Amongst the largest and most existential health threats faced this century are the triple planetary crises of climate change, biodiversity loss, and environmental destruction. The International Court of Justice (ICJ) acknowledged in its landmark Advisory Opinion on States’ Obligations in the Area of Climate Change of 2025 that our world is facing “an existential problem of planetary proportions that imperils all forms of life and the very health of our planet.” 1
This statement reflects the rapidly growing consensus that human health is highly interdependent with the health of the environment, nature, and planet at large. Environmental science suggests that seven out of nine vital “planetary boundaries” have been crossed or are severely endangered by now. This includes crossing “safe operating spaces” for climate change, biodiversity loss, disruption of nitrogen cycles, ocean acidification, and the introduction of harmful “novel entities,” such as “forever” chemicals, plastics, and medicine residues.Reference Kitzmann 2
This article examines how the emerging framework of “Planetary Health” challenges us to explore and expand the boundaries and role of global health law. Specifically, it discusses how this newly emerging concept could inspire novel systems thinking as well as eco-centric, non-Western, indigenous perspectives into the conceptualization, design, implementation and/or interpretation of existing or new global health law instruments and health related rights.
The article starts by defining Planetary Health and explaining how global health concerns came to embrace One Health and, more recently, Planetary Health. It then highlights the need for integrating Planetary Health perspectives more firmly within global health law and proposes several ways in which it may inspire new thinking and approaches for regulating global health through international law.
Defining Planetary Health
Despite the rapid development of the field of Planetary Health in academic literature, a settled definition of the concept does not (yet) exist, including within the purview of international law.Reference Rossa-Roccor and Ip 3 Different disciplines ascribe different meanings and purposes to the concept, ranging from improved environmental sustainability within the health care sector (e.g. reducing waste or ecological footprints of hospitals) to taking multi-sectoral action to combat climate change, reversing biodiversity loss or changing food production and human diets. 4 Many definitions take inspiration from the interdisciplinary Planetary Health Alliance’s definition, which in turn builds on the Rockefeller Foundation-Lancet Commission’s definition of 2015: 5
Planetary Health is a solutions-oriented, transdisciplinary field and social movement focused on analyzing and addressing the impacts of human disruptions to Earth’s natural systems on human health and all life on Earth. […] Planetary Health focuses on the ways that human-caused disruptions to the Earth system affect human health. Given the complex interactions between human activity, environmental changes, and the many dimensions of human health, we will need all of society […] to drive solutions.
From Global Health to One Health to Planetary Health
Planetary health thinking has gradually become more central to global health thinking. Global health actors, such as the World Health Organization (WHO), increasingly engage on environmental pollution, clean air, climate change, biodiversity protection and the prevention of diseases at the human-animal-environment interface. Our understanding of human health is arguably advancing from public health to global health to One Health to Planetary Health.Reference Faerron Guzmán and Ruiz de Castañeda 6 These concepts are not mutually exclusive but invite increasingly complex levels of systems thinking and relational reflections on relevant human-ecosystem interactions, structures, processes, and feedback loops.
The concept of Planetary Health may in some way resemble the concept of One Health, in that it is also concerned with health at the human-animal-environmental interface, or the relationships between humans and non-humans. However, it extends beyond this interface by considering a wide variety of ecological harms and effects on a planetary scale. Examples include pollution by persistent chemicals (novel entities), disruptions in climate systems, nitrogen cycles or ocean systems, natural resource use, and population movements, including displacement. Safeguarding Planetary Health effectively will require making equitable changes in all areas of human life, including patterns of consumption, agriculture, industrialization, and fossil fuel use.Reference Pongsiri 7
Legal Imperatives for Planetary Health
During the drafting of the new WHO Pandemic Agreement, the concept of “One Health” challenged the negotiators to consider and formulate new types of legal obligations in light of evolving environmental health threats. Article 5 of the Agreement stresses the importance of protecting human health through prevention and preparedness and places obligations on states to identify and address the “drivers” of pandemic disease. Similarly, the notion of “Planetary Health” can challenge states to more boldly and holistically regulate in favor of Planetary Health and protection of planetary boundaries.
In some ways, Planetary Health is already well-regulated through the field of international environmental law. However, international environmental law remains fragmented, focused on isolated environmental threats.Reference Phelan, Negri and Hesselman 8 Planetary Health also embraces a wider range of health-related topics not traditionally covered by environmental law treaties or (binding) global health law, such as food security, nutrition, population movements, displacement and conflict, mental health, environmentally mediated infectious diseases and/or non-communicable diseases, or reproductive health. Planetary Health further heavily emphasizes equity, health of vulnerable people, integration of knowledges and rights of Indigenous peoples and the various co-benefits that could result from more holistic governance. Similar to the concept of One Health, Planetary Health may equally require cooperation of multiple (inter)governmental agencies based on respective expertise and areas of work, such as the United Nations Environment Programme, WHO, Food and Agricuture Organizaton of the United Nations, UN-Habitat, UNESCO, or the World Meteorological Organization. Additionally, a Planetary Health perspective could expand our understanding of the areas of law and governance that global health law comprises or directly interacts with in this domain, including international environmental law, international and regional human rights law, food and agricultural law or the law of the sea.Reference Toebes, Burci and Toebes 9
Expanding Global Health Law to Include Planetary Health
Practically, conceptually, and normatively, Planetary Health thinking may be able to influence the direction of development of global health law in different ways, rooted in more holistic “systems thinking” approaches.
