Reentering the Paris Climate Agreement is a must for the US, but it’s no panacea

This month marks the fifth anniversary of the Paris Climate Agreement, and the Biden administration appears poised to rejoin the multilateral pact. It’s important to note that — however significant — participation in the Paris Agreement is no panacea. 

“The Paris Agreement succeeded by changing the paradigm of climate diplomacy,” the Brookings Institute has pointed out. “In critical ways, it bets on the force of rising norms and expectations rather than law to achieve its aims. To succeed in the end, this is the bet that will need to pay off.”

Planetary health — the relatively new field of practice defined as the health of human civilization and the state of the natural ecosystems on which our health depends — should be a guiding paradigm that signatories to the Paris Agreement leverage in defining new norms of collaboration and climate commitments. Doing so will help signatories overcome existing hurdles inherent to the agreement, such as norms guiding the transfer of wealth from high-income countries (most responsible for the climate crisis) to low-income countries (most vulnerable to its impacts).

Our health is interconnected across national borders. Ebola and coronavirus made this deadly clear. The integrity of forests from the Congo to Borneo and Brazil impact my health directly, whether I live in Jakarta, Johannesburg or Jacksonville, Fla. Loss of Amazonian rainforest is a driver of California’s recurring droughts and wildfires. Adopting a planetary health lens to climate-motivated investments in, for example, health systems globally could be a game-changer for the climate.

The practice of health care world-wide largely ignores the ecological and social determinants of human health: the quality of the food we eat, water we drink and air we breathe, our livelihoods and household economies. The World Health Organization’s (WHO) definition of health as a comprehensive state of physical, social and mental wellbeing implies interconnectedness to nature. Yet, global health practices for a century have focused narrowly on disease prevalence in one species, humans, mostly in a vacuum, neglecting our dependence on nature and ecological determinants of health. In that same century the life-giving ecosystems of planet Earth have all but collapsed.

As the U.S. prepares to reenter the Paris Agreement, and commit to bold targets, we urge the Biden administration to (re)fashion health system infrastructure at home and abroad based on the planetary health approach. The good news is a flourishing example of such a health system exists for inspiration and guidance. 

In a project that began in 2007 in Indonesian Borneo, in cooperation with government officials, financial and technical investments from high-income countries have implemented community-designed solutions to deforestation. With these investments, communities halted rampant logging in a climate-critical tropical rainforest, while simultaneously improving people’s health and reducing poverty. The community concluded it could stop logging with 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 entirely 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, and everyone could access care with non-cash payment options like rainforest seedlings used for reforestation. (Some 22,000 tree seedlings were used by patients in 2019 to pay for their health care.

And this planetary health approach is working remarkably well. The Proceedings of the National Academy of Sciences of the U.S. recently published Stanford University’s analysis of the 10-year impact of this program. Between 2007 and 2017, the intervention helped decrease infant mortality 67 percent in the medical center’s catchment population of 120,000 people, and there were significant declines in diagnosed cases of malaria, tuberculosis, neglected tropical diseases, chronic obstructive pulmonary disease and diabetes. Logging households decreased 90 percent, the loss of ancient forest halted and — significantly where climate is concerned, and therefore human health globally — $65.3 million worth of above ground carbon was protected.

This work demonstrates an actionable framework for governments to both finance and simultaneously achieve United Nations’ Sustainable Development Goals (SDGs) — as outlined by the Paris Climate Agreement — related to poverty reduction, nature conservation and improved human health. These results have been noticed by the United Nations, which gave Health In Harmony a Global Climate Action Award for climate change leadership.

There is renewed hope as the U.S. rejoins the Paris Climate Agreement, and indeed, this is the moment for a revolution. The health of our planet demands it. President-elect Joe Biden’s $2 trillion plan for a clean energy revolution is paramount and past due. Still, we must reach beyond carbon math and revamp the very paradigms on which our societies, and health systems, operate. 

Now is the time for government signatories to adopt a planetary health mindset, act upon humanity’s interdependence with nature and build smarter health care systems like this one in Borneo. Doing so is a pathway for the Paris Agreement to successfully stabilize our climate. 

Jonathan Jennings is the executive director of Health In Harmony, an international non-profit that is reversing rainforest deforestation and climate change by working at the intersection of human and ecosystem health. Prior to joining Health in Harmony, Jennings was Deputy Executive Director for Doctors Without Borders Canada.

Dr. Kinari Webb is the founder of the nonprofit Health In Harmony.