We live in the Anthropocene, an era defined by human impact on the planet. From greenhouse gases altering the climate to plastics filling our oceans, the footprint of humankind is everywhere. While this age is often spoken of with despair, Islam offers a way of looking at the world that can transform how we live in it.
The Islamic lens shifts our gaze. Planetary health is not only about survival or managing resources. It is about recognising the Creator, honouring the trust He has placed on us, and living responsibly in balance with the rest of creation.
Consumption and moderation
The Anthropocene is marked by overconsumption: fast fashion, fast food, endless energy demands. Islam teaches the opposite: eat and drink, but waste not by excess (Qur’an 7:31). Imagine if Muslims, who number nearly two billion, practiced this daily. Wasting less food, eating simply, and valuing halal and tayyib (wholesome) consumption would reduce emissions from food production, cut landfill waste, and preserve resources. A prophetic tradition teaches us to use water sparingly even while standing by a flowing river. In the Anthropocene, where water stress affects billions, such guidance is transformative.
Balance in land and resources
Deforestation, soil degradation, and loss of biodiversity define the Anthropocene. The Qur’an describes creation as set in mīzān (balance) and warns not to disrupt it. Classical Islamic societies applied this through hima (protected zones) where grazing and logging were restricted to preserve ecosystems. Reviving this ethic today could mean Muslims leading in protecting forests, restoring landscapes, and creating green sanctuaries in cities. Restoring balance is not only ecological work but also a fulfilment of our role as khulafā’ (trustees).
Energy and responsibility
The burning of fossil fuels drives much of the Anthropocene’s crisis. While large systems are slow to change, Islamic ethics can shape individual and community responsibility. A mosque that runs on solar power, an institution that reduces energy waste, or families that choose public transport over private cars are all examples of acts of worship. When energy use is guided by the principle of amānah (trust), conservation becomes an expression of faith.
Waste and plastics
Plastic is a defining pollutant of our age, choking rivers and oceans. Islam directly prohibits wastefulness. The Prophet ﷺ taught that even a small crumb of bread should not be discarded. This mindset, if truly lived, means resisting the throwaway culture of the Anthropocene. Carrying reusable containers, supporting circular economies, and avoiding single-use plastics become not only environmental actions but also spiritual duties.
Justice across generations
The Anthropocene has created deep inequities. The poorest often suffer most from climate change while contributing least to its causes. Islam’s principle of justice (ʿadl) and doing good (iḥsān) requires that we think of others, including future generations. Cutting waste, living simply, and advocating for fair policies are ways Muslims can enact intergenerational justice. The Prophet ﷺ said: “If the Final Hour comes while you have a seedling in your hand, plant it.” This teaching encourages us to act responsibly today even if we may not see the results.
A different Anthropocene
If Muslims were to live fully by these principles of moderation, balance, justice, and responsibility, the Anthropocene would look very different. Instead of being an age defined by human exploitation, it could become an age defined by human stewardship.
Planetary health through an Islamic lens is not only about protecting ecosystems but also about aligning our daily lives with the recognition of Allah. In doing so, we rediscover balance, reduce waste, live responsibly, and honour the trust of creation. That is how Islam, if practiced with consciousness, can truly change the world.
Recent studies have highlighted the pervasive presence of microplastics in various food items, raising significant concerns regarding human health and environmental safety. Among the foods identified with the highest levels of microplastics are seafood, honey, beer, and certain fruits and vegetables. The contamination of these food items is primarily attributed to environmental pollution and the use of plastic in food packaging and processing.
Seafood, particularly bivalves such as mussels and oysters, has been extensively documented as a major source of microplastic contamination. These organisms filter large volumes of seawater, leading to significant bioaccumulation of microplastics in their tissues, which subsequently enter the human food chain (Miller et al., 2020; Dambrosio et al., 2023). A study conducted in Taiwan indicated that residents could ingest approximately 16,000 microplastic particles annually through seafood consumption (Lin, 2024). Furthermore, marine fish, which may consume smaller fish containing microplastics, can also accumulate these contaminants, thereby posing risks to human health (Samarajeewa, 2023).
In addition to seafood, recent research has uncovered microplastics in honey, beer, and dairy products. A study in Ecuador found microplastics present in honey and beer, emphasizing the need for broader investigations into terrestrial food sources (Diaz-Basantes et al., 2020). Moreover, microplastics have been detected in milk and other refreshments, indicating that the contamination extends beyond aquatic environments (Diaz-Basantes et al., 2020). The presence of microplastics in these products raises concerns about their potential health impacts, as they can disrupt gut microbiota and lead to inflammation (Pramaningsih, 2023; Hwang et al., 2020).
