We are currently living in the Anthropocene, a geological era in which human activities are the primary determinant of our climate and environment. The Lancet Commission on Health and Climate Change previously described climate change as the greatest threat to human health in the 21st century and the 2015 report reframed this as the greatest public health opportunity, given that we can actively reduce our environmental impact and that actions taken can directly benefit health.1

Human health is dependent on planetary health, and it is threatened directly through extreme events such as droughts, flooding, storms and heatwaves as well as indirectly by the impact that climate change has on food production, air quality and ecologies.1 In 2019, we saw widespread climate disruption (including European heatwaves, Australian bush fires and flooding in the UK) and air pollution remains the largest cause of global death, responsible for around 7 million additional deaths per year.1

Our interference with the natural world is linked to new and emerging infectious diseases, due to climate change (climate sensitive infectious diseases have been linked with changes in the geographical spread of vector-borne diseases, increased waterborne disease transmission following extreme weather events and biodiversity loss),1 alongside our disruption of ecosystems and habitats (including novel interactions between humans and natural viral hosts as well as intensive farming practices). The majority (70%) of novel and emerging infectious diseases are zoonotic,2 transmitted from animals to humans (sometimes subsequently mutating to enable human-to-human transmission). Recent zoonotic epidemics include variant Creutzfeldt–Jakob disease, bird flu, swine flu, Ebola, Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV-1).

As we are all acutely aware, most recently, the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the COVID-19 pandemic, with bats thought to be the viral species of origin. We are likely to see further zoonotic viral epidemics and climate related health crises if we continue our current trajectory of environmental disruption.1. . .

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