São Paulo Declaration for Planetary Health

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We, the global planetary health community, raise an alarm that the ongoing degradation of our planet’s natural systems is a clear and present danger to the health of all people everywhere. A just, global transition in how we live is required to optimize the health and well-being of people and the living world in which we are embedded.

The COVID-19 pandemic is the most recent in a series of distress signals ringing around the world. Climate change, biodiversity loss, and destruction of the quality of air, water, and soil are eroding the fundamental life support systems that we all depend on. From tropical storms devastating populations across the Caribbean and Pacific, historic heat waves and fires from North America to Australia and the Amazon, to the worst locust outbreak in 70 years destroying crops in East Africa, lives and livelihoods have been lost particularly among the most poor and marginalized communities. Every dimension of human health and well-being is now affected by global environmental change. The planetary health science is clear: we can no longer safeguard human health unless we change course.

We need a fundamental shift in how we live on Earth, what we are calling the Great Transition. Achieving the Great Transition will require rapid and deep structural changes across most dimensions of human activity. This includes how we produce and consume food, energy, and manufactured goods; how we construct and live in our cities; and how we consider and measure growth, progress and development, and govern ourselves. It will also require rethinking our values and relationship within Nature and to each other from human exceptionalism, domination, and scarcity to interdependence, equity, and regeneration. The Great Transition offers the possibility of greater richness of experience, greater well-being, and an enhanced opportunity for all beings to thrive. It will take practitioners, scholars, and policy makers across every dimension of human activity working together. It will require listening to, integrating, and amplifying voices in every community from Indigenous Peoples, faith traditions, artists, entrepreneurs, to scientists. Every person, in every place, from every calling, has a role to play in safeguarding the health of the planet and people for future generations.

This declaration was produced by the planetary health community at the 2021 Planetary Health Annual Meeting in São Paulo, Brazil, and is supported by the below signatories. We represent communities that are bridged across geographies, cultures, sectors, disciplines, and generations. We call on governments, the private sector, civil society, and the general public to commit to the Great Transition to safeguard a healthy and equitable future for humanity and protect all life on Earth.

Key Messages

For All--

Set an intention. We invite you to consider yourself a partner in planetary healing. We all live together in an interconnected world and the actions of each of us inspire others. Therefore, together, we pledge to dedicate our lives to the service of humanity, and to the protection and restoration of the natural systems on which humans and all other species who share our home depend.

For the Agricultural Sector and Food Systems--

Recognize that the agricultural sector and food systems are at the center of planetary health in terms of meeting our global food needs, achieving social justice, and decreasing our footprint on natural systems. How this sector moves forward with agricultural practices and food options will determine the future of human health and well-being. Promote sustainable intensification practices as well as healthy diets, and include planetary health experts in developing solutions to reduce the environmental and health impacts of this sector. Utilize all ways of knowing, including the latest science and millennia of traditional and Indigenous knowledges, to implement agricultural systems that meet demand and reduce pressure on natural systems.

For Artists, Poets, Writers, and Musicians--

Help humanity fashion new narratives about our relationship to Nature and to each other that rejects the myth of human exceptionalism and emphasizes our interdependence. Revitalize and highlight the richness and beauty of the diverse cultural traditions and languages that we have, especially to celebrate environment and health interlinkages. Create art that reflects what the Great Transition can look and feel like, and inspires the public to act.

For Businesses--

The sustainability and long-term profit of businesses depends on the well-being of society and Nature. Investments and corporate principles must correspond to planetary health values and strategies that decrease greenhouse gas emissions, increase biodiversity, reduce soil, air and water pollution, and improve health equity. Companies must begin investing in and implementing plans for net-zero, Nature-positive businesses immediately, and uphold agreements already in place including the Aichi and Paris accords. To achieve this, enact sustainable economic and business models that respect planetary boundaries and operationalize planetary health. Advocate for government policies and incentives that promote the Great Transition.

