This article examines how the emerging framework of “Planetary Health” challenges us to reconsider the role and boundaries of global health law, for example by engaging with systems thinking, eco-centric perspectives, Indigenous knowledge, and newly emerging human rights. How does planetary health inspire novel thinking or new approaches around the conceptualization, design, implementation and/or interpretation of global health law and health-related rights, aiming to protect vital ecological foundations or determinants of health?

The 2022 and 2025 floods in Pakistan forced more than 33 million people to flee from their homes, destroyed medical facilities across a large portion of Punjab, Khyber-Pakhtunkhwa, Sindh, and Balochistan, and revealed major deficiencies in government management, healthcare systems, environmental protection, and climate preparedness. Pakistan emits <1% of worldwide greenhouse gases, yet remains among the most climate-sensitive nations, reflecting global inequities in climate impact. Floods destroyed basic health determinants, thus contributing to infectious disease epidemics, malnutrition, and mental health problems. To evaluate the short- and long-term flood impacts, this article applies the Disaster Management Cycle, along with the One Health, Planetary Health, and Doughnut Economy frameworks. The framework demonstrates the impact of floods on the health and healthcare system while simultaneously eroding the ecosystem and making the population more susceptible. The article identifies priorities for climate-adaptive health care infrastructure, environmental recovery, equity-centered disaster preparedness, and integration of One Health principles into medical education.

The planetary health diet (PHD) is a mostly plant-based diet that aims to optimise human health while minimising the environmental impact of food production. Limited data exist on whether the PHD fulfils key nutritional requirements during pregnancy. This research aimed to examine the PHD in early pregnancy and how it aligns with daily nutrient intake and European Food Safety Authority (EFSA) dietary guidelines. Pregnant women (n 678) from two Irish cohorts (ROLO and MicrobeMom) were analysed, and PHD index (PHDI) scores were assigned based on data from 3-d food diaries. Women were dichotomised by the median score to create a ‘High PHDI’ (> 88·99) and a ‘Low PHDI’ group (≤ 88·99). Differences in nutrient intakes and adherence to dietary guidelines between ‘High’ and ‘Low’ PHDI groups were explored. Compared with those with a ‘Low’ score, those with a ‘High’ PHDI score reported higher intakes of dietary fibre (g/d) (17·32 (13·39, 21·08) v. 21·74 (18·28, 25·88), P < 0·001), Fe (mg/d) (10·48 (8·48, 12·82) v. 12·06 (9·48, 14·60), P < 0·001), folate (µg dietary folate equivalent per d) (250·73 (193·88, 312·45) v. 279·57 (219·43, 356·81), P < 0·001) and Ca (mg/d) (837·75 (695·36, 1056·72) v. 956·57 (751·84, 1155·03), P < 0·001). A greater proportion of women in the ‘High PHDI’ group met EFSA recommendations for dietary fibre intake (10·3 % v. 28·9 %, P < 0·001). The PHD may support maternal nutritional adequacy in pregnancy while promoting environmental sustainability. Our findings provide valuable insights that can inform future dietary recommendations for pregnancy, contributing to both maternal health and planetary well-being.

There have been no culturally validated measures to screen for depression in Madagascar. In 2022–2023, we conducted qualitative studies in the Bay of Ranobe area in southwestern Madagascar to understand local mental health syndromes specific to this region. We found that the 8-item Patient Health Questionnaire (PHQ-8) shares symptoms with the general distress-like, depressive-like and grief-like syndromes elicited locally. We adapted the PHQ-8 to align with the unique symptoms found in the region that were missing from the measure. We administered the adapted PHQ-8 to 809 participants aged 16 and above. We found that the one-factor (Depression) model (root mean square error of approximation [RMSEA] = 0.046, standardized root mean square residual [SRMR] = 0.053, Comparative Fit Index [CFI] = 0.993 and Tucker–Lewis Index [TLI] = 0.991) had a better fit to our data than the two-factor (Cognitive–Affective and Somatic) model (RMSEA = 0.047, SRMR = 0.052, CFI = 0.994 and TLI = 0.990). The one-factor (Depression) model demonstrated good internal consistency (MacDonald’s omega coefficient $ {\omega}_0 $ = 0.81 and ordinal alpha $ {\alpha}_0 $ = 0.87). We conducted a multigroup confirmatory factor analysis to establish measurement invariance (MI) across four groups (sex, ethnicity, level of education and age group) and found that all levels of MI were achieved across groups. Our research provides a validated method to assess the probable prevalence of current depression in southwestern Madagascar.