Systems Thinking in Planetary Health
“Systems thinking” within Planetary Health typically foregrounds the variegated (inter)dependencies of human health on the health of Earth’s various natural components, processes, and ecosystems, as impacted by man-made social systems.Reference Pongsiri 10 It supports that effective health governance depends on successful regulation or governance of a wide variety of different drivers of ecological harms and health inequalities, as well as consideration of underlying factors and determinants of health, whether environmental, social, economic, or personal (see also Figure 1).Reference Iyer 11
Fig 1. Long description
The diagram is organized into five vertical sections that narrow from left to right like a funnel.
1. Underlying Drivers (Dark Blue): Lists Culture, Values, Behavior; Consumption; Population Size, Demographic Change; and Technologies.
2. Environmental Changes (Green): Features a central globe of Earth surrounded by a network of interconnected nodes including Biodiversity Loss, Pollution, Land Use / Cover Change, Nutrient Overloading, Climate Change, Resource Scarcity, and Marine Degradation.
3. Proximate Causes (Medium Blue): Lists Air Quality, Fresh Water Quality/Access, Food Quality/Quantity, Toxic Exposures, Infectious Disease Exposure, and Extreme Weather Events.
4. Modifying Factors (Light Blue): Represented by five vertical translucent ovals. Labels at the bottom indicate these factors are Ethnicity, Race, Gender, and Age; Wealth; Governance; Social; and Infrastructure.
5. Health Impacts (Red Circle): Two white arrows from the previous sections point into a large red circle. The circle lists Nutritional Diseases, Infectious Diseases, Noncommunicable Diseases, Direct Injuries, Child & Reproductive Health, and Mental Health.
“Systems thinking” can manifest itself through integration of insights from Earth systems or ecosystems thinking into global health law and Planetary Health. Such approaches emphasize how ecological processes and systems provide the foundations for human health, along with positive or negative influences by human behaviors.Reference Iyer 12 Earth systems thinking forces us to consider the various “ecological determinants of health” when regulating for global health generally, or for specific health issues. For example, in the context of tobacco use or smoking under the FCTC , how might a Planetary Health perspective invite states and other relevant actors to address the environmental impact of the production, transport, use, and waste of tobacco and related products, including vapes?Reference Lomngam 13
Finally, systems thinking can also manifest itself in mapping carefully the range of relevant fields of international law that govern Planetary Health in general or specific issue areas, and engaging in methods of “systemic legal integration/interpretation.” Systems thinking may already be reflected in existing global health law principles that pursue more holistic policy responses, such as “whole of society” and “whole of government” approaches, or the concept of “Health in All Policies.”Reference Toebes, Turkie and Gostin 14
Eco-Centric Perspectives
Planetary Health also provides a framework for questioning the historically rather “anthropocentric” outlook of global health law, i.e. as centered on the human experience of health and disease. Rather than, for example, “animal health,” “plant health,” “ecosystem health,” or the importance of a healthy microbial world. Planetary Health thinking invites us to develop more eco-centric, biocentric or anthropocosmic views on human health so that we can unpack how the health of the planet as a whole, and our species as part of it, depends on complex critical and often unseen ecological processes.Reference Ip 16 It further invites us to extend our thinking to the impact of human activity, as regulated by law, on the health of the planet.
