Challenges, Volume 10, Issue 1 (June 2019) – 31 articles

The project “A Plurality of Lives” was funded and hosted by the Pufendorf Institute for Advanced Studies at Lund University, Sweden. The aim of the project was to better understand how a second origin of life, either in the form of a discovery of extraterrestrial life, life developed in a laboratory, or machines equipped with abilities previously only ascribed to living beings, will change how we understand and relate to life. Because of the inherently interdisciplinary nature of the project aim, the project took an interdisciplinary approach with a research group made up of 12 senior researchers representing 12 different disciplines. The project resulted in a joint volume, an international symposium, several new projects, and a network of researchers in the field, all continuing to communicate about and advance the aim of the project. Full article

I have been involved in studying and working within what is now called the Anthropocene for almost 50 years, and in all that time, not only have we failed to make much progress, but the state of the Earth’s ecosystems has generally worsened. Yet somehow we must create a world in which everyone on Earth has good health and a good quality of life—a matter of social justice—while living within the physical and ecological constraints of the one small planet that is our home; this is the focus of the new field of planetary health. Our worsening situation is not due to lack of knowledge, science and technology; in broad terms, we knew most of the challenges and many of the needed solutions back in the 1970s. Instead, the challenges we face are social, rooted in cultural values, political ideologies, legal and economic systems, ethical principles and spiritual/religious beliefs. Therefore, we have to move beyond science and technology and address these broader socio-cultural issues by engaging in economic, legal and political work, complementing and supplementing ‘head stuff’ with ‘heart, gut and spirit stuff’, and working from the grass roots up. Full article

Social licence is rooted in perceptions of local rights holders and stakeholders. The disease focus of aquaculture health policy, practices, and research insufficiently reflects societal expectations for aquafarms to protect health of shared resources. Our case study of Atlantic salmon (Salmo salar) farming in British Columbia (BC), Canada, assessed the readiness of aquaculture to change from managing health as the absence of disease to a perspective of health as well-being to maintain social licence. We drafted an index of well-being based on agroecosystem health and socio-ecological health principles. We then reviewed publicly available industry and government information and undertook key informant interviews. The industry was well situated to develop and use a well-being index. Interviewees saw value in a well-being index and found it compatible with area-based management. Many elements of the index were being collected but there would be challenges to overcoming feelings of over-regulation; negotiating specific indicators for local situations; and securing the necessary expertise to integrate and assess the diversity of information. Health conflicts and disagreements facing salmon farming in BC are like those in other aquaculture sectors. Social licence may be improved if companies transparently report their state of the health by adapting this conceptual framework. Full article

There are works that study personality and task performance but there are no (or very few works) that study the balancing of personalities within teams that work together towards a common goal in computer-based tasks. This study investigates how personality compatibility in collaborative tasks affects performance, intra-group communication and participants’ emotions for computer-based tasks and introduces the challenges for research in this field. Using the DISC (dominance, inducement/influence, submission/steadiness, compliance) tool for personality assessment and team compatibility, 12 teams were created with either balanced or imbalanced personality compositions. Results showed statistical differences in emotions between the two experimental conditions and also differences in terms of time needed for the completion of the game. The present work showed the qualitative differences between cooperative tasks and revealed the challenges of studying further team compatibility for different tasks. Full article

Biophysics research tends to focus on utilizing multidisciplinary technologies and interdisciplinary collaborations to study biological phenomena through the lens of chemistry and physics. Although most current biophysics work is focused on studying extant biology, the fact remains that modern biological systems at some point were descended from a universal common ancestor. At the core of modern biology is the important question of how the earliest life on (or off) Earth emerged. Recent technological and methodological advances developed by biophysicists in Japan have allowed researchers to gain a new suite of knowledge related to the origins of life (OoL). Using these reports as inspiration, here, we highlight some of the significant OoL advances contributed by members of the biophysical research field in Japan with respect to the synthesis and assembly of biological (or pre-biological) components on early Earth, the co-assembly of primitive compartments with biopolymer systems, and the evolution of early genetic systems. We hope to provide inspiration to other biophysicists to not only use the always-advancing suite of available multidisciplinary technologies to continue their own line of work, but to also consider how their work or techniques can contribute to the ever-growing field of OoL research. Full article