Fruits and vegetables are also increasingly recognized as potential carriers of microplastics. A recent study from Turkey reported the occurrence of microplastics in commonly consumed fruits and vegetables, highlighting the importance of assessing food safety from the ground up (Aydın, 2023). The contamination of these food items may occur through soil pollution or the use of plastic-based fertilizers and pesticides, which can introduce microplastics into the agricultural food chain (Fiore, 2023).
The mechanisms of microplastic contamination are multifaceted, involving not only environmental pollution but also the processing and packaging of food. Research indicates that food processing techniques and the materials used in packaging can contribute to the release of microplastics into food products (Fiore, 2023; Hussain et al., 2023). For instance, microwave heating of plastic containers has been shown to release millions of microplastic and nanoplastic particles into food (Hussain et al., 2023). This highlights the critical need for improved regulatory measures and analytical techniques to monitor and mitigate microplastic contamination in food products.
In conclusion, the latest findings underscore the alarming prevalence of microplastics in various food items, particularly seafood, honey, beer, and fruits and vegetables. The implications for human health are significant, necessitating further research and action to address this emerging environmental issue.
References
• Aydın, R. (2023). Occurrence of microplastics in most consumed fruits and vegetables from Turkey and public risk assessment for consumers. Life, 13(8), 1686. https://doi.org/10.3390/life13081686
• Dambrosio, A., Cometa, S., Capuozzo, F., Ceci, E., Derosa, M., & Quaglia, N. (2023). Occurrence and characterization of microplastics in commercial mussels (Mytilus galloprovincialis) from Apulia region (Italy). Foods, 12(7), 1495. https://doi.org/10.3390/foods12071495
• Diaz-Basantes, M., Conesa, J., & Fullana, A. (2020). Microplastics in honey, beer, milk and refreshments in Ecuador as emerging contaminants. Sustainability, 12(14), 5514. https://doi.org/10.3390/su12145514
• Fiore, C. (2023). Are microplastics a macro issue? A review on the sources of contamination, analytical challenges, and impact on human health of microplastics in food. Foods, 12(21), 3915. https://doi.org/10.3390/foods12213915
• Hussain, K., Romanova, S., Okur, İ., Zhang, D., Kuebler, J., Huang, X., …
Sustainable healthcare is a transformative approach that not only ensures the effective delivery of healthcare services but also aligns with the principles of planetary health. Planetary health recognises the interconnectedness of human health and the environment, emphasising that the well-being of humanity depends on the health of the Earth’s ecosystems. By reducing healthcare’s environmental impact, sustainable healthcare contributes to mitigating climate change, conserving natural resources, and safeguarding global health outcomes.
This approach addresses the urgent need for healthcare systems to operate in harmony with environmental, economic, and social priorities, paving the way for a future where healthcare not only heals individuals but also preserves the planet for generations to come.
What is Sustainable Healthcare?
Sustainable healthcare is a model designed to meet the current and future health needs of populations while minimising its environmental footprint, ensuring financial efficiency, and promoting health equity. This includes reducing carbon emissions, managing resources responsibly, and integrating environmental stewardship into all aspects of healthcare delivery. It also directly supports planetary health by addressing environmental factors that impact human health.
Examples of Sustainable Healthcare Around the World
1. Greener NHS (United Kingdom):
The NHS is leading by example with its commitment to becoming the world’s first net-zero health system by 2040. Initiatives like electric ambulances, energy-efficient hospitals, and reducing single-use plastics have already saved over £90 million annually. These efforts align with planetary health principles by mitigating climate change and improving air quality.
2. Kaiser Permanente (United States):
Achieving carbon neutrality in 2020, Kaiser Permanente invests in renewable energy, green buildings, and sustainable procurement. Their approach not only reduces their environmental impact but also saves millions of dollars annually, demonstrating that sustainability can drive financial and planetary health benefits.
3. Narayana Health (India):
By implementing lean and efficient healthcare practices, Narayana Health has reduced waste and energy use, ensuring affordable care while minimising environmental harm. Their initiatives contribute to planetary health by conserving limited natural resources.
4. South Africa’s Green Hospitals Programme:
Through solar energy systems, rainwater harvesting, and energy-efficient medical equipment, South African hospitals are addressing local health needs while reducing their carbon footprint. These practices demonstrate how sustainability can advance planetary health in resource-limited settings.
Enablers for Sustainable Healthcare
1. Strong Leadership and Policies:
Governments and healthcare leaders must adopt sustainability as a core organisational value, supported by clear policies and incentives.
2. Innovation and Technology:
Advancements such as renewable energy, energy-efficient hospital systems, and digital health tools are critical for reducing healthcare’s ecological footprint.
3. Education and Awareness:
Training healthcare professionals in sustainable practices ensures they are equipped to lead this transformation.
4. Collaboration:
Public-private partnerships and international collaborations help share best practices and pool resources for larger-scale impact.