For Cities and Urban Planners--

Recognize that most of humanity now lives in cities, and that this trend will continue with much of the world’s future population growth expected to be in cities in developing economies. Design cities with environmentally-friendly materials that can be reused and recycled. Design and incentivize green, energy efficient buildings in neighborhoods mapped out with outdoor spaces and optimized for active transportation. Ensure accessible public transportation for all inhabitants to reduce automobile usage and promote equity. Create waste management systems that protect surrounding ecosystems and recapture energy and water. Design cities to meet their potential to dramatically reduce our ecological footprints while optimizing physical and mental health.

For Economists--

Promote planetary health by transitioning away from Gross Domestic Product (GDP) growth as the primary metric for measuring economic success and development. Instead, emphasize metrics and investments that support preservation and regeneration of Nature, human well-being, equity, and happiness--the things we truly value. This would allow the economy to serve all of us and the living world in which it is embedded.

For Financial Institutions--

Rethink the meaning of ethical as well as equitable investing and lending in a time when our impacts on natural systems are putting the poorest people in the world, Indigenous communities, and future generations in harm’s way. Do not invest in projects and enterprises that profit from degrading Nature and thus harming humankind. Rather, prioritize those that emphasize human well-being and regeneration of natural systems.

For Funders--

Allocate long-term and stable funding for generating new planetary health knowledge and the translation of that knowledge into practice. Support scaling up planetary health solutions as well as reducing vulnerabilities and inequities in communities worldwide. Focus on transdisciplinary research, policy, practice, and social movement building to encourage revitalization efforts and progressive actions for our most pressing planetary health needs. Co-design calls for grants based on the needs of end-user stakeholders. Break down systemic barriers for accessing capital by prioritizing funding that reaches those who are representative of their communities.

For Governments--

Center planetary health in international, national, and local policies, recovery plans, and budgets, specifically in post COVID-19 plans and economic and environmental policies. Implement actions for a just economic decarbonization and energy transition for a green and healthy recovery. The health co-benefits and co-harms of policies must be considered and evaluated in government decision-making now and into the future. As an urgent first step, take action to promote public access to health services as a human right. Work with the most marginalized and disenfranchised communities facing the disproportionate effects of planetary health issues. Listen to and entrust them with the resources to develop solutions. Center inclusion and equity when developing plans and solutions as that is the way to achieve a healthy and safe world for all.

For Health Practitioners--

Immediately incorporate planetary health concepts and values into the main curricula and professional codes of conduct for all future health practitioners. Educate patients on the concepts of planetary health and utilize health practitioners’ trusted voices to raise awareness about the adverse effects of our current dysfunctional relationship with our planet. Draw upon diverse knowledge practices beyond westernized disciplines including those of Indigenous Peoples. Advocate for patient-centered policies that advance planetary health, including public access to health services as a human right, and incorporate solutions and community services beyond the clinic.

For the Health Sector--

Reorient all aspects of health systems toward planetary health--from procurement, energy sources, healthcare efficiency, to waste reduction. Commit to achieving a Nature-positive, carbon neutral healthcare system before 2040, while strengthening health systems’ resilience to global environmental changes. Disease prevention, health promotion, and health equity must be at the heart of this transition. Incorporate health perspectives and practices beyond traditional Western methods, including traditional knowledges led by Indigenous Peoples, as well as other integrative health practices. Consider social and ecological determinants of health for both individuals and communities, including public and active transportation; access to health care facilities; green spaces to provide social, recreational, and mental health benefits; air, soil, and water quality; and access to affordable and nutritious diets, particularly for lower income communities. Advocate for public access to culturally appropriate health services as a human right.

For International Organizations--

Overcome silos for an inclusive form of multilateralism that centers healthy people and a healthy planet and recognizes their interdependence. Cross-cutting, transdisciplinary cooperation is imperative to merge multiple agendas and strengthen the health-environment nexus. Work towards enhanced governance through equitable influence of low-, middle- and high- income countries and the protection of human and environmental rights.

For Jurists and Lawmakers--

Improve governance mechanisms including transparency and accountability, and hold those who cause planetary health damage to account. Advocate and urgently implement the legal recognition of the ‘Rights of Nature’ through legal personhood of Nature designation. Additionally, advocate for ecocide as a crime within international law, while also recognizing Indigenous First or Natural law around the globe, prioritizing the rights of Nature. In addition, create policies and legal structures that ensure future generations have at least the same quality of life as we do now.