The purpose of this paper is to discuss behaviour change beyond communication to trigger “organic growth”—a marked increase in the competencies, skills and knowledge in communities, societies and local economies. The paper discusses the challenge of triggering organic growth to help communities to build their capacity through “organic change”—concerted actions at an individual or community level to gain control over the social, economic and political influences that are necessary to improve people’s lives and health. The paper discusses how organic change sometimes involves an emotional or symbolic response that can be triggered by an evidence-based argument as part of a behaviour change approach. The paper concludes that it is useful to visualise behaviour change in a fresh way that goes beyond communication to articulate capacity building and community action, and that this is best represented through the terms “organic growth” and “organic change”. Full article

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive tumor type and is usually detected at late stage. Here, mathematical modeling is used to assess the feasibility of two-step early detection with biomarkers, followed by confirmatory imaging. A one-compartment model of biomarker concentration in blood was parameterized and analyzed. Tumor growth models were generated from two competing genomic evolution models: gradual tumor evolution and punctuated equilibrium. When a biomarker is produced by the tumor at moderate-to-high secretion rates, both evolutionary models indicate that early detection with a blood-based biomarker is feasible and can occur approximately one and a half years before the limit of detection by imaging. Early detection with a blood-based biomarker is at the borderline of clinical utility when biomarker secretion rates by the tumor are an order of magnitude lower and the fraction of biomarker entering the blood is also lower by an order of magntidue. Regardless of whether tumor evolutionary dynamics follow the gradual model or punctuated equilibrium model, the uncertainty in production and clearance rates of molecular biomarkers is a major knowledge gap, and despite significant measurement challenges, should be a priority for the field. The findings of this study provide caution regarding the feasibility of early detection of pancreatic cancer with blood-based biomarkers and challenge the community to measure biomarker production and clearance rates. Full article

Environmental health research is gaining interest due to the global concern of environmental factors impacting health. This research is often multifaceted and becomes complex when trying to understand the participation of multiple environmental variables. It requires the combination of innovative research methods, as well as the collaboration of diverse disciplines in the research process. The application of collaborative approaches is often challenging for interdisciplinary teams, and much can be learned from in-depth observation of such processes. We share here a case report describing initial observations and reflections on the collaborative research process of the Data Mining and Neonatal Outcomes (DoMiNO) project (2013–2018), which aimed to explore associations between mixtures of air pollutants and other environmental variables with adverse birth outcomes by using an innovative data mining approach. The project was built on interdisciplinary and user knowledge participation with embedded evaluation framework of its collaborative process. We describe the collaborative process, the benefits and challenges encountered, and provide insights from our experience. We identified that interdisciplinary research requires time and investment in building relationships, continuous learning, and engagement to build bridges between disciplines towards co-production, discovery, and knowledge translation. Learning from interdisciplinary collaborative research experiences can facilitate future research in the challenging field of environmental health. Full article

Focusing on the Bill and Melinda Gates Foundation (BMGF) as a case study, this paper explores the relationship between philanthrocapitalism, economic history, and global and planetary health. The Wellcome Trust is also briefly discussed, chiefly in the context of planetary health. The paper argues that in the last 45 years there has been an increased preference for market-based approaches, often called neoliberalism, particularly in the U.S. and its allies. This has generated greater inequality in many high-income settings and weakened the norm of taxation. This has provided a setting in which philanthrocapitalism has flourished, including the BMGF. The latter has in turn become an important actor for global health, partially balancing the adverse consequences of neoliberalism. Planetary health is here defined as the interaction between global health and global environmental change, including to the climate and other elements of the Earth System. Although the Wellcome Trust has recently made funds available for ecological health research, it continues to invest in fossil fuels. The Gates Foundation provide no or minimal grants for ecological or planetary health but appear to have recently substantially divested from fossil fuels, for unclear reasons. The paper concludes that these large philanthrocapitalist organizations partly compensate for the decline in attention to global health driven by market-preferring solutions, but remain insufficiently proactive in the face of the great dangers associated with declining planetary health. Full article