5. Financial Investment:
Initial funding and incentives for sustainable projects can catalyse significant long-term savings and environmental benefits.
Benefits of Sustainable Healthcare
Adopting sustainable healthcare practices yields multiple benefits that align with the goals of planetary health:
1. Environmental and Planetary Impact:
• Reduced pollution and carbon emissions contribute to climate change mitigation.
• Responsible resource use helps preserve ecosystems and biodiversity.
2. Improved Health Outcomes:
Cleaner air and water, reduced exposure to harmful chemicals, and access to green spaces enhance public health, aligning with the planetary health approach to improving the determinants of health.
3. Financial Savings:
• Greener NHS: Annual savings of £90 million from energy efficiency projects.
• Newcastle Hospitals’ Electric Couriers: Savings of £25,000 annually, with a break-even period of less than a year.
4. Increased Resilience:
Sustainable practices make healthcare systems more resilient to climate-induced disruptions like extreme weather events or resource shortages.
5. Global Leadership:
Adopting sustainable healthcare demonstrates leadership in addressing both global health and environmental challenges.
Convincing the Healthcare Industry
Healthcare providers have a moral and strategic obligation to adopt sustainable practices. The industry must recognise its significant contribution to carbon emissions and the opportunity to lead in addressing climate and health challenges.
Key Arguments for Action:
• Protect Public Health: Reducing pollution directly benefits patient and community health.
• Cost-Effectiveness: Many sustainable practices pay for themselves within a few years, delivering long-term savings.
• Future-Readiness: Early adoption positions organisations as leaders in innovation and resilience.
• Alignment with Planetary Health Goals: Sustainable healthcare directly supports the global commitment to preserving the planet’s ecosystems for future generations.
Is There a Role for Medical Education?
Medical education plays a pivotal role in advancing sustainable healthcare and planetary health:
1. Incorporating Sustainability into Curricula:
Educate medical students about the environmental impact of healthcare and equip them with the knowledge to implement sustainable practices.
2. Promoting Leadership:
Prepare future healthcare professionals to advocate for and lead sustainability initiatives within their organisations.
3. Encouraging Research and Innovation:
Support research into green healthcare innovations and evidence-based strategies to improve sustainability in clinical practice.
4. Fostering Interdisciplinary Thinking:
Bridge medical education with environmental sciences to develop holistic approaches that integrate healthcare delivery with planetary health objectives.
A Call to Action
Sustainable healthcare is no longer an option—it is an imperative for the health of both people and the planet. By adopting sustainable practices, healthcare organisations can address climate change, reduce costs, and improve health outcomes while contributing to planetary health.
The time to act is now. Leaders, policymakers, and educators must champion sustainable healthcare to ensure a resilient, equitable, and environmentally responsible future. Will your organisation rise to this challenge and lead the way towards a healthier world?
Recently, I had the privilege of catching up with an old colleague, Professor Razita Sham, who has been appointed as a Professor in the Kulliyyah of Medicine, International Islamic University Malaysia (IIUM). Prof Razita, who is retiring from UNIMAS, and I share a professional history. Although she is more senior than I am, we completed our public health training together at UKM from 1999 to 2003.
Currently, she serves as a short-term consultant for WHO, focusing particularly on One Health. At IIUM, she has been appointed to help with the implementation of the Master of Public Health (MPH) and Doctor of Public Health (DrPH) programmes. Meanwhile, I have been appointed as part of an expert group working on integrating planetary health into higher education, a role I am deeply passionate about.
During our discussion, we delved into the concepts of planetary health and One Health, which seem to be increasingly interconnected in global health discourse. Prof Razita shared an insightful perspective that resonates with me—she sees One Health as a process or approach, and planetary health as the ultimate outcome.
This conceptualisation makes sense. One Health provides a structured, actionable framework. Originating with a focus on food security, it has since expanded to address complex challenges such as zoonosis, where Prof Razita is currently contributing by developing an action plan. One Health’s strength lies in its ability to bring together human, animal, and environmental health experts to address interconnected health issues.
Planetary health, on the other hand, broadens the focus, encompassing the health of the Earth as a system, where human well-being is inextricably tied to the sustainability of natural systems. It represents the ultimate goal—a thriving planet that supports all forms of life, addressing not just zoonotic diseases but also climate change, environmental degradation, and inequities in global health.
While One Health provides clear, actionable steps, planetary health offers a vision of where those actions should lead us. Both are vital in today’s world, where challenges transcend traditional disciplinary boundaries. By integrating these approaches into education and action, we can ensure that the next generation of health professionals and policymakers is prepared to address these global challenges.
My conversation with Prof Razita left me inspired. It reinforced the importance of collaboration, not just across disciplines but also among those working on interconnected frameworks. As we move forward, aligning processes like One Health with outcomes like planetary health is essential for building a healthier, more sustainable future.
