climate injustice. Political dialogue must include, in addition to the top-down decisions of governments, the bottom-up demands and initiatives identified, developed, and/or led by groups within civil society. One method to encourage participation is that of “radical listening,” used by the NGO Health in Harmony to engage rainforest communities in Indonesia, Madagascar, and Brazil.
Economies, too, can reorient themselves toward models based on wellbeing and regeneration. The Wellbeing Economy Alliance (WEA) is a movement for economic justice that brings together many of these innovative economic frameworks, including regenerative economy, circular economy, the “doughnut economy,” and others. There are many solutions; for this reason, the WEA seeks to foster sharing, dialogue, and the identification of the most suitable solution for each context.
Urban planning can also be conceived to promote harmony between the environment and society, according to the principles of environmental urbanism, as is happening in Medellín (Colombia). The new Urban Plan (Plan urbano de Medellín 2024–2027) takes into account both the city’s geographical characteristics and the social needs of the urban environment.
The legal and human rights field can help guide our behavior and repair some of the injustices linked to climate change. Climate litigation is becoming increasingly common, as are declarations by international bodies defending climate justice, also invoking the right to health and to a healthy environment (such as the advisory opinion of the International Court of Justice, which we analyzed here).
Finally, it is essential to inform and educate everyone in order to enable the change in mindset that underlies the Great Transition. The Planetary Health Education Framework provides guidance for educational institutions, students, and educators so that they can create educational programs and learning resources suited to different social and environmental contexts and local priorities. The framework encompasses knowledge, values, and practices structured into five educational areas: interconnection with Nature; the Anthropocene and health; systems thinking and complexity; equity and social justice; and movement building and systems change. The aspiration of Planetary Health, as established in the São Paulo Declaration, is to become a subject of reflection for every person—regardless of their field of study or work sector—in order to shape planetary citizens and agents of change who consider Planetary Health an integral part of our lives, relationships, and systems.
One thing is clear: the Planetary Health movement is growing, and with it its potential to transform our societies and our coexistence with the Planet. The path toward the Great Transition is still long; new leaders and experts will be needed in every field to adopt a more ecocentric mindset, stronger interdisciplinary and cross-sectoral alliances, effective communication strategies to change the narrative widely, the mobilization of more funds, and the engagement of an ever-larger number of people.
All this must be created and nurtured with one idea in mind: our actions must not be aimed “only” at avoiding the avoidable—that is, the climate catastrophe—but can lead to a regeneration of the Planet, which gives us home and opportunity, which welcomes and sustains us. Why not treat it as a loved one? If the Planet is sick, then let’s heal it.
Article by Lucia Giannini, coordinator of the Climate and Health section of the Italian Climate Network.