Modernization has now been linked to poor developmental experience, the onset of immune dysregulation and rising rates of chronic diseases in many parts of the world. Research across the epidemiological, clinical, and basic science domains supports the concept that poor developmental experience, particularly during prenatal life, can increase the risk of chronic disease, with enduring effects on long-term health. Single ‘omics’ approaches are ill-suited to dealing with the level of complexity that underpins immune dysregulation in early life. A more comprehensive systems-level view is afforded by combining multiple ‘omics’ datasets in order to delineate correlations across multiple resolutions of the genome, and of the genomes of the microorganisms that inhabit us. In this concept paper, we discuss multiomic approaches to studying immune dysregulation and highlight some of the challenges and opportunities afforded by this new domain of medical science. Full article

Work that addresses the cumulative impacts of resource extraction on environment, community, and health is necessarily large in scope. This paper presents experiences from initiating research at this intersection and explores implications for the ambitious, integrative agenda of planetary health. The purpose is to outline origins, design features, and preliminary insights from our intersectoral and international project, based in Canada and titled the “Environment, Community, Health Observatory” (ECHO) Network. With a clear emphasis on rural, remote, and Indigenous communities, environments, and health, the ECHO Network is designed to answer the question: How can an Environment, Community, Health Observatory Network support the integrative tools and processes required to improve understanding and response to the cumulative health impacts of resource development? The Network is informed by four regional cases across Canada where we employ a framework and an approach grounded in observation, “taking notice for action”, and collective learning. Sharing insights from the foundational phase of this five-year project, we reflect on the hidden and obvious challenges of working across scales, sectors, and sites, and the overlap of generative and uncomfortable entanglements associated with health and resource development. Yet, although intersectoral work addressing the cumulative impacts of resource extraction presents uncertainty and unresolved tensions, ultimately we argue that it is worth staying with the trouble. Full article

Intimate partner violence (IPV), as the most common form of violence against women, is recognised as a fundamental violation of women’s human rights and a significant public health concern worldwide. IPV is also a widespread phenomenon in Africa where the associated health challenges can be particularly serious due to fragile healthcare systems. To date, there is no systematic research on IPV and its association with healthcare use among adult women in Angola. Therefore, we conducted the present study on IPV among women of childbearing age (15–49 years) in Angola by analysing cross-sectional data from Angola Demographic and Health Survey (2015–2016). The objectives were to assess the predictors of IPV and its association with healthcare use. IPV was assessed by women’s experience of physical, emotional and sexual violence, and healthcare use was assessed by self-reported medical visits during last 12 months. Logistic regression methods were used to analyse the data. Our findings showed that more than two-fifths of the women reported experiencing any IPV (41.1%, 95%Confidence Interval (CI)= 38.7 to 43.6), with physical IPV (32.3%, 95%CI = 30.3 to 34.5) being the most prevalent followed by emotional (27.3%, 95%CI = 25.3 to 29.4), and sexual IPV (7.4%, 95%I = 6.6 to 8.4). In the multivariate analysis, women’s religious background, husband’s alcohol drinking, spousal age difference, and frequency of attending church appeared to be the most important predictors of IPV. Nonpregnant women who experienced emotional [OR = 1.476, 95%CI = 1.154,1.887] and sexual IPV [Odds Ratio (OR) = 1.393, 95%CI = 1.068,1.816] had increase odds of healthcare visits during last 12 months. In conclusion, our findings suggest a noticeably high prevalence of IPV among Angolan women. Those who experience emotional and sexual IPV might be at higher odds of suffering from medical conditions and should be given special attention in primary care settings. Full article

Ecology is both blessed and burdened by romanticism, with a legacy that is multi-edged for health. The prefix ‘eco-’ can carry a cultural and political (subversive) baggage, associated with motivating environmental activism. Ecology is also practiced as a technical ‘science’, with quantitative and deterministic leanings and a biophysical emphasis. A challenge for planetary health is to avoid lapsing into, or rejecting, either position. A related opportunity is to adopt ecological thought that offers a rich entrance to understanding living systems: a relationality of connectedness, interdependence, and reciprocity to understand health in a complex and uncertain world. Planetary health offers a global scale framing; we regard its potential as equivalent to the degree to which it can embrace, at its core, ecological thought, and develop its own political narrative. Full article