It was a pleasant and unexpected meeting, one that reminded me of how far we have come since our training days at UKM, and how much there is still to learn from one another as we navigate the evolving landscape of public and planetary health.
In the modern landscape of education and community engagement, success has long been measured by outputs—metrics like the number of publications, course completions, or participants reached. While these indicators of process are essential, they often offer only a superficial view of the real-world change that such efforts can achieve. True impact extends beyond these processes, reaching deeper levels of personal and societal transformation. Impact affects various spheres: individuals who experience personal growth, families whose values and dynamics are enriched, communities that gain cohesion, institutions that drive meaningful progress, nations that grow in stability and well-being, and even the planet, which benefits from sustainable practices and global cooperation. By shifting our focus from process to impact, we can foster change that is both meaningful and lasting.
Understanding Impact
Impact in education and community work can be conceptualised as the tangible, enduring benefits that result from these initiatives, spanning multiple levels. At the personal level, education or community engagement fosters individual growth, strengthening personal values and building resilience (Bryson et al., 2020). This transformation often extends to family dynamics, where these newly acquired values shape interactions, fostering environments that support learning, empathy, and well-being (World Health Organization [WHO], 2017). At the community level, the process of engagement is critical; however, true impact occurs when communities transform in ways that reflect growth and shared values, addressing issues from literacy to healthcare access (Fraser et al., 2019). Institutional impact further amplifies this by driving policies, shaping curricula, and creating initiatives that reinforce societal values and equity. Nationally, impactful education produces skilled professionals and engaged citizens, contributing to financial stability, political resilience, and sustainable progress (UNESCO, 2015). Ultimately, the ripple effect of these transformations has the potential to address global challenges, fostering planetary health and sustainability (Crawford et al., 2021).
Why Impact Matters
Aligning Actions with Purpose
While output-based metrics track the processes of learning, such as course completion rates or publication counts, focusing on impact reorients efforts toward purpose. This approach ensures that educational and research activities are truly meaningful, working to create compassionate professionals, sustainable communities, or informed citizens. In medical education, for example, impact could be measured by improved patient outcomes rather than just the number of doctors trained (Bryson et al., 2020).
Creating Sustainable Change
A focus on impact cultivates changes that endure beyond the lifespan of a project. In community health, for example, a programme aimed at reducing disease prevalence may have sustainable impact if it results in long-term behavioural change, such as improved hygiene practices or healthier lifestyle choices among community members (Green et al., 2018). Sustainable transformation, as opposed to temporary gains, requires that the underlying values and practices endure over time, leading to lasting benefits for individuals and societies.
Encouraging Accountability
Evaluating impact holds educators, researchers, and community leaders accountable not only for the processes they initiate but also for the long-term effects of their work. Questions of impact shift the focus from quantitative outputs to qualitative change, asking whether a project has improved social values, supported financial sustainability, or contributed to political stability (UNESCO, 2015). This accountability framework enhances the integrity of educational and research programmes by ensuring they deliver genuine societal benefits.
Enhancing Financial and Social Value
Focusing on impact also supports the wise allocation of resources, with funding directed towards projects that yield significant, long-term benefits. Financial impact can be seen in economic resilience, as educational programmes improve employability and health initiatives reduce public healthcare costs (Crawford et al., 2021). Social value is equally crucial; by promoting equity, inclusion, and community welfare, impactful initiatives strengthen the social fabric and build resilience.
Addressing Global Challenges and Planetary Health
Educational and research institutions, by aligning with the United Nations Sustainable Development Goals (SDGs), can actively contribute to planetary health and sustainability (UNESCO, 2015). For instance, research that advances environmental literacy or fosters sustainable practices directly supports global sustainability goals, emphasising that every local initiative has the potential to contribute to a healthier planet.
Measuring Impact Beyond Traditional Metrics
Impact measurement requires a nuanced approach, utilising tools and methods that capture both immediate and long-term effects across multiple domains. Personal growth can be assessed through reflective evaluations and surveys that track changes in values and behaviours (WHO, 2017). Community impact might involve participatory research methods that gather qualitative insights from community members, while financial sustainability can be gauged through Social Return on Investment (SROI) analyses, which quantify economic benefits against costs (Green et al., 2018). Policy analysis can measure political impact, tracing how research influences governance or legislative change (Bodilly et al., 2017). At the planetary level, environmental impact assessments aligned with SDG metrics allow institutions to measure contributions toward global sustainability (Crawford et al., 2021).
