Shaping our Sustaining Health initiative

The city of New York came to a standstill on Sunday as hundreds of thousands of people joined the People’s Climate march. Chants of “Show me what democracy looks like – This is what democracy looks like” echoed around Times Square as people from over 2000 groups and organisations joined thousands more individuals all wanting to get their voice heard on the issue of climate change. The Wellcome Trust’s Sustaining Health team were also in town to hear from a diverse range of experts, to help us shape our Sustaining Health initiative. Kate Arkless Gray gives a taste of the discussions taking place in New York…

“Never before has a species thought its way out of a Darwinian selection process” said Ted Bianco, from the Trust’s Sustaining Health team, opening the discussion ‘Sustaining Health: Linking environment, nutrition and health’.

There is a real sense of energy in New York as the world’s leaders convene for the UN Climate Summit. The whole city is alive with people discussing commitments to change, debating what can be done, and forging new collaborations. Ban Ki-Moon proclaimed that leaders are “not here to talk, but to make history”.

For our own part, the Wellcome Trust, together with the International Research Institute for Climate & Society (IRI), Columbia University Mailman School of Public Health and Meteos, hosted an event to bring together a range of global voices to discuss the links between climate and health. These included public health researchers, economists, investors, social entrepreneurs, climate scientists and more.

We began with Professor Kirk Smith, Convening Lead Author of ‘Human Health: Impacts, Adaptation, and Co-benefits’ the IPCC fifth assessment report, giving an overview of the report’s findings in relation to health.

With 190 countries signed up to it (and thus having to sign off the report) getting everyone to agree was not straight forward. Smith explained the report’s strength comes from the number of countries involved, but it was a double-edged sword at times, and the need for unilateral agreement affected the content.

Smith summed up the report by splitting the issue into three eras: The present – where it’s very difficult to assign a significant burden of disease to human-caused climate change to date, although local effects are occurring; the future up to 2050 – where growing health impacts can be expected if adaptation measures are not taken, but could be greatly reduced if they were; and the future post 2050 – where there is a risk in the higher emissions scenarios that exceeds conceivable adaptation potentials, thus leading to major impacts on health, particularly among the poor.

With the scene set, the discussion began. Our panel – Steve Davis, President and CEO, PATH, Ricardo Fuentes Nieva, Head of Research for Oxfam GB, Patrick Kinney, Professor of Environmental Health Sciences, Mailman School of Public Health and Madeleine Thomson, Senior Research Scientist at IRI – gave their reflections and opened up the conversation to the room.

Smith’s assertion that climate change is “the most regressive tax in history” chimed with Fuentes Nieva. Introducing a theme that continued throughout the afternoon, he reminded us that while climate change is a global problem, it doesn’t affect everyone equally. The most vulnerable people, the poorest people, the ones less able to adapt to change, will be at the frontline where climate change exacerbates existing problems.

Two trends – the increasing numbers of vulnerable people, together with a growing increase in inequality – mean that without action, we risk leaving people behind.

The discussion around the role of science and technology included the potential benefits of big data, which led to John Krebs voicing the need for linking data sets and connecting the silos. Anne Johnson highlighted the mismatch in the places with available data and those where action is needed.

John Balbus (NIH-NIEH) pointed out that health is late to the climate impact data-modelling game, which could be an avenue worth exploring, while Madeleine Thomson reminded us of the need to consider whether data is collected and shared in a format that meets the need of people on the ground.
It’s not just researchers that need access to accurate, relevant and fit for purpose data. Health ministers also need access to reliable data, in a format that is useful to them.

Climate change is a global problem, but solutions need to be locally appropriate. What works in one place won’t always work elsewhere, and so far the focus has often been on solutions that work for middle-income settings, rather than the most vulnerable.

Another exciting concept is that of ‘Healthy Cities’ however Kinney remarked that despite much activity in this area, there has been little in terms of assessing the cost-effectiveness of measures linking obesity, pollution and city development.

Richard Horton reflected on “Countdown to 2015” – a scientific network set up when it became clear that the millennium development goal on child and maternal mortality would be missed. He suggested that perhaps there could be lessons taken from this collaboration, which tracked indi

cators that mattered to the public as well as to governments. Long-term investment in bringing people together is needed.

The question was raised of how to get corporations involved in the debate and taking action. Understanding the financial markets and changes in the way they are working with technology and health could be key to that.

Other areas touched upon during the afternoon included food security – alternative crops and food sources need consideration, population and family planning – a sensitive issue, which would need careful handling, social networks and use of technology to drive behavioural change, and the collection of metrics on exposure.

Finally, Kirk Smith called for artists, philosophers and authors to help start a cultural revolution to help inform and create debate to combat and survive climate change and protect our future.

It was a gracious, honest conversation, with people from different backgrounds bringing their experience and perspectives to the discussion on linking environment, nutrition and health.

It’s given us plenty of food for thought and we will continue to listen to a wide range views from disparate sectors to inform our decisions on how the Wellcome Trust can have an impact on sustaining health.

You can find out more about the Sustaining Health initiative on on the Wellcome Trust website. A record of the live tweets  from the event in New York using the hashtag #SustHealth are available on the @WellcomeLive twitter account.

Image credits: Kate Arkless-Gray