Examples of urban restoration and rewilding are critical in promoting grass roots efforts to restore ecosystems diversity in built environments. Honey bees are a vital part of many ecosystems, and urban beekeeping is a growing initiative with multiple benefits, spanning from ecological revitalization, to community cooperation, education, and cohesion. Here, we provide our own experience establishing an extensive system of roof top apiaries as cooperative effort between residents, schools, organizations, and businesses in the city of Detroit, Michigan. Our goal was to contribute to both the health of honey bee colonies and the education of their importance to our urban environment, through wide community engagement including interactive children’s educational events. Honey produced from this not-for-profit initiative is donated to local charities and small businesses, for fundraising, and also used for food and beverages in hospitality around the city. Research collaborations with scientists studying honey bee colony health, including the microbiome of honey bees, will explore possible solutions to help protect from pathogens and diseases. Most of all, we hope that this example will be of inspiration to others to take steps towards ecological solutions, in any and every form, within their own communities. Full article

This paper introduces Energy-Product-Service Systems (EPSS) to overcome the issues in the liberalized energy market. Currently, conventional energy services are highly commoditized, thus eroding their competitiveness in a liberalized energy market. In addition, customer benefits from the current system are hard to analyse, because it is difficult for customers to observe the quality of the results of energy consumption. EPSS incorporates energy sector with other related sectors to design and deliver immediate result of energy usage that suit to customer’s specific needs is expected to provide better performance than current system. However, EPSS service design and implementation involve high risk and performance uncertainties. Therefore, this study proposes a method to design and to evaluate EPSS and compare its performances with energy product/service performance in current system through Simulation-Based Design (SBD). SBD is used to construct EPSS service considering stakeholders’ interest and to evaluate the service performance, by simulating alternative scenarios in order to seek conditions that are expected to fulfil stakeholders’ requirements. In the proposed analysis, three service features, that is, service consumption management, operational system design and electricity supply management are introduced and used to develop EPSS alternative design for space-heating service. Afterwards, customer satisfaction and the company’s benefit for each service scenarios are simulated and compared with the performance of the current system. In this context, EPSS design that includes operational system design and electricity supply management results in better benefit for all stakeholders. Full article

The emerging concept of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political, and otherwise)—emphasizes that the health of human civilization is intricately connected to the health of natural systems within the Earth’s biosphere. In the clinical setting, narrative medicine underscores the importance of absorbing, reflecting upon, and responding to the narratives—the stories—conveyed by patients. Education and interventions using the tenets of narrative medicine have demonstrated value to both patient and provider. Given the grand interconnected challenges of our time—compounded by misinformation and quasi-scientific narratives propagated by the ideology of neoliberalism—we argue that the principles and practice of narrative medicine can be applied on a larger scale, one with planetary health in mind. The role of beliefs, expectations, and agency—mindsets—in the link between narrative and planetary health are emphasized. We use a story of our own to demonstrate that the biological buffering capacity in response to a fast-food meal does not sit on a level socioeconomic playing field. Patient, community, and global health narratives are melding with powerful narratives set by commercial entities. The success of planetary health as a new concept will be strengthened by attention to the ways in which storytelling can influence positive change. No less important is an understanding of the ways in which stories contribute to what ails person, place, and planet. Full article

The problems and challenges associated with planetary health are vast and interconnected, and are therefore requiring of research which takes an all-of-society perspective. Following calls for input from behavioural scientists in discussions about planetary health, we here present a review and synthesis of recent research on utopian thinking and lay beliefs about societal change. For some time, utopian theorists have recognised the capacity of ideals for society to motivate social change behaviour, but this has largely been ignored by behavioural scientists. However, recent research has shown that utopian thinking elicits social change behaviour among ordinary people, and that a utopia with pro-environmental content tends to be especially motivating. Furthermore, changes which are seen as increasing levels of warmth and morality in society elicit greater levels of support and motivation to bring about those changes. These findings have implications for how social movements for planetary health can proceed and provide hope for motivating the necessary social change. We present this work in the hope that it can contribute to the furtherance of efforts for the achievement of planetary health. Full article