In the area of infectious disease, Global Health Law may be viewed as focusing largely on regulating (the sharing of) pathogens or genetic resources for curative medical advances, and the protection of human health. This is reflected in the WHO Pandemic Treaty and related legal regimes in international environment law, such as the Nagoya Protocol on Equitable and Fair Sharing of Genetic Resources to the Biodiversity Convention.Reference Willetts, Fleming and Morgera 17 A Planetary Health perspective could help bridge environmental conservation and global health objectives by regulating the rights and duties associated with pathogen and genetic data sharing across human, animal, and plant health for protection of human health, alongside rights, obligations, and values that promote the preservation of genetic diversity, healthy ecosystems, and biodiversity as such. The Pandemic Agreement encapsulated a more holistic preventative environmental health approach through its reference to One Health. Yet during negotiations, any references to systemic issues of climate change and biodiversity — reflecting a more holistic Planetary Health approach — were omitted.Reference Phelan, Negri and Hesselman 18
Decolonialization and Indigenous Knowledge
Planetary Health thinking in global health law may equally invite or foreground non-Western, Indigenous, and other traditional knowledges, experiences, and perspectives on health and the interconnectedness of humans to the natural world. Indigenous peoples have strong traditional and innovative practices that respect and protect planetary health, rooted in worldviews that recognize the interconnectedness of lands, peoples, environment, and planet, and the importance of human caring for the natural world as part of the act of caring for our own health and well-being, emphasizing respectful relationships.Reference Redvers 19 Holistic, systemic, collective, and harmonious understandings of health at the “human-animal-nature-environment” interface are not commonly associated with Western, often medicalized, perspectives on health, but more so with traditional and Indigenous knowledge systems and practices.Reference Seifert and Guzmán 20
In this sense, Planetary Health may well align with a decolonialization agenda for global health law insofar as it actively investigates, counters, and decenters prevalent Western ideas about what it means to be healthy, promote, or enjoy good (global) health; or to universally enjoy (the right to) a highest attainable standard of health; or to live in a “healthy environment.” A decolonial Planetary Health perspective may center Indigenous knowledge systems that emphasize more holistic forms of (preventative) health interventions, such as nature-based solutions.Reference Hogeveen 21 Similarly, it may challenge us to expose the values, interests, or powers served or obscured by legal systems in place, in line with broader decolonial thinking for global health law and international law.Reference Erondu, Sharma, Mulumba, Phelan and Sirleaf 22
New Rights for Planetary Health
The concept of Planetary Health law can expand the area of global health law to include new legal ideas, concepts, and interpretations of health-related rights under international and national law. So far the “human right to health” and “human right to a healthy environment” have both been (re)interpreted in light of the evolving planetary crisis and various breaches of planetary boundaries, whilst future generations are increasingly recognized as holders of human rights, including health. In some jurisdictions, new human rights have been emerging to safeguard specific planetary boundaries, such as the “right to a stable climate system” or a “right to clean air.”Reference Hammersley and Villasante 23
Especially in Global South jurisdictions, the right to a healthy environment has been rapidly evolving to reflect more “eco-centric” rights of nature as well. 24 Although such rights may be understood as protecting (elements of) the environment without evidence of immediate harm to humans — e.g. rivers, forests, and ecosystems — the Inter-American Court of Human Rights recently clarified that new rights of nature would help to preserve the “ecological conditions that are essential for life,” preventing cascading effects on many different species dependent on vital ecosystems, including humans.Reference Vera 25 With this approach, the Court views human life and health as part of nature, not separate from it.
Finally, the United Nations Committee on Economic, Social and Cultural Rights recently affirmed in its new General Comment 27 of November 2025 that all rights, including the right to health, should be exercised within planetary boundaries, and that states should take action to promote Planetary Health. 26 This implies that the right to health itself cannot be realized without regard to planetary limits; the natural resources consumed and the waste generated in securing health must be treated as legally relevant considerations.
Conclusion
As the world faces health threats of “planetary proportions,” Planetary Health challenges us to consider the role, place, and meaning of global health law in safeguarding and promoting human health in response to new threats. Rooted in systems thinking and promoting non-Western, eco-centric and indigenous views on the human-environment interface, Planetary Health thinking may inspire new normative and regulatory questions for the field of global health law.
Specifically, this contribution raised the question of how Planetary Health thinking could assist global health lawyers in conceptualizing and unpacking the “complex interactions between human activity, environmental changes, and the many dimensions of human health,” 27 so that important drivers, underlying factors and determinants, environmental threats, and health impacts may be better addressed at the intersections of various relevant overlapping legal framework(s) and institutions.
Planetary Health may also inspire recalibrations of existing health-related human rights at the fundament of global health law, e.g. through the right to a healthy environment, clean air, a stable climate, or via new “Rights of Nature.” The latter arguably most clearly aligns with Planetary Health themes and concepts discussed in this contribution, such as the close interdependencies between humans and nature; the promotion of eco-centric or anthropocosmic perspectives in law; or the possibilities for decolonizing existing knowledge and practices within global health law, including by integrating Indigenous and traditional worldviews and practices from Global South peoples specifically.
Finally, as new perspectives and approaches begin to emerge and take hold, we may be embarking on a process of redrawing and expanding the boundaries of global health law, opening up to new topics, areas, and frontiers for research and legal practice. We may also increasingly witness tensions between new and old approaches or different health objectives. For example: what does it practically mean for the right to health to be (equitably) exercised “within (safe) ecological limits”? How should we assess effective infectious disease management strategies relying on toxic (aerial) herbicide spraying, in light of the possible long-term negative environmental health effects? Will a more holistic, systemic Planetary Health perspective be able to support and overcome such balancing acts? What may be learned from traditional or indigenous knowledges and practice in this respect? Such questions must be part of the wider research agenda for Planetary Health and global health law. This contribution has provided a framework for engaging in such Planetary Health-driven research in law.
Acknowledgments
The ideas in this column were developed during a December 2025 Global Health Law Consortium Conference at the University of Groningen (The Netherlands). In the development of this column, the authors are grateful for the thoughtful research assistance of Bella Jansson.
Funding statement
Open access funding provided by University of Groningen.
Disclosures
Benjamin Mason Meier is a member of the Editorial Board of The Journal of Law, Medicine & Ethics. The authors have nothing further to disclose.
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