CAROLINE ANITHA DEVADASON, LUKE JACKSON AND JENNIFER COLE

Planetary health is a multi-disciplinary approach that addresses the interconnections between the processes of environmental change and their impacts on human health and well-being, at scale. The planetary health concept builds on the ecological framing of planetary boundaries and supports the UN Sustainable Development Goals and the Paris Climate Change Agreement, both of which recognize the importance of regional and global coordination to solve complex environmental and development challenges. Links between environmental change and human health are both direct (e.g. impact of air pollution on respiratory and cardiac functioning) and indirect (e.g. extreme weather events or sea-level rise leading to permanent displacement) but there is plausible connection between the change in natural systems and human well-being. The planetary health approach requires transboundary perspectives covering issues that one country cannot address in isolation. Solutions, however, may be local, national, regional or international. The work of The Rockefeller Foundation Economic Council on Planetary Health, through its Secretariat based at the Oxford Martin School at the University of Oxford, aims to provide a policyoriented, economic perspective to developing solutions. The central economic concept is that externalities – or costs and benefits to another party that are not priced, regulated or consented to – should better address planetary boundaries than at present. The analysis pays attention to equity and distributional issues, recognising how different people, institutions, countries and trajectories of development are affected by the impact of planetary health and the measures proposed to address it. This work seeks to target recommendations at global and national policy-makers. A series of background papers has been developed by the Secretariat. These papers aim to illustrate where solutions might be identified and applied, diagnosing planetary health issues by highlighting drivers of change, significant environmental impacts and the resulting human health impacts. This paper explores the impacts from climate change and associated sea level rise on human health and livelihoods. Small islands states, particularly in the Pacific, are on the front line of these impacts, and this paper identifies fisheries as key sources of government revenue and economic livelihoods in Pacific Island Countries that are at risk. The governance of the response to the challenges that Pacific Island Countries face are a key topic of this paper, including the issue of climate-related migration and refugees.