Four decades ago, several health movements were sprouting in isolation. In 1980, the environmental group Friends of the Earth expanded the World Health Organization definition of health, reminding citizenry that, “health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease—personal health involves planetary health”. At the same time, a small group of medical clinicians were voicing the concept of “clinical ecology”—that is, a perspective that sees illness, especially chronic illness, as a response to the total lived experience and the surroundings in which “exposures” accumulate. In parallel, other groups advanced the concept of holistic medicine. In 1977, the progressive physician-scientist Jonas Salk stated that “we are entering into a new Epoch in which holistic medicine will be the dominant model”. However, only recently have the primary messages of these mostly isolated movements merged into a unified interdisciplinary discourse. The grand, interconnected challenges of our time—an epidemic of non-communicable diseases, global socioeconomic inequalities, biodiversity losses, climate change, disconnect from the natural environment—demands that all of medicine be viewed from an ecological perspective. Aided by advances in ‘omics’ technology, it is increasingly clear that each person maintains complex, biologically-relevant microbial ecosystems, and those ecosystems are, in turn, a product of the lived experiences within larger social, political, and economic ecosystems. Recognizing that 21st-century medicine is, in fact, clinical ecology can help clear an additional path as we attempt to exit the Anthropocene. Full article

Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the challenges identified. This emerging movement has not yet agreed upon a code of ethics to underpin the rapidly expanding body of research being carried out in its name. However, a code of ethics might support the principles for planetary health set out in the Canmore Declaration of 2018. Phrases such as “Public Health 2.0”, “Human Health in an Era of Global Environmental Change”, or “A safe and just operating space for humanity” are often used in planetary health discussions, but are not always clearly defined and so far, the field lacks a strong guiding ethical framework. In this paper, we propose a starting point towards a code of ethics for planetary health that builds on the Canmore Declaration. We chose to propose 12 ethical principles in recognition of the need for a 12-Step Programme for the planet. The human race must identify and reject damaging behaviours. Evidence of the harm we are causing the planet is no longer enough and refraining from certain current practices is essential for Earth’s future health. We must motivate advocacy and calls for action. We believe a shared ethical code can act as a tool to enable and encourage that process. This paper is presented to the planetary health community as a starting point, not as a finished agenda. We welcome comments, critiques, additions and the opportunity to rework our approach accordingly. Full article

Arctic and subarctic regions are sensitive to climate change and, reversely, provide dramatic feedbacks to the global climate. With a focus on discovering paleoclimate and paleoceanographic evolution in the Arctic and Northwest Pacific Oceans during the last 20,000 years, we proposed this German–Sino cooperation program according to the announcement “Federal Ministry of Education and Research (BMBF) of the Federal Republic of Germany for a German–Sino cooperation program in the marine and polar research”. Our proposed program integrates the advantages of the Arctic and Subarctic marine sediment studies in AWI (Alfred Wegener Institute) and FIO (First Institute of Oceanography). For the first time, the collection of sediment cores can cover all climatological key regions in the Arctic and Northwest Pacific Oceans. Furthermore, the climate modeling work at AWI enables a “Data-Model Syntheses”, which are crucial for exploring the underlying mechanisms of observed changes in proxy records. Full article

Traditional (bio) ethics relies to a large degree on the analysis of problems to determine the right course of action. In particular, in medicine, a dominant text declares that there is a “Common Morality” that applies to all people. This paper will argue that ethics is culture bound and that, in a pluralistic society, a common morality approach to the resolution of problems has significant limitations. I will argue that more attention needs to be paid to the process of agreeing to a way forward given that there is disagreement. I will illustrate how this applies not only at the clinical level but also at the level of national and international politics. A theoretical understanding of compromise and a look at ways of describing the way people make ethical decisions as opposed to seeking an ideal ethical code is presented as a way in which we can manage problems better in a pluralistic society. Full article

