Explanation of the long-list of knowledge gaps in Planetary health

For this exercise, the KNAW committee has defined Planetary health as the field dealing with the interactions between global environmental change (e.g., climate change, biodiversity loss, global pollution, land erosion, …) and human health in the broadest sense (i.e., including physical and mental health and aspects such as health equity, health care, and core determinants like nutrition and infection).

Although the remit of the committee is to advise on a research agenda, the ultimate goal of informing interventions and policies to counter global environmental change and protect human health should always be kept in mind. Many disciplines from the natural and life sciences, behavioural sciences, and humanities can potentially contribute, and according to the committee all relevant perspectives need to be included in a Planetary health research agenda.

Source publications

In creating a long-list of knowledge gaps we started from four available overviews of knowledge gaps and/or open research questions for the whole field of Planetary health:

  • The publication Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health, which launched the concept of ‘Planetary health’ in 2015, and which among many other things also contained a list of priority areas for research, based on an extensive literature review and discussion in a broad group of international experts.
  • The paper by Ebi et al. on Transdisciplinary research priorities for Human and Planetary Health, which summarizes the results of a workshop under the auspices of the Future Earth Health Knowledge Action Network, held in May 2019 in Taipei and attended by 42 international participants with various backgrounds in environmental health, both in academia and in (inter)governmental organisations and non-profit organisations.
  • The final draft of the HERA (Health and Environment Research Agenda) project, which aims to deliver an EU research agenda for the Environment, Climate & Health 2021-2030. This is based on a web-based survey among several hundred scientists to identify knowledge gaps, on an analysis of policy documents, and on a survey among several hundred policy-makers.
  • The National Science Foundation (NSF) report Research priorities for Environmental and Human Health, which was prepared by the NSF Advisory Committee on Environmental Research and Education, on the basis of on an online symposium to explore some of the research gaps that the COVID-19 pandemic has revealed. This is based on consensus among committee members, mostly academics.

 We used these reports to create a general overview of knowledge gaps, but soon found out that these reports do not cover all subfields of Planetary health in sufficient detail. We therefore decided to add knowledge gaps identified in ‘sectoral’ publications, i.e., reports focusing on specific environmental changes (such as climate change or biodiversity loss), specific pathways (such as infectious diseases or food), or specific policy aspects (such as ethical or governance issues).

We limited ourselves to reports published in 2015 or later, and only included knowledge gaps falling within the above-mentioned boundaries of Planetary health. The latter implied that in its explanation of the knowledge gap the report had to make an explicit reference to one or more global environmental changes (i.e., climate change, biodiversity loss, global pollution, altered biogeochemical cycles of nitrogen and phosphorus, land use and land cover change, and depletion of freshwater and arable land), and that the proposed research topic had to have a clear link with human health or its immediate determinants (such as food or infection).

Knowing that the long-list will be used as the basis for further selection on the basis of, for example, relevance for policy or researchability, we strove for a level of detail that would give policy-makers and researchers a sufficiently concrete understanding of what each item means, without losing sight of the whole range of questions. We therefore aimed to limit the total number of specific knowledge gaps to around 100. 

Some further explanations of the draft long-list

We have used a conceptual structure starting with a distinction between four main areas, i.e.:

  1. Understanding human health impacts of global environmental change. This area includes knowledge gaps of an ‘explanatory’ nature, such as impacts of climate change or biodiversity loss on human health or on food production and infectious diseases. It also included knowledge gaps related to the environmental impacts of the health care system itself.
  2. Protecting human health against global environmental change. This area includes knowledge gaps of a more policy-oriented nature, related to various mitigation and adaptation strategies, changes in food production and consumption, infectious disease control, and health care policies that can contribute to countering global environmental change and/or its health impacts.
  3. Creating conditions conducive to implementation of mitigation and adaptation strategies. This area includes knowledge gaps of a more implementation-oriented nature, related to creating behaviour change among policy-makers and the general public, creating transformational change, governance issues, and ethical and legal issues.
  4. Enabling research on global environmental changes and health. This area includes recommendations with regard to data and methods of Planetary health research, such as creating an adequate data infrastructure, developing new measurement and analytic methods, and improving quantitative models. This area also includes some general recommendations on research practices and the training of scientists (these are not strictly speaking knowledge gaps, and have therefore been written in italics). 

The current version of the long-list contains around 30 broader research themes and 120 specific knowledge gaps, with each of the latter being illustrated by one or two literal quotes from source documents. The references mentioned in these quotes also illustrate the range of sources used for compiling the long-list.

Please note that phrasings of research themes and knowledge gaps have been systematized and harmonized in order to bring inputs from a wide range of source documents into a common conceptual structure. Although this sometimes leads to somewhat awkward wordings, it seemed necessary to do so because readers would otherwise have difficulty recognizing the interrelationship between different parts of the long-list.


Annex 1. References long-list