Brian M. Berman

Bold new approaches are urgently needed to overcome global health challenges. The proposed Advanced Research Projects Agency for Health (ARPA-H) is intended to provide rapid health breakthroughs. While new technologies for earlier disease detection and more effective treatment are critical, we urge equal attention be given to the wider (physical, emotional, social, political, and economic) environmental ecosystems driving the non-communicable disease (NCD) crisis in the first place. This requires an integrated, cross-sectoral vision that spans the interwoven connections affecting health across the scales of people, places, and planet. This wider “exposome” perspective considers biopsychosocial factors that promote resilience and reduce vulnerabilities of individuals and communities over time—the many variables driving health disparities. Since life course health is strongly determined by early life environments, early interventions should be prioritized as a matter of effectiveness and social justice. Here, we explore the origins of the Advanced Research Project Agency and point to its potential to build integrated solutions, with wisdom and ethical value systems as a compass. Since the planned ARPA-H is anticipated to spawn international collaborations, the imagined concept is of relevance to a broad audience of researchers. With appropriate input, the quest for health equity through personalized, precision medicine while deconstructing unacceptable structural inequities may be accelerated.

The “Earthrise” photograph, taken on the 1968 Apollo 8 mission, became one of the most significant images of the 20th Century. It triggered a profound shift in environmental awareness and the potential for human unity—inspiring the first Earth Day in 1970. Taking inspiration from these events 50 years later, we initiated Project Earthrise at our 2020 annual conference of inVIVO Planetary Health. This builds on the emergent concept of planetary health, which provides a shared narrative to integrate rich and diverse approaches from all aspects of society towards shared solutions to global challenges. The acute catastrophe of the COVID-19 pandemic has drawn greater attention to many other interconnected global health, environmental, social, spiritual, and economic problems that have been underappreciated or neglected for decades. This is accelerating opportunities for greater collaborative action, as many groups now focus on the necessity of a “Great Transition”. While ambitious integrative efforts have never been more important, it is imperative to apply these with mutualistic value systems as a compass, as we seek to make wiser choices. Project Earthrise is our contribution to this important process. This underscores the imperative for creative ecological solutions to challenges in all systems, on all scales with advancing global urbanization in the digital age—for personal, environmental, economic and societal health alike. At the same time, our agenda seeks to equally consider our social and spiritual ecology as it does natural ecology. Revisiting the inspiration of “Earthrise”, we welcome diverse perspectives from across all dimensions of the arts and the sciences, to explore novel solutions and new normative values. Building on academic rigor, we seek to place greater value on imagination, kindness and mutualism as we address our greatest challenges, for the health of people, places and planet.

The concept of planetary health blurs the artificial lines between health at scales of person, place, and planet. It emphasizes the interconnected grand challenges of our time, and underscores the need for integration of biological, psychological, social, and cultural aspects of health in the modern environment. Here, in our Viewpoint article, we revisit vaccine pioneer Jonas Salk’s contention that wisdom is central to the concept of planetary health. Our perspective is centered on the idea that practical wisdom is associated with decision-making that leads to flourishing—the vitality and fullest potential of individuals, communities, and life on the planet as a whole. The SARS-CoV-2 pandemic has illustrated the acute consequences of unwise and mindless leadership; yet, wisdom and mindfulness, or lack thereof, is no less consequential to grotesque biodiversity losses, climate change, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health inequalities, and social injustices. Since mindfulness is a teachable asset linked to both wisdom and flourishing, we argue that mindfulness deserves much greater attention in the context of planetary health.

Planetary health is a broad multidisciplinary effort that attempts to address what has been described as “Anthropocene Syndrome”—the wicked, interrelated challenges of our time. These include, but are not limited to, grotesque biodiversity losses, climate change, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health inequalities, social injustices, erosion of wisdom and civility, together with the many structural underpinnings of these grand challenges. The ultimate aim of planetary health is flourishing along every link in the person, place and planet continuum. The events of “2020” have illuminated the consequences of “mass trauma” and how sub-threshold anxiety and/or depressive symptoms erase the rigid lines between mental “health” and mental “disorders”, and unmasked the systemic forms of injustice, discrimination, and oppression that have too often escaped discourse. Here, we query the ways in which post-traumatic growth research might inform the larger planetary health community, especially in the context of a global pandemic, broadening socioeconomic inequalities, a worsening climate crisis, and the rise of political authoritarianism. The available research would suggest that “2020” fulfills the trauma criteria of having a “seismic impact on the assumptive world”, and as such, provides fertile ground for post-traumatic growth. Among the many potential positive changes that might occur in response to trauma, we focus on the value of new awareness, perspective and greater wisdom.

The term “Anthropocene Syndrome” describes the wicked interrelated challenges of our time. These include, but are not limited to, unacceptable poverty (of both income and opportunity), grotesque biodiversity losses, climate change, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health inequalities, social injustices, the spread of ultra-processed foods, consumerism and incivility in tandem with a diminished emphasis on the greater potential of humankind, efforts toward unity, or the value of fulfilment and flourishing of all humankind. Planetary health is a concept that recognizes the interdependent vitality of all natural and anthropogenic ecosystems—social, political and otherwise; it blurs the artificial lines between health at scales of person, place and planet. Promoting planetary health requires addressing the underlying pathology of “Anthropocene Syndrome” and the deeper value systems and power dynamics that promote its various signs and symptoms. Here, we focus on misinformation as a toxin that maintains the syndromic status quo—rapid dissemination of falsehoods and dark conspiracies on social media, fake news, alternative facts and medical misinformation described by the World Health Organization as an “infodemic”. In the context of planetary health, we explore the historical antecedents of this “infodemic” and underscore an urgent need to remediate the misinformation mess. It is our contention that education (especially in early life) emphasizing mindfulness and understanding of the mechanisms by which propaganda is spread (and unhealthy products are marketed) is essential. We expand the discourse on positive social contagion and argue that empowerment through education can help lead to an information transformation with the aim of flourishing along every link in the person, place and planet continuum.

The concept of planetary health blurs the artificial lines between health at scales of person, place and planet. At the same time, it emphasizes the integration of biological, psychological, social and cultural aspects of health in the modern environment. Our grandest challenges in the Anthropocene ultimately stem from human attitudes to each other and to our environment. However, solutions rarely confront the underlying value systems that created these interconnected problems, or the attitudes that perpetuate them. Too often, the dominant focus is on the “worst of human nature”, and devalues or neglects the importance of empathy, kindness, hope, love, creativity and mutual respect—the deeper values that unite, empower and refocus priorities of individuals and groups. Here, we call to normalize more creative, mutualistic approaches—including the perspectives of traditional and indigenous cultures—to positively influence normative value systems. We revisit the power of inspiration with the profound example of the Apollo 8 Earthrise photo which galvanized a fledgling planetary health movement over 50 years ago. Through the inaugural Earth Day that followed, we are reminded that its early organizers were not constrained in how they defined the “environment”. They and their primary speakers were as concerned about value systems as they were about pollution—that we cannot hope to solve our problems without addressing the attitudes that created them in the first place. We explore the ways in which the awe of Earthrise—and the contemporary science of creativity and studies of utopian thinking—might reinvigorate imagination, kindness and mutualism. We revisit the fundamental challenge offered by Pulitzer-Prize-winning microbiologist Rene Dubos and others in the afterglow of the Earthrise photo, and the inaugural Earth Day. This is a question of imagination: What kind of world we want to live in?