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From ‘ego’ to ‘humility’: making interdisciplinary and intersectoral initiatives work for global and planetary health

By guest contributors Timothy Carandang, Aaron Joe, Marianne Bongcac, Karen Ceballos

During the Prince Mahidol Award Conference (PMAC) 2023, with the theme “Setting a New Health Agenda: At the Nexus of Climate Change, Environment, and Biodiversity”, the Swedish Institute for Global Health Transformation (SIGHT) and the Planetary and Global Health Programme of St. Luke’s Medical Center College of Medicine (PGHP-SLMCCM) in the Philippines jointly organized a side event entitled “Intensifying Interdisciplinary and Intersectoral Initiatives in Global and Planetary Health: Why and How”. The hybrid workshop was a combination of short presentations, a panel discussion, a group breakout session, and interactive real-time surveys using Slido.

The presentations highlighted the necessity – as well as the challenges – of adopting interdisciplinary and intersectoral approaches to addressing complex global and planetary health problems such as climate change and future pandemics. Umea University’s Dr. Masoud Vaezghasemi and Uppsala University’s Dr. Ashish KC shared their reflections from taking part in SIGHT’s Fellowship Program, which allowed them to collaborate with scientists from other Swedish universities and disciplines to design collaborative research on global and planetary health issues. Meanwhile, Dr. Renzo Guinto, St. Luke’s PGHP’s inaugural director, told the story of the birthing pains – and the early successes – of the first planetary health program in the Philippines and Southeast Asia which he established in 2020 at the beginning of the pandemic. Dr. Kyi Thar from the Asian Development Bank (ADB) provided insights from interdisciplinary projects funded by ADB on health security, climate change, and digitalization in Asia and the Pacific region. The latter part of the workshop was devoted to a group breakout activity, where groups of attendees examined barriers and opportunities to solving global and planetary health problems, specifically climate change, biodiversity loss, and air pollution.

A Profitable Arbitrage Opportunity

Drawing from the language of financial economics, Dr. Vaezghasemi framed the interdisciplinary approach as a ‘profitable arbitrage opportunity’ wherein experts from various disciplines can mutually take advantage of the wealth of knowledge and expertise offered by different colleagues. Maximizing this opportunity requires stakeholders with diverse perspectives to be open-minded and seek to find common ground. In his sharing about an interdisciplinary project assessing the impact of climate change and biodiversity loss on women and children in Bangladesh, Dr. KC highlighted interdisciplinary communication as a critical competency for collaborators to hone in order to reach a shared understanding of the problem at hand.

In his presentation, Dr. Guinto quoted the late Anthony McMichael, one of the first epidemiologists to study the links between climate change and human health: “The health sector must lift its gaze to bigger, ecological horizons. This will require a radical extension of the public health agenda…, and an ability to collaborate with unfamiliar disciplines such as climatology and ecology.” Hence, his approach in the Philippines is to encourage medical students to “gain friends from other disciplines, from outside the medical school” and be exposed early to interdisciplinary and intersectoral initiatives. Some of the recent efforts of the St. Luke’s Planetary and Global Health Program include: the Next Generation One Health Philippines (NGOHP) fellowship program; an interdisciplinary workshop on climate change and mental health; establishment of  Planetary Health Philippines (a national community of Filipino planetary health advocates); and the CATA-Earth Consortium for planetary health education, which is participated in by eight universities from Asia and Europe. St. Luke’s experiences reinforce Dr. Thar’s message that interdisciplinarity should start at home. Drawing from his experiences in ADB, he also emphasized that similar challenges and goals between countries in the Asia-Pacific must encourage united efforts and enable more international partnerships in the region.

Researchers from Asia and Europe discussing about the challenges and opportunities in addressing planetary health problems like climate change and biodiversity loss

It’s All About Building Bridges

In the group breakout session, ineffective interdisciplinary and intersectoral communication and collaboration were identified as persistent challenges, marked by the inaccessibility of data between stakeholders and the lack of clarity of roles of other disciplines in addressing global and planetary health problems. Some interesting ideas that emerged include democratizing climate and air pollution data through the set-up of open-access repositories, as well as integrating planetary health education in less prioritized disciplines such as psychology and journalism. Deeper engagement with the humanities and the social sciences was also highlighted as key to bridging gaps in our understanding of global and planetary health issues by capturing people’s lived experiences, which are often neglected in the name of “big data”.

The group breakout participants also highlighted the need to foster partnerships between sectors that are traditionally distant from each other such as the academe and the private sector. One suggestion raised is establishing internship programs for young scientists and industry professionals to promote bidirectional learning and facilitate future research collaborations. More national and international fellowships – such as the SIGHT and St. Luke’s fellowship programs – were also advocated by participants; these platforms will help produce the next generation of scholars, practitioners, and leaders who are not afraid to