Conference Agenda

Climate change contributes to compounding crises of social and health inequities. Underlying these intersecting problems is a global consumptogenic system of institutions, actors, norms, policies, and commercial activities that incentivise excessive production and consumption of fossil fuel-reliant goods and services with negative environmental, social, and health impacts. Low- and middle-income countries, and socially disadvantaged groups are most likely to bear the brunt of global failures to reign in the consumptogenic system. In order to promote planetary health equity (PHE) – the equitable enjoyment of good health in a stable ecosystem – this panel contributes inter-disciplinary approaches to understanding the structures and actor-dynamics that constitute and maintain the consumptogenic system, as well as parameters for coherent governance to improve planetary health equity outcomes.

The panel draws on emerging work from the [Project name removed for anonymous review process], which seeks to provide a roadmap for PHE. [Project name removed for anonymous review process] is an initiative [Affiliation removed for anonymous review process] on ‘Governance for planetary health equity’. With perspectives from political economy, public health, networks and systems science, this panel will present new conceptual thinking and empirics around the complexities, dynamics, and trajectories of the global consumptogenic system in the 21^st century.

Panellists will tackle the following questions:

1. What is the PHE crisis and the contributing governance failures therein?
2. How can we understand the networked architecture of institutions and actors in the global consumptogenic system?
3. What is needed for coherent governance for PHE?
4. What new lines of research flow from an enquiry into the governance of the consumptogenic system and planetary health equity?

Planetary health equity (PHE) is the equitable enjoyment of good health in a stable ecosystem. PHE is a concept that recognises the impact of climate change on social and health inequities. It also recognises the importance for health equity of considering planetary systems. PHE therefore embodies the common drivers of climate change and health inequity.

PHE is in crisis. Human-made climate change is devastating global populations through hotter temperatures, wildfires, and more severe and frequent storms, flooding, and landslides. A tsunami of health inequities will result from this. People and nations who are poor, the elderly, people with disabilities, and those who are socially marginalised are the least able to adapt to the changing climate, unable to escape the floods, fires and heat, and live in dwellings and environments that amplify its effects. All of this climate change-exacerbated social inequity adds to existing inequities in disease burdens and premature mortality.

Here we argue that addressing this PHE crisis demands understanding and action on the structural drivers of social inequity and climate change. These drivers come in the potent form of the global consumptogenic system of institutions, actors, norms, policies, and commercial activities that incentivizes the excessive production and consumption of fossil fuel-reliant goods and services regardless of the environmental, social and health costs. From existing global evidence, it is clear that to reduce health inequities requires inter-sectoral action focused on reducing social inequities and mitigating climate change. To address global environmental degradation requires a rethink of economic models, and progressive policy and business activities that value the environment.

Yet, despite the unfolding catastrophe, little effective political and policy attention is given to transform the consumptogenic system and act in the interests of PHE. Arguably, nothing will change unless entrenched power inequities are addressed. Powerful consumptogenic interests work hard to prevent necessary structural interventions and maintain the status quo that serves them well. For decades, these interests have controlled the narrative, set the rules of the game and underwritten social and political rights and norms. In this paper, we discuss a research agenda seeking to understand how to transform the consumptogenic system, and with a focus on power through structures, institutions, and ideas driving major change in policy and business activities we explore the implications for governance and PHE.

International institutions are key building blocks of planetary health equity (PHE) governance. Individual institutions are components of clusters of institutions which, in turn, form elements of larger governance systems. The architecture or structure of governance systems has important implications for their performance. Enhanced PHE requires globally effective and equitable governance. In order to understand the governance system for PHE, we must move beyond analysis of its constituent parts and engage in macro and system-level analysis. Identifying sites of governance intervention and enhancing governance performance is contingent on understanding the macro structures of the PHE governance system.

PHE touches on at least three different macro governance superclusters – economic governance, climate change, and public health. Using tools from network science and drawing on system of systems analysis, this paper explores the structure of these superclusters and the potential relationship between system architecture and system dynamics. More specifically, we describe the formal governance ‘supercluster complex’ for PHE at the global level, explain its emergence, and explore its implications for policy and action.

Tackling planetary health inequities is fundamentally an intersectoral problem. Climate change, social inequities, and health inequities are interconnected and compound each other, as downstream impacts of complex intersecting upstream political, economic, social, and cultural drivers. On the part of governments, these challenges require a holistic approach and solutions, in line with Target 17.14 of the Sustainable Development Goals, to “enhance policy coherence for sustainable development” as part of the means of implementation of the sustainable development agenda. Beyond the state, transforming the consumptogenic system and addressing planetary health inequities requires action across governance levels, multilateral organisations, policy sectors, and among state and non-state actors. Scholarship and practice to develop and achieve successful Governance for Planetary Health Equity (GfPHE) must consider these multiple dimensions of coherence.

This research agenda requires a process-oriented approach to the issue of policy coherence, examining the political and institutional contexts that shape coherence within policymaking processes. The normative approach articulated by [Author removed for anonymous review process] is based on the rationale that policymaking processes that challenge dominant power structures and reflect norms of human rights, equality, and democracy, are more likely to contribute to strategies for development that promote social justice. In their latest report, the Civil Society Reflection Group on the 2030 Agenda for Sustainable Development argue that policy coherence requires governance coherence, namely providing the institutions responsible for the implementation of the SDGs with effective political and legal instruments necessary for achieving development goals.

This conceptualisation of governance coherence will be presented in relation to its implications for developing a Planetary Health Equity Impact Assessment framework to support coherent action for climate change and health equity. It provides the parameters for a research agenda to analyse the multiple relevant dimensions of governance, their inter-relationships, and attributes of coherence between them, such as the ideas, interests, and institutional norms shaping governance environments. A governance coherence approach, therefore, enables both analyses required for understanding the complexity of drivers of climate change, social inequities, and health inequities – as well as generating useful insights for identifying ways forward in addressing these intersecting challenges.