For Media--

The Great Transition depends on a free press and an open platform for discussions, connections, and sharing. Commit to inform and educate society on planetary health science, values, challenges, and solutions. Tell the stories of those who are protecting Nature and fighting for justice and equity, and elucidate the connections between their actions, a safe environment, and human health. Hold to account those who are damaging the planet’s natural systems and mistreating other people. Inspire and motivate rather than eliciting fear. Use imagery that is honest and respects the dignity of peoples portrayed. Fight infodemics of misinformation, and lift up the voices of those who do not traditionally hold power.

For Researchers--

Engage with and initiate transdisciplinary efforts to inform and operationalize planetary health-focused research, policy, and practice, with an emphasis on solution-focused inquiry and applications that are inclusive of all ways of knowing and backgrounds. Work actively to promote a fair and equitable research and education environment involving middle- and low- income countries, so that all scientists can be real partners in finding solutions for our common problems. Promote open science principles and practices. Elevate co-designed and participatory-based research with communities. Emphasize methods and collaborations to better communicate planetary health and increase public and political awareness. Work to develop solutions for all those in need.

For Schools--

Teach planetary health education from an early age. Advance universal education and embed planetary health throughout primary and secondary school levels, while ensuring women and girls have equity in access to such information. Utilize transdisciplinary and participatory approaches to design teachers’ education and training materials, as well as school materials that are appropriate for specific age groups and contexts. Incorporate Nature-based and experiential learning outside of the classroom. Educate and empower youth to become current and future leaders of planetary health action, and foster their ability to influence the decision-making of their parents, communities, and beyond.

For Spiritual leaders of all faiths--

Lead in the creation of unity and solidarity among all peoples of the world, based on our shared, common home. Expand the mindset of humanity to embrace ancient teachings and wisdom to foster a flourishing and pluralistic civilization in harmony with the planet. Help guide people to reinvest in our relationship within Nature with the reverence and awe that is felt by so many, and emphasize the moral dimension of protecting all life on Earth. Utilize religious and spiritually affiliated institutions for planetary health education, training, engagement, and action.

For Technology professionals--

Consider the power and the impact of technology to facilitate transformative solutions for the benefit of all people and the planet, and to transmit evidence-based information. Support international work designed to prevent web-based misinformation. Design technology for longevity in order to reduce waste. Co-develop tools with local stakeholders adapted to contextual needs and planetary demands, while not forgetting lessons from Nature, traditional societies, and past undertakings. Engage across disciplines, sectors, and worldviews to develop and advance planetary health promoting technologies, as well as to ensure accessibility and transparency are at the forefront of design and decision-making.

For Universities and Higher Education--

Advocate for and prioritize the allocation of resources to enable and encourage transdisciplinary planetary health scholarship and education within and between institutions. Align faculty promotion and research incentives courageously to better ensure co-creation and translation of evidence into applicable policy and practice. Ensure that planetary health curricula are embedded in all programs and faculties in order to foster planetary health citizens, regardless of discipline. Promote access and equity across institutions so that all people can participate in research and education.

For Youth Representatives--

Recognize the importance of all generations in the Great Transition. Empower your peers and elders to advocate for planetary health. Push back against the common tokenization of youth to ensure young people and future generations have an equal seat at decision-making tables. Join planetary health groups, organizations, and co-create in service for your and all generations. Be brave and creative in your reimagination of and leadership toward a future that is healthy and fair for all beings.


We, the planetary health community, call upon all stakeholders to take urgent and decisive action to achieve the Great Transition. Our recommendations and list of stakeholders are not exhaustive. Rather, they are a compass guiding us towards the most promising pathways to support a more just and resilient post-pandemic world. We cannot work or live in silos: Catalyzing and implementing fundamental shifts in how we live on Earth will require systemic partnerships across all of human society. While everyone has their own unique role, only by working together as a global community, rooted in planetary health principles, can we co-create to achieve the Great Transition.

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