The Role of University Rankings in Measuring Impact
Increasingly, university ranking systems are recognising the importance of impact-focused metrics, moving beyond traditional outputs to capture the broader contributions of institutions to society and the environment. The Times Higher Education (THE) Impact Rankings evaluates universities based on their alignment with the United Nations Sustainable Development Goals (SDGs), offering insights into how institutions address global challenges such as poverty and health (Times Higher Education, n.d.). The QS Stars University Rating System includes an “Impact” category that assesses community engagement and social responsibility (QS Quacquarelli Symonds, n.d.), while the UI GreenMetric World University Rankings specifically measures environmental sustainability practices on campuses (Universitas Indonesia, 2023). U-Multirank, funded by the European Commission, takes a multidimensional approach that includes regional engagement and knowledge transfer, allowing for a more nuanced assessment of local impact (U-Multirank, n.d.). These rankings encourage universities to prioritise sustainable practices, community engagement, and social responsibility, fostering a global movement towards impact-driven education.
A Future Built on Impact
As we navigate the future of education, research, and community engagement, a focus on impact is essential for creating meaningful, lasting change. This approach reframes educational initiatives as investments in personal development, family and social values, financial resilience, political stability, and planetary health. By integrating these dimensions into the core of educational and research efforts, institutions can drive progress on multiple fronts, fostering a more resilient, equitable, and sustainable society. In essence, a shift from process to impact enables us to fulfil not only the immediate goals of education and research but also the broader, transformative changes that these fields can inspire.
Disclaimer: This article was created using OpenAI’s ChatGPT for research and educational purposes.
References
Bodilly, S. J., Chun, J., Ikemoto, G. S., & Stockly, S. (2017). Improving school leadership: The promise of cohesive leadership systems. Rand Corporation.
Bryson, J. M., Patton, M. Q., & Bowman, R. A. (2020). Working across boundaries: Making collaboration work in government and nonprofit organizations. John Wiley & Sons.
Crawford, M., Hoque, Z., & Moll, J. (2021). Public sector reform and performance management: Managing on the edge. Routledge.
Fraser, N., Bunting, M., & O’Brien, M. (2019). Community engagement: Key to better health and education outcomes. World Health Organization.
Green, C., Hinton, P., & Ridley, M. (2018). Sustainable health and community development: Building resilience and equity. Oxford University Press.
Times Higher Education. (n.d.). Impact Rankings 2023. Times Higher Education. https://www.timeshighereducation.com/impactrankings
U-Multirank. (n.d.). What is U-Multirank? https://www.umultirank.org
UNESCO. (2015). Education 2030: Incheon declaration and framework for action towards inclusive and equitable quality education and lifelong learning for all. UNESCO.
Universitas Indonesia. (2023). UI GreenMetric World University Rankings 2023. Universitas Indonesia. https://greenmetric.ui.ac.id/
World Health Organization. (2017). Community engagement framework for quality, people-centered, and resilient health services. WHO.
The MBBS programme is designed to produce doctors who are competent, compassionate, and safe. This aim extends beyond technical proficiency to cultivate healthcare professionals who are ethically driven, empathetic, and dedicated to the wellbeing of both their patients and society at large. As the world faces increasingly complex health challenges due to environmental crises, these qualities of compassion and competency must also extend to planetary health. Recognising the profound connections between human and environmental health, doctors today must be prepared to understand and address health issues within a broader ecological context.
Moreover, the future of healthcare is uncertain, and doctors will confront unknown and unpredictable challenges. Emerging diseases, environmental degradation, and new public health threats will require healthcare professionals who are adaptable, forward-thinking, and equipped to approach health holistically. Integrating planetary health into the MBBS curriculum aligns with these objectives, preparing future doctors to respond to the interwoven challenges of environmental and human health. Through the framework of Education for Sustainable Development (ESD) and recent updates to the Malaysian Qualifications Framework (MQF), medical educators can seamlessly incorporate planetary health principles without increasing total learning time. This paper outlines how these concepts can be embedded within the existing curriculum, equipping the next generation of doctors to safeguard both human health and environmental sustainability in an unpredictable future.
