Enhancing Planetary Health to meet the SDGs: Integrating Indigenous and Local Knowledge in human health decision-making and planning in Fiji
The proposed lab aims to co-identify the various socio-ecological transitions (e.g., changes to governance arrangements, need for new data and capacity building, integration customary decision-making into national policies) and co-develop a priority sub-set of associated strategies that will be required to facilitate social transformations within human health planning and decision-making that integrates Indigenous and local knowledge (ILK) in meeting the Sustainable Development Goal 3 (i.e., SDG 3-Human Health). Adopting systems thinking, the lab will take into consideration synergies with other SDGs (e.g., land, water, climate change, partnerships) and local sustainability goals . This lab will provide the first opportunity within human health in the Pacific Islands where we explore the potential role of ILK for enhancing planetary health and thus meeting the new SDGs. This lab will be conducted in partnership with the Ministry of Health and provides an opportunity to inform national planning activities related to the SDGs. Success of the proposed lab will enable similar labs to be delivered across other Pacific Islands. Fiji is both a Small Island Developing State (SIDS) and a Least Developed Country (LDC) with a rich ILK base.
ILK is often overlooked in planning, policy and programs that operate within the nexus of human health and global environmental change. The recent Lancet Global Burden of Disease Study 2015 and Lancet Commission report on Planetary Health 2014 has many references to environmental change processes and it potential to shape various health outcomes such as food and water security, but fail to acknowledge the need for diverse knowledge systems in dealing with complexities and informing the agenda of the new Sustainable Development Goals SDGs. To do so will require human health responses to broaden its empirical scope, engage beyond a single epistemology and intellectual stream to complement Western dominated scientific knowledge, which has its own limitations in addressing global environmental change processes and subsequently meeting the SDGs. Human health has synergies with all the SDGs and retains a central position across the entire SDG framework; as a major contributor and beneficiary of sustainable development policies.
Pacific Islands are particularly vulnerable to environmental change processes due to their characteristically small physical size, exposure to natural disasters, extremely open economies and low adaptive capacity. Environmental change processes are amplifying risks to human health; increasing demand for adequate and safe housing, clean water and sanitation, access to healthy food and protection from natural hazards requires appropriate planning and governance structures. Despite the rich presence of ILK across the Pacific Islands (e.g., related to traditional medicines and foods, architecture, natural resource management) there is limited formal recognition or integration of such knowledge in human health policies and plans that can help inform the SDGs. Planetary health emphasis that nature and society are inextricably linked and thus the health of people are dependent on the health of the planet. There is a need for health practitioners and policy makers to recognise this duality and apply integrated conceptualisations that value plural knowledge streams in planning and policy processes if we are to ensure health security and meet the SDGs. To do so, may require new partnerships, overcoming deeply held values and perceptions, innovative financing mechanisms or developing different tools for data gathering.
Recognising the significance of the co-design and co-production of knowledge between policy makers and practitioners working across scales and sectors for facilitating transformational change, we aim to bring together diverse stakeholders working within and external to human health field, including government representatives, NGOs, media, donors, regional actors, Indigenous community leaders and the small business sector. Through this lab we aim to ‘open up’ the dialogue and empower stakeholders to implement change. This requires committing to the inclusive involvement of stakeholders, framing the engagement process as a collaboration among full partners, and co-developing the capacity to envision and realize transformational changes — including envisioning new governance structures to allow for these changes to take place. We recognize the limitations of this lab to fully generate transformative changes, and instead, seek to build the collaborative networks, understanding, and capacity toward empowerment. The participatory co-production approach we describe will build governance capacity in today’s decision-maker community to develop and realise future sustainability goals.