Newborns defined as being of “low birth weight” (LBW) or “small for gestational age” (SGA) are global health issues of concern because they are vulnerable to mortality and morbidity. Prenatal exposures may contribute to LBW/SGA. In this review, we searched peer-reviewed scientific literature to determine what location-based hazards have been linked with LBW/SGA in the industrialized nations of Canada and the USA. After selecting studies based on inclusion/exclusion criteria, we entered relevant details in to an evidence table. We classified and summarized 159 articles based on type of environment (built = 108, natural = 10, and social = 41) and general category of environmental variables studied (e.g., air pollution, chemical, water contamination, waste site, agriculture, vegetation, race, SES, etc.). We linked the geographic study areas by province/state to political boundaries in a GIS to map the distributions and frequencies of the studies. We compared them to maps of LBW percentages and ubiquitous environmental hazards, including land use, industrial activity and air pollution. More studies had been completed in USA states than Canadian provinces, but the number has been increasing in both countries from 1992 to 2018. Our geographic inquiry demonstrated a novel, spatially-focused review framework to promote understanding of the human ‘habitat’ of shared environmental exposures that have been associated with LBW/SGA. Full article

This concept paper discusses the potential impact of chlorinated public drinking water on the assembly of the intestinal microbiome in infancy. The addition of chlorine or hypochlorite to metropolitan drinking water is routinely used worldwide as a sanitizer because of its potent anti-microbial properties. It is one of the most effective means of delivering safe drinkable water because it produces a residual disinfectant that persists within the distribution system. Levels of chlorine used to treat metropolitan water are considered safe for the individual, based on toxicity studies. However, to our knowledge there have been no studies examining whether levels of persistent chlorine exposure from tap water are also safe for the ecosystem of microorganisms that colonize the gastrointestinal tract. Given the importance of the microbiome in health, persistent exposure to low levels of chlorine may be a hitherto unrecognized risk factor for gut dysbiosis, which has now been linked to virtually every chronic non-communicable disease of the modern era. Although effects may be subtle, young children and infants are more susceptible to ecological disturbance, given that the microbiome is highly influenced by environmental factors during this period. Here I outline considerations for the safety of water disinfectants not just in terms of toxicity to the host, but also for the ecosystem of microorganisms that inhabit us. Research in this is likely to bear fruitful information that could either bring attention to this issue, potentially driving new innovations in public water management; or could help confirm the safety profile of chlorine levels in public drinking water. Full article

There is a growing recognition of the links between the increasing prevalence of noncommunicable diseases, environmental concerns including biodiversity loss and ecosystem degradation, and socioecological issues such as ecological (in)justice. This has encouraged a number of recent calls for the development of integrative approaches aimed at addressing these issues—also known as nature-based solutions. An example of an emerging nature-based solution is a ‘green prescription’, broadly defined as a nature-based health intervention. Green prescriptions are typically designed for patients with a defined need and they have the potential to supplement orthodox medical treatments, particularly those aimed at addressing noncommunicable diseases. It is also thought that green prescriptions could bring about significant environmental, economic, and social co-benefits. However, researchers have recently expressed concerns over taking the ‘dose of nature’ approach, in that it may be too reductionistic for the complex social settings in which it is provided. Here we frame a holistic philosophical perspective and discuss green prescribing logic, types, mechanisms and fundamental remaining questions and challenges. We place a significant emphasis on the potential co-benefits of green prescriptions, and the importance of taking a planetary health approach. More research is needed to determine how this potential can be realised, and to further understand the complexities of the nature–human health relationship. However, with additional research and support, there is huge potential for green prescriptions to contribute to both reactive (health care) and proactive (health promoting) public health solutions whilst enhancing the natural environment. Full article

Technologies such as blockchain, big data, and the Internet of Things provide new opportunities for improving and scaling up the collection of life cycle inventory (LCI) data. Unfortunately, not all new technologies are adopted, which means that their potential is not fully exploited. The objective of this case study is to show how technological innovations can contribute to the collection of data and the calculation of carbon footprints at a mass scale, but also that technology alone is not sufficient. Social innovation is needed in order to seize the opportunities that these new technologies can provide. The result of the case study is real-life, large-scale data collected from the entire Dutch dairy sector and the calculation of each individual farm’s carbon footprint. To achieve this, it was important to (1) identify how members of a community can contribute, (2) link their activities to the value it brings them, and (3) consider how to balance effort and result. The case study brought forward two key success factors in order to achieve this: (1) make it easy to integrate data collection in farmers’ daily work, and (2) show the benefits so that farmers are motivated to participate. The pragmatic approach described in the case study can also be applied to other situations in order to accelerate the adoption of new technologies, with the goal to improve data collection at scale and the availability of high-quality data. Full article

