This topic aims at supporting activities that are enabling or contributing to one or several expected impacts of destination 2 ‘Living and working in a health-promoting environment’. To that end, proposals under this topic should aim for delivering results that are directed, tailored towards and contributing to most of the following expected outcomes:

• Climate and environmental policies are supported with better knowledge on the Earth natural systems and human health interactions;
• Sustainable planetary health policies which foster co-benefits to human health and the health of ecosystems are supported with robust evidence;
• Cross sectorial and multidisciplinary scientific collaborations, including expertise in public health and One Health, are established;
• Public authorities rely on indicators about the impacts on human health of changes or degradation of natural systems to support adaptation and mitigation strategies to natural hazards;
• Policymakers have better tools to improve the predictive capability and preparedness as well as to envision prevention strategies to deal with the impacts on human health of changes or degradation of ecosystems;
• Citizens are engaged and informed about the impact of natural systems’ degradation on human health and behaviours aiming at the conservation of ecosystems are promoted.

Globally, life quality and expectancy have increased to unprecedented levels over the last decades due to the significant public health, agricultural, industrial and technological achievements of the 20th century. On the other hand, the ongoing trend of environmental degradation and global climate and environmental changes has introduced new pressures, which involve large impacts on human health and might put at risk the recent public health gains.

Among others, climate change, biodiversity loss, biological invasions, environmental pollution, changes in land use and degradation, deforestation, thawing permafrost (in polar regions, and particularly in the Arctic), overfishing, new animal diseases and acidification of water bodies can result in reduced food and water availability and safety and increased exposure to factors causing infectious and non-communicable diseases. Additionally, changes in weather and climate extremes have been observed across the globe, resulting in an increase of the frequency and intensity of extreme weather events such as heavy precipitation and floods, heat waves and hot extremes, droughts and tropical cyclones.

There is increasing evidence showing that many of these environmental stressors and changes can cause profound short- and long-term negative impacts on human health and well-being, contributing to increased morbidity and mortality worldwide. Understanding and acting upon these challenges calls for a multidisciplinary, cross-sectorial and trans-border approach ranging from the local to the global scale. The effects can be direct due to increases in floods, heatwaves, water shortages, landslides, exposure to ultraviolet radiation, exposure to pollutants, among others, or indirect and complex, as climate change -mediated or ecosystem-mediated. In addition, it is imperative that the solutions and initiatives chosen to prevent environmental degradation are safe for human health and the environment.

Planetary health is a concept focused on the interdependencies between human health and the state of earth’s complex natural systems. A key focus is on understanding how the current trend of human-related environmental degradation can affect the health and well-being of current and future generations. The Rockefeller Foundation-Lancet Commission on Planetary Health^[1] published a report in 2015, laying the foundation for the development of this important new field of study^[2]. In 2020 the Helsinki declaration^[3] was published, resulting from a conference where participants discussed how to implement the planetary health approach in Europe in the context of the European Green Deal. Planetary health is also a priority topic in the research agenda in environment, climate and health proposed by the Coordination and support action HERA^[4].

Applicants are invited to submit proposals providing actionable evidence for policymakers to take preventive actions to protect the human health and wellbeing by exploring the links between human health and environmental degradation in an integrated and comprehensive manner. More fragmented contributions focused on less studied aspects such as the links between climate change and health and, between biodiversity and health, will also be considered.

To advance the knowledge on planetary health to support policymaking in this area, the applicants should address several of the following activities:

• Provide strengthened evidence for health and wellbeing impacts of planetary changes, considering a systems thinking framework or a fragmentary approach focused on the impacts of climate change and biodiversity loss on human health (for biodiversity loss, proposals should not focus on the connection between the biodiversity loss and ecosystem degradation with the prevention of zoonotic emerging diseases since this topic will be covered by CL6-2023-BIODIV: Interlinkages between biodiversity loss and degradation of ecosystems and the emergence of zoonotic diseases);
• Provide improved understanding and modelling of human–ecological systems interactions and ecosystem-mediated effects on human health and well-being, including the attribution of health outcomes to environmental change;
• Provide a methodology to identify and prioritise threats for public health caused by environmental degradation, with a view to improving preparedness of health systems to these threats, through structured processes that move from evidence to recommendations and decisions;
• Investigation how infections agents that might have the capacity to adapt to other host species can spread via the environment, and how this type of insight might lead to enhanced monitoring strategies;
• Lay the foundations for integrated surveillance systems considering already established monitoring systems (e.g. systematic wastewater monitoring) and using available and newly collected health, socioeconomic, and environmental data for defined populations over longer time periods. This would provide early detection of emerging disease outbreaks (e.g. zoonotic diseases, potential permafrost release of new and old pathogens) or changes in nutrition and non-communicable disease burden and support the assessment of the integrated health, environmental, and socioeconomic effect of policies and technologies.
• Explore strategies to reduce environmental damage and harmful emissions (e.g. air pollution) including assessment of health co-benefits through engagement with relevant HE partnerships and missions;
• Explore implications of planetary health for health systems and public health and identify opportunities to mitigate adverse health impacts of environmental degradation;
• Improve risk communication to policymakers, public authorities, industry and the public and support evidence-informed decisions by policymakers, by increasing capacity to do systematic reviews and provide rigorous policy briefs;
• Advance knowledge and actions to reduce the burden of non-communicable diseases while reducing the environmental pressure in areas like nutrition, physical activity, and mobility, and to assess the integrated health, environmental, and socioeconomic effect of those actions (i.e. behaviour change interventions, policies or new technologies);
• Provide better understanding on adaptation to climate and other environmental changes to protect human health, including the interactions between different planetary boundaries and the need to integrate adaptation and mitigation strategies;
• Improved health impact assessment approaches accounting for environmental externalities and estimating the cost and benefits of interventions versus no action.

This topic requires the effective contribution of social sciences and humanities (SSH) disciplines and the involvement of SSH experts, institutions as well as the inclusion of relevant SSH expertise, in order to produce meaningful and significant effects enhancing the societal impact of the related research activities. Researchers should carefully integrate distributive considerations in their analysis by considering, where relevant, disaggregated effects for different socio-economic groups.

In order to optimise synergies and increase the impact of the projects, all projects selected for funding from this topic will form a cluster and be required to participate in common networking and joint activities. Without the prerequisite to detail concrete joint activities, proposals should allocate a sufficient budget for the attendance to regular joint meetings and to cover the costs of any other potential common networking and joint activities.

Applicants envisaging to include clinical studies should provide details of their clinical studies in the dedicated annex using the template provided in the submission system. See definition of clinical studies in the introduction to this work programme part.

[1] https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)60901-1.pdf

[2] “Our definition of planetary health is the achievement of the highest attainable standard of health, well-being, and equity worldwide through judicious attention to the human systems—political, economic, and social—that shape the future of humanity and the Earth’s natural systems that define the safe environmental limits within which humanity can flourish. Put simply, planetary health is the health of human civilisation and the state of the natural systems on which it depends”

[3] A call for urgent action to safeguard our planet and our health in line with the helsinki declaration – ScienceDirect, https://www.sciencedirect.com/science/article/pii/S0013935120314973

[4] https://www.heraresearcheu.eu/