The EAT-Lancet Commission recommends increasing the consumption of nut trees worldwide as part of a sustainable diet. Integrating more nut tree species in urban gardening initiatives could provide members access to locally grown nuts and provide ecosystem services to urban landscapes. This study investigated the reported presence and diversity of nut tree species in urban community gardens, as well as the motivations and challenges for adopting and expanding those trees. Based on an online survey with 111 responding projects from the urban community gardening network in Germany as our case study, we found that nut tree species exist in almost half of all responding projects surveyed, albeit in a few numbers of individual trees and producing low yields. Projects are motivated by the provisioning, regulating, and cultural ecosystem services they provide, such as the nutritional value of nuts, the provision of food for animals, and the potential for education of members about agroforestry and nut use. Yet projects are hindered by limited space, local laws and regulations, and the interaction of nut trees with other species in the garden. Although only 50% of projects plan to incorporate more nut tree species in the future, most recognize the importance of nuts as part of a healthy diet. Governmental leadership is necessary to secure long-term contracts for urban gardens, so that more nut trees can be planted, and city residents can exploit the benefits of the ecosystem services they provide.

Poor mental health is a leading contributor to the global burden of disease but there is poor understanding of how it is influenced by people's interactions with ecological systems. In a theory-generating case study we asked how interactions with ecosystems were perceived to influence stressors associated with psychological distress in a rural setting in Uganda. We conducted and thematically analysed 45 semi-structured interviews with residents of Nyabyeya Parish. Poverty and food insecurity were the primary reported causes of ‘thinking too much’ and related idioms suggesting psychological distress. Households bordering a conservation area reported that crop losses from wildlife contributed to food insecurity. However, forest resources represented important safety nets for those facing poverty and food insecurity. Commercial agricultural expansion also emerged as a salient theme in the lives of residents, reportedly exacerbating poverty and food insecurity amongst poorer households but contributing incomes to wealthier ones. Our exploratory study suggests how two globally prevalent land uses, nature conservation and commercial agriculture, may influence social determinants of psychological distress in the study area. We highlight co-benefits and trade-offs between global sustainability goals that could be managed to improve mental health.

The United Nations’ Agenda 2030 provides a framework of 17 Sustainable Development Goals (SDGs) to achieve peace and prosperity for people and planet, now and into the future(1). The United Nations Decade of Action on Nutrition emphasises that food and nutrition are key levers for optimising both human and planetary health and that individuals working in food, nutrition and health play an essential role in contributing to the SDGs(2,3). This project aimed to (i) map the work being done by staff and higher degree students at Monash University’s Department of Nutrition, Dietetics and Food and its alignment with the SDGs, and (ii) assess the impact of this process on workforce capacity to embed the SDGs in future work activities. Three mapping workshops; one pilot, one in-person and one online, were conducted (n = 28), beginning with a short expert-led seminar about the SDGs before participants engaged in an interactive activity to record their work activities (research, education or engagement) relating to the SDGs. Mapping data were analysed to determine which SDGs were being prioritised and in what type of activities. To determine the impact on workforce capacity, participants completed pre- and post-workshop surveys that assessed their knowledge of and confidence regarding the SDGs. From the three workshops, 129 work activities were described, each linked to one or more of the SDGs. Of those, 41% were education, 36% were research, and 23% were engagement activities. Work activities spanned all 17 of the SDGs, with the most commonly aligned being Goal 3 Good Health and Wellbeing (53% of work activities), Goal 10 Reduced Inequalities (37% of work activities), Goal 4 Quality Education (36% of work activities), Goal 12 Responsible Consumption and Production (34% of work activities), and Goal 17 Partnerships for the Goals (27% of work activities). The pre- and post-workshop surveys indicated increased staff knowledge and confidence related to the SDGs. The percentage of participants that could correctly identify the number of SDGs increased from 43% to 96%, and the percentage of participants that recognised the correct aim of the SDGs increased from 43% to 86%. Regarding confidence in talking about the SDGs, the percentage of staff who indicated that they ‘avoid talking about them’ or are ‘not confident’ decreased from 39% to 4%, and the number of staff who were confident talking about the SDGs ‘in general terms’ increased from 39% to 75%. Nutrition professionals are well-placed to support progress towards each of the SDGs. Workshops such as these provide an opportunity to increase workforce capacity to discuss, share and relate their work to the SDGs and provide a periodic pulse-check to identify opportunities for greater contribution to this urgent, global Agenda.

Climate change significantly impacts our planet’s health, ecosystems, plants, animals and humans, increasing extreme weather events and the incidence and prevalence of infectious diseases, including zoonotic diseases. We reviewed the environmental changes affecting human, animal and planetary health and conducted a bibliometric analysis from 2012 to 22 that included these components. We identified 448 publications published on the topic throughout that period. Then, we reflected on the Research Directions question: How can we improve and facilitate multi-sectoral collaboration in warning and response systems for infectious diseases and natural hazards to account for their drivers, interdependencies and cascading impacts? The bibliometric analysis of planetary health has shown increasing interest among researchers since 2017, peaking in 2022. Lancet Planetary Health was the journal with more published articles; The London School of Hygiene and Tropical Medicine was the best-placed institution, and The United States led in topic-related publications. On the other hand, the climatic and pandemic global environmental crises demand fostered surveillance, which should concentrate on the drivers of disease, giving signals that account for human and animal health and environmental degradation. In response to global crises, higher education curricula should integrate One Health and Planetary Health approaches to achieve transdisciplinary thinking, allowing transcend knowledge, research and observation into action.