The grand challenges of our time—climate change, biodiversity losses, and global non-communicable disease rates—underscore that humanity and the planet are in crisis. Planetary health provides a unifying concept wherein efforts toward remediation and survival can be concentrated. Evidence derived from the animal kingdom and from human demography suggest that there is cause for optimism in planetary health. With proper navigation, a transition toward a new epoch—one of symbiotic flourishing—is possible. Responses to the current challenges can usher in a new reality, one in which the core value is the well-being of all. This paper presents the philosophies and perspectives of renown biophilosopher, Jonas Salk, who—after developing the first effective vaccine to prevent polio, one of the great achievements in public health—expanded his vision beyond the prevention of individual diseases to that of addressing the basic problems of humankind. This vision is very much in line with our current understanding of and approach to planetary health. In response to changing conditions, planetary limits, and evolutionary pressure, new values, new communities, and new modes of interacting will likely emerge and be integrated with developments in science, technology, economics, the arts, and international relations, resulting in our survival and enhanced health and well-being. Full article

We are living in the Anthropocene period, where human activity has become the dominant influence on climate and the environment. Addressing the question of how nature and societies will evolve in the Anthropocene is one of the grand challenges of our time. This challenge requires a new form of leadership, one capable of transmuting the eroding relationship between business, society and nature. Yet at this critical time, leadership theory is at a crossroads, with many arguing that leadership, as a field of study, should be abandoned. Operating in parallel to this Anthropocene challenge is an increasing understanding of the complexity of the genome, including the inherent plasticity of our genomic hierarchies, and the influence of the genome on health, disease and evolution. This has demanded a change in thinking to view the genome from an evolutionary systems perspective. To address the imbalance presented by the Anthropocene, we propose using a genomic lens as the basis for thinking about leadership evolution. In arguing this, we aim to provide the pathway for an improved synergistic relationship between business, society and nature, one that can guide the future of humanity in the unstable world we have created. Full article

In rural Africa, income generating activities of many households heavily depend on agricultural activities. In this paper, we present the results of a multi-year intervention whereby dairy farmers and small-scale entrepreneurs were taught to convert their milk into a probiotic yoghurt using an innovative bacterial starter culture and basic equipment. This intervention creates additional sources of income and employment for people involved in the delivery of milk as well as production, distribution, and sales of yoghurt. Besides the economic benefits, the consumption of the probiotic yoghurt can contribute to reduction of the incidence and severity of diarrhea, respiratory tract infections, atopic diseases, alleviate the symptoms of stomach ulcers, and decrease the uptake of aflatoxins in the body. With minimal external financial support, 116 communities or small entrepreneurs have been able to start, expand, and maintain a business by production and sales of probiotic yoghurt. Applied business models and success rate in terms of revenues and profitability varied per region and depended on location, culture, ownership structure, wealth status, and gender. Full article

Recurrent cholera outbreaks in sub-Saharan Africa (SSA) attracted a lot of research interest, raising questions about the effectiveness of current prevention and control methods. However, research on cholera and other water-borne diseases in Africa is dominated by epidemiological studies, while investigations on the environmental drivers and reservoirs of cholera remain scarce. The current discourse relating cholera to the environment in SSA is often limited to the rudimentary statement that, “cholera is caused by the consumption of contaminated water and food”. Yet, beyond this simplistic view, literature elsewhere shows that cholera outbreaks are controlled by its complex interactions with environmental drivers and reservoirs. This brings to question whether cholera can be eradicated in SSA without understanding these complex interactions. The current review seeks to (1) highlight the nature and dynamics of recent cholera outbreaks in SSA, (2) discuss the importance of environmental reservoirs of Vibrio cholerae, and anthropogenic and hydroclimatic drivers in controlling the dynamics of cholera outbreaks, and (3) highlight key knowledge gaps and future research directions, and the need to harness emerging research tools such as modeling, machine learning, data mining, and genomics techniques to better understand the cholera dynamics. By bringing to fore these often-overlooked issues in cholera research, we seek to stimulate discussion, and promote a shift toward cross-disciplinary research on cholera and other water-borne diseases in SSA and beyond. Full article