Understanding Planetary Health, Sustainability, OneHealth, and Nature-Based Solutions
Planetary health, sustainability (specifically, the Sustainable Development Goals or SDGs), OneHealth, and nature-based solutions (NbS) are interconnected yet distinct approaches within environmental and health frameworks. Here’s a comparison:
Focuses on how environmental health affects human wellbeing (Whitmee et al., 2015; Myers & Frumkin, 2020)
Specifically targets interactions between human, animal, and environmental health, particularly zoonotic diseases (Rabinowitz et al., 2018)
Practical actions that protect, sustainably manage, or restore ecosystems to address societal and health challenges (IUCN, 2023)
Primary Goal
To balance current needs with preserving resources and stability for future generations (United Nations, 2015)
To protect human health by safeguarding natural ecosystems and addressing environmental risks (Whitmee et al., 2015)
To address health risks at the intersection of human, animal, and environmental health, especially focusing on zoonoses
To leverage natural systems to enhance resilience and provide ecosystem services that benefit both human and planetary health (IUCN, 2023)
Focus Areas
Resource management, waste reduction, social equity, economic stability, and environmental protection (Raworth, 2017)
Human health impacts from climate change, pollution, and ecosystem degradation (Prescott & Logan, 2019; Myers & Frumkin, 2020)
Zoonotic disease control, ecosystem health, and the interconnectedness of human and animal health (Rabinowitz et al., 2018)
Climate change adaptation, ecosystem restoration, green infrastructure, urban green spaces, and sustainable agriculture (World Economic Forum, 2024)
Applications
Multisectoral approach: energy, agriculture, economics, social policy, etc. (United Nations, 2015)
Primarily within healthcare and public health, with a focus on preventing environmental impacts on human health (Myers & Frumkin, 2020)
Predominantly used in infectious disease control, veterinary science, and environmental health
Used in urban planning, public health, climate resilience, water management, and more (IUCN, 2023; World Economic Forum, 2024)
Relationship to Health
Indirect: Sustainable practices support health by maintaining stable resources and healthy environments (Raworth, 2017)
Direct: Addresses how environmental degradation leads to immediate and long-term health impacts on populations
Direct: Examines the specific health implications of human-animal-environment interactions, focusing on shared diseases
Direct: NbS provide ecosystem services that enhance air and water quality, reduce disease vectors, and promote mental and physical wellbeing (IUCN, 2023)
Scope Comparison
Broader scope, incorporating planetary health as a subset (United Nations, 2015)
More focused within sustainability, specifically relating to environmental impacts on health (Whitmee et al., 2015)
Narrowest scope, focusing specifically on health issues arising from human-animal-environment interactions (Rabinowitz et al., 2018)
Targeted approach within planetary health, using ecosystems to deliver sustainable health and environmental outcomes (World Economic Forum, 2024)
This table clarifies that sustainability is the broadest framework, with planetary health focusing on environmental impacts on human wellbeing. OneHealth and NbS are more specific, with NbS providing actionable solutions that align with both planetary and human health.
The Role of Nature-Based Solutions in Planetary Health and Medical Education
Nature-based solutions, supported by frameworks like those from the International Union for Conservation of Nature (IUCN), are integral to planetary health, providing ecosystem services that benefit human wellbeing. Examples include the role of green urban spaces in reducing respiratory diseases, wetlands in water purification, and mangroves in coastal resilience. Pharmaceutical companies are also beginning to invest in NbS, recognising their importance in sourcing medicinal compounds sustainably and supporting biodiversity that mitigates disease spread (World Economic Forum, 2024).
By incorporating NbS concepts into medical education, future healthcare professionals can better understand how ecosystem health directly impacts human health. This approach allows doctors to recommend preventive strategies that support both individual and community health, aligning with planetary health goals.
Seamless Integration of Planetary Health and NbS in Medical Education
Nature-based solutions can be seamlessly integrated into MBBS modules. Here’s a structure for how these topics align with existing curriculum goals:
1. Physiology and Pathology
• Embed environmental factors, such as pollution and climate change, in discussions of respiratory and cardiovascular health.
• Include studies on nanoplastic exposure and its potential inflammatory effects in cardiovascular health modules (Jin et al., 2022).
• Integrate the effects of urban green spaces on lowering rates of respiratory diseases due to reduced pollution and increased physical activity.
2. Community Medicine and Public Health
• Teach how NbS can mitigate vector-borne diseases, such as dengue and malaria, by restoring wetlands and promoting urban green spaces.
• Discuss the importance of sustainable food systems within nutrition topics, linking agroforestry practices with improved nutrition and reduced pesticide use (World Economic Forum, 2024).
• Explore mental health benefits of nature exposure, using urban green space initiatives as a case study.
3. Pharmacology
• Examine sustainable medicinal sourcing and the role of biodiversity in providing plant-based medicines. Pharmaceutical companies’ investments in biodiversity protection reflect this approach (World Economic Forum, 2024).
• Discuss antibiotic stewardship to prevent environmental contamination and antimicrobial resistance (Singer et al., 2019).
4. Clinical Rotations
• Include case studies that address health impacts of environmental changes, such as heat-related illnesses and waterborne diseases from pollution and ecosystem degradation.
• Emphasize NbS as community-level solutions in clinical practice, such as recommending exposure to green spaces for stress management and discussing community advocacy for clean water and air.
Expected Outcomes of Integrating Planetary Health and NbS
Aligned with the updated MQF and ESD principles, the following are the expected outcomes for medical graduates 4-5 years after completing a curriculum that integrates planetary health and NbS:
1. Holistic Patient Care with Planetary Health Awareness
Graduates will deliver patient care that considers environmental factors affecting health, advising patients on lifestyle choices that support both personal and planetary wellbeing.
