“Humanism, I strongly believe, must excavate the silences, the world of memory, of itinerant, barely surviving groups, the places of exclusion and invisibility, the kind of testimony that doesn't make it onto the reports but which more and more is about whether an overexploited environment, sustainable small economies and small nations, and marginalised peoples outside as well as inside the maw of the metropolitan centre can survive the grinding down and flattening out and displacement that are such prominent features of globalisation." Edward W Said
Said was not known as an environmentalist. Yet these words could well have been describing the challenges to planetary health in excavating the stories and data born from natural disasters, urban crowding, lost species as well as the populations displaced by disaster, conflict, and lost livelihoods. Born to Palestinian parents, with American citizenship, growing up in Jerusalem with the most English of first names, the author of the seminal text Orientalism challenged the history of the Middle East documented in the language of the West. Said became in his lifetime one of the most notable voices in human rights, on comparative literature, with the uncanny ability to put a fresh examined angle on old positions and stories.
It is beholden on each sector to tell the stories of our era well. Using in medicine’s case, the language of science, human contact, and medical ethics. But also using lessons learnt from successes in recent global health challenges. Global health as a discipline is a definition or construct of the last decade and half - although its origins derive from the established practices of international and public health. Its focus is on health for all – globally and equally. Among collective global health successes are the increases in worldwide child survival, the ongoing fight against tobacco, and for HIV AIDS treatment. Ongoing struggles but with significant gains, are in addressing LGBTIQ rights to health, maternal mortality, and universal health coverage. In modern health history the global HIV AIDS crisis is considered a global health success story in the sense that collective societal action on a global scale around the challenges of a disease with a death sentence – became written into a history of lives saved through access to anti-retroviral treatment. The lessons of HIV AIDS are well documented. Community activism as a global public good. Human rights at the centre. Science driven research agenda. Partnerships across business, government, communities, schools, and media. (See AIDs and Global Health: the path to sustainable development: Lo and Horton 2015).
In comparison, climate change, environment and health, and planetary health campaigns are sometimes accused of being devoid of a strong human face. They are also sectors where passionate good people and organisations have too often failed to find their common launch pad. Part of the reason for delayed societal action often has sometimes been attributed to the lack of immediate regard of personal risk. Furthermore, the urgent impetus to act very locally is sometimes disconnected from global support or learning networks. While not disregarding the obvious differences to the HIV crisis in detail, there are some pertinent lessons in global health for the health and environment community to consider.
As always, the solutions lie with all ‘ordinary’ people in health -- able to take on global health lessons, not repeat the same mistakes, and apply them in extraordinary fashion to the challenges we are facing in advancing health for people and planet.