How International Relations scholars could participate in the emerging interdisciplinary field named planetary health? This question guided Nicole De Paula’s article, What is planetary health? Addressing the environment-health nexus in Southeast Asia in the era of the Sustainable Development Goals: opportunities for International Relations scholars, published in the latest issue of RBPI (vol. 61, n. 1). De Paula’s argument focuses in the Southeast Asia example in order to identify opportunities for IR scholars to improve health-environmental synergies to implement the SDGs.

Along the article, De Paula highlights that is mandatory to recognize the links between environmental change and health to achieve a more holistic development towards a low-carbon economy. At the same time that these links surround the planetary health concept and demonstrate the interdependencies of the environment with human health, they paving the way for the work of internationalists. De Paula was interviewed by Tiago Tasca, editorial assistant of RBPI.

Your article focuses on the links between environmental change and health to introduce a new theme within International Relations scholars: planetary health. This concept has some epistemological convergences with the Global Health agenda (e.g., actors, challenges of private funding influence, health topics, etc.). In your opinion, what are the main differences and convergences between the Global Health and the Planetary Health research agendas? Could these two research agendas be overlayed?

Excellent point. Indeed, one of the first questions that researchers, not only from our field, ask is: is planetary health different from other existing agendas? There’s ample room to discuss this, but a short answer is, yes!

The reason for this is that planetary health recognizes that humanity is currently facing a paradox. Despite modern biomedicine, technology and industrial development having brought incalculable benefits and improvements in health and wellbeing worldwide, especially in the last century, we seem to have reached a point of diminishing returns as we are losing sight of our fundamental interdependence and our inseparability from nature. This intrinsic connection has become widely apparent to many health and sustainability experts worldwide but only recently articulated by the Rockefeller Foundation-Lancet Commission on planetary health, which stressed the urgent need for new thinking that gives “judicious attention” to how human social systems and the Earth’s natural systems combined “define the safe environmental limits within which humanity can flourish” as captured by the idea of planetary health.

Although planetary health evolves from previous approaches, such as public health, global health, One Health and Eco health, it investigates the effects of environmental change on human health, raising deep questions about our political, economic, and social systems. Previous approaches can be considered a little narrower than planetary health, which now offers an opportunity for addressing the root causes of environmental degradation. To put human health and well-being at the center of our development policies, there’s a need to not only recognize but also implement the principles of sustainable development. The work of planetary health experts is now to demonstrate the social, economic, and environmental synergies and explore how, concretely, the planetary health approach can achieve results on the ground.

According to your argument, what is missing is a greater effort to avoid a siloed understanding of structural, social and ecological health determinants. What are the main reasons and drivers that are behind this “siloed understanding”? In your opinion, overcoming this “siloed understanding” is a crucial step to achieve the SDG n. 3 (health and well-being) and SDG n. 13 (climate action)? Why?

At the moment, the UN Sustainable Development Goals (SDGs) are our best bet to promote an integrative approach towards a holistic development.

Even though I focused on SDG 3 (health and well-being), it’s crucial to understand that all SDGs are about our health. Better education, gender equality, peace, climate justice, safe water, energy efficiency, to quote a few themes, impact public health policies and how the implementation of our health policies, in turn, impact our social-ecological environment.

Implementing such a multi-sectoral collaboration among agricultural, environmental and health sectors in the current national contexts remains a considerable challenge, not only because these sectors still work in silos but because those sectors are intertwined with the interests of big transnational companies. Bearing this in mind, in what degree a bioethics approach and an environmental literacy could enrich and improve the planetary health paradigm under the development-cooperation-equity nexus? How?

One of the key problems that we face today, as I note in the article, is approaching health in a way that goes beyond the human body and the combat of diseases, a disease focused orientation. What the planetary health movement emphasizes is the need for prevention and consideration of other factors that, at first glance, seemed unrelated to public health. For example, the use of unprecedented toxic chemicals in farms are increasingly suspected to be contributing to obesity, diabetes, some metabolic syndromes and the exploding incidences of autism and other neuro-behavioral disorders. The food industry is also another area of concern. The shift to processed and ultra-processed food are turning our meals into dangerous moments. Some food hardly even qualifies as food anymore, and our increasing separation from nature (including our natural microbial communities constituting our gut microbiome) is contributing to increasing chronic illnesses and vulnerability to infectious diseases.

This is why I argue that implementing such a multi-sectoral collaboration among agricultural, environmental and health sectors in the current national contexts should be a priority, despite being challenging. This is something difficult given that those sectors are, in many occasions, intertwined with the interests of big transnational companies and reflects power inequalities. In the end, planetary health is deeply political.

In your opinion, what elements are essential to achieve an operational dialogue (with practical implications towards public policies outcomes) between IR scholars and public health decision-makers?

Initially, when I joined the Planetary Health Alliance to represent my organization, Global Health Asia Institute, I did not understand how I could play a role in this new and growing community. Most of experts were coming from the public health community and interactions remained a bit too connected to the “doctor’s world.” Progressively, I could witness a change within the Alliance, which recognized and called for social scientists and educators to join the movement. In the end, science and data alone don’t induce behavior change. Climate change is the biggest example of that. Despite the urgency of the global problem of anthropogenic greenhouse gas emissions, concrete action is bogged down by politics as can be seen by the US’s pulling out of the Paris Accord to save coal industry jobs. Yet, as reported by the World Health Organization an estimated 4.2 million deaths occur every year as a result of exposure to ambient (outdoor) air pollution mainly related to fossil fuel burning. Brazil’s election of President Bolsonaro similarly reflects the growing populist sentiments driven by immediate economic concerns taking precedence over the present and future health of people and ecosystems.

Internationalists can have many roles in this context and I detail them in the article. To give three examples, they can, first, be catalysts of change by bringing siloed communities together. These are professional with excellent understanding of the “big picture.” They can advocate for these links in different areas, such as trade, humanitarian and environmental affairs. Second, they can contribute with academic research that takes into consideration power relations and root causes of social inequities at regional and global levels by analyzing, for example, multilateral negotiations or public health policies. Finally, they can demonstrate the negative effects of the rise of populism and assist with the dissemination of trusted dissemination of information related to planetary health, which could combat one of the greatest threats to our democracies at the moment. In the end, this article is groundbreaking as it is the first one published in an IR journal in Brazil and it is written by an internationalist. It opens a new research agenda for a group of professionals that are essential for this movement and yet remain little represented.

Read the article

Paula, Nicole De. (2018). What is planetary health? Addressing the environment-health nexus in Southeast Asia in the era of the Sustainable Development Goals: opportunities for International Relations scholars. Revista Brasileira de Política Internacional, 61(1), e012. Epub December 10, 2018.

About the authors

Nicole De Paula – Mahidol University Phayathai Campus – Faculty of Public Health and Global Health Asia Institute, Thailand (

Tiago Tasca – Editorial Assistant of RBPI.

How to cite this interview

Cite this article as: Editoria, "What is planetary health? Addressing the environment-health nexus in Southeast Asia in the era of the Sustainable Development Goals: opportunities for IR scholars – An interview with Nicole De Paula, by Tiago Tasca," in Revista Mundorama, 06/02/2019,

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