2. Advocacy for Sustainable Healthcare
Graduates will promote sustainable practices in healthcare settings, such as reducing waste, supporting biodiversity, and conserving energy, contributing to planetary health goals.
3. Community Engagement and Environmental Health Advocacy
Graduates will educate communities on the benefits of NbS, advocating for policies that promote health through clean air, water, and urban greenery.
4. Ethical Responsibility in Environmental Health
Graduates will understand their role in promoting ecosystem protection as a foundation for health, supporting efforts to reduce health disparities related to environmental degradation.
Recommendations
Integrating planetary health and NbS into the MBBS curriculum, without adding new topics, enriches medical education by promoting a global awareness of health interdependencies. This integration equips doctors to address health in ways that support human and environmental sustainability, making a positive impact on society and the planet.
Disclaimer
This article was created with assistance from ChatGPT, an AI language model, to provide an overview of integrating planetary health into medical education. While the content has been reviewed to ensure accuracy and relevance, readers are encouraged to consult additional sources and expert opinions when implementing educational frameworks.
References
International Union for Conservation of Nature. (2023). Nature-based solutions. Retrieved from https://iucn.org/our-work/nature-based-solutions
Jin, H., Ma, T., Sha, X., Liu, Z., & Zhou, Y. (2022). Nanoplastics and cardiovascular diseases: A link from the environment to human health. Environmental Research, 204, 112281. https://doi.org/10.1016/j.envres.2021.112281
Landrigan, P. J., Fuller, R., Acosta, N. J. R., Adeyi, O., Arnold, R., Basu, N., & Zhong, M. (2018). The Lancet Commission on pollution and health. The Lancet Planetary Health, 2(1), e26-e36. https://doi.org/10.1016/S2542-5196(17)30173-8
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., & Ezzati, M. (2021). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2224-2260. https://doi.org/10.1016/S0140-6736(12)61766-8
Myers, S. S., & Frumkin, H. (2020). Planetary health: Protecting nature to protect ourselves. Island Press.
Prescott, S. L., & Logan, A. C. (2019). Planetary health: From the wellspring of holistic medicine to personal and public health imperative. Explore, 15(2), 98-106. https://doi.org/10.1016/j.explore.2018.11.008
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Rabinowitz, P. M., Natterson-Horowitz, B., Kahn, L. H., & Kock, R. (2018). One Health and Planetary Health: Perspectives from the U.S. National Institutes of Health. National Institutes of Health.
Raworth, K. (2017). Doughnut economics: Seven ways to think like a 21st-century economist. Chelsea Green Publishing.
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The rise of planetary health as an essential framework for addressing the intersecting challenges of human and environmental health has created a need for clarity. However, it is often confused with other important global frameworks, including global health, sustainable development goals (SDGs), Education for Sustainable Development (ESD), environmental health, and One Health. Each of these frameworks carries distinct objectives and approaches. The concept of Sejahtera, deeply embedded in Malaysia’s National Education Philosophy, offers a holistic lens that integrates not only physical and environmental health but also mental, social, and spiritual well-being. By streamlining these overlapping frameworks through Sejahtera, higher education can adopt a more balanced and culturally relevant approach to global well-being. This article explores the need for curriculum reform in higher education to incorporate both planetary health and Sejahtera.
Origins and Frameworks of Health and Sustainability
Each framework—whether it is planetary health, global health, or the SDGs—arose at different times in response to specific global challenges. Their individual inception dates and objectives highlight the need to integrate them into a coherent framework for education. This can be achieved by leveraging Sejahtera’s holistic approach.
Table 1 provides a comparative overview of these frameworks, outlining their origins, year of inception, time frames, and objectives.
Table 1: Comparison of Planetary Health, Global Health, ESD, One Health, Environmental Health, and SDGs
Framework
Origin of Idea
Year Announced
Time Frame
Objective
Environmental Health
Rooted in public health practices of the 19th century, focusing on the relationship between environment and health.
19th century, formalised mid-20th century
Ongoing
To manage and mitigate environmental risks to reduce the burden of disease and promote healthy living environments (WHO, 2021).
Global Health
Emerged from public health and international health efforts, particularly during the 20th century, and became well-established post-2000.
Mid-20th century but evolved into the modern concept in the 2000s.
Ongoing
To address health disparities and improve health equity by focusing on global health challenges, with an emphasis on disease prevention and access to healthcare.
One Health
Developed from the veterinary and medical sciences with a focus on human-animal-environment interactions, particularly zoonotic diseases.
Early 2000s
Ongoing
To achieve optimal health for humans, animals, and the environment through a multidisciplinary approach, particularly in the control of zoonotic diseases.
ESD (Education for Sustainable Development)
Introduced by UNESCO to incorporate sustainable development into education systems worldwide.
2002
Target 2030
To foster knowledge, skills, values, and behaviours that promote sustainability across various aspects of society.
SDGs (Sustainable Development Goals)
Evolved from the Millennium Development Goals (MDGs), adopted by the United Nations to address a wide range of global challenges.
2015 (UN General Assembly)
Target 2030
To create a comprehensive framework for sustainable development, addressing poverty, inequality, climate change, and health through 17 interconnected goals.
Planetary Health
Initiated by the Rockefeller Foundation-Lancet Commission, focusing on the connection between human health and the state of natural ecosystems.
2015
Ongoing
To safeguard human health by preserving the integrity of the Earth’s natural systems, recognising the importance of maintaining ecological balance to support human well-being.
Sejahtera: Clarifying Overlapping Frameworks
Sejahtera offers a valuable framework that can help clarify the confusion between these overlapping global health and sustainability frameworks. Malaysia’s National Education Philosophy highlights the importance of fostering holistic well-being, which encompasses not only intellectual development but also emotional, spiritual, and physical balance. The National Education Philosophy emphasizes the creation of balanced individuals who contribute to societal harmony and well-being based on faith, knowledge, and a sense of responsibility (Kementerian Pendidikan Malaysia, 2021).
This philosophy resonates with planetary health’s emphasis on sustainability and human health, but Sejahtera extends it by adding a spiritual and ethical dimension that is often absent in other global frameworks. By integrating Sejahtera into higher education curricula, universities can foster a more holistic approach that addresses not only the scientific and medical aspects of planetary health but also its cultural and spiritual dimensions.
Curriculum Reform: Integrating Sejahtera and Planetary Health
To achieve this integration, universities must shift toward interdisciplinary learning that incorporates the social, spiritual, and cultural dimensions of well-being alongside environmental and health sciences.
Incorporating Sejahtera and planetary health requires fostering a curriculum that moves beyond a purely scientific understanding of environmental health. For example, medical students could be taught about the impacts of environmental degradation on mental health, while also exploring the spiritual practices that help individuals and communities cope with these challenges. Case-based learning can be employed to engage students in real-world scenarios where they must balance scientific knowledge with ethical and spiritual considerations.
Sustainability projects on university campuses can also provide hands-on learning opportunities, allowing students to apply planetary health and Sejahtera principles to create green spaces, conserve energy, and promote community resilience. These projects help students understand the practical applications of sustainability while also fostering a sense of responsibility toward the environment and society.
Streamlining Frameworks for a Coherent Educational Approach
Given the frequent confusion between planetary health and other frameworks like global health, the SDGs, and One Health, integrating Sejahtera provides a unifying philosophy that clarifies these overlapping areas. Sejahtera’s focus on holistic balance offers a cohesive framework that brings together the strengths of each of these approaches, providing students with a clear and integrated understanding of how they can promote sustainable well-being. By incorporating Sejahtera into higher education curricula, universities can ensure that students are equipped with the knowledge, skills, and values necessary to tackle the world’s most pressing environmental and health challenges.
Conclusion
Incorporating Sejahtera and planetary health into higher education curricula offers a transformative opportunity to promote a holistic and integrated approach to global health and sustainability. While planetary health provides the scientific foundation for understanding the relationship between human health and the environment, Sejahtera adds a culturally grounded framework that promotes harmony between humans, nature, and society. This alignment with Malaysia’s National Education Philosophy ensures that future generations are equipped not only to address the environmental and health challenges of our time but also to foster spiritual and ethical well-being in their personal and professional lives.
Disclaimer: The ideas expressed in this article were generated with assistance from ChatGPT, an AI language model.
References
Capon, A. G., & Horton, R. (2019). Planetary health: Safeguarding health in the Anthropocene epoch. The Lancet, 390(10114), 865-870.
Kementerian Pendidikan Malaysia. (2021). Falsafah Pendidikan Kebangsaan. Available at https://www.moe.gov.my.
Rockström, J., Steffen, W., Noone, K., Persson, Å., Chapin III, F. S., Lambin, E., … & Foley, J. A. (2009). A safe operating space for humanity. Nature, 461(7263), 472-475.
Rockefeller Foundation-Lancet Commission. (2015). Safeguarding human health in the Anthropocene epoch: Report of the Rockefeller Foundation–Lancet Commission on planetary health. The Lancet, 386(10007), 1973-2028.
Whitmee, S., Haines, A., Beyrer, C., Boltz, F., Capon, A. G., Ferreira de Souza Dias, B., … & Rockström, J. (2015). Safeguarding human health in the Anthropocene epoch: Report of The Rockefeller Foundation–Lancet Commission on planetary health. The Lancet, 386(10007), 1973-2028.
UNESCO. (2014). Education for Sustainable Development: A Roadmap for Implementing the Global Action Programme on ESD. Available at https://unesdoc.unesco.org/ark:/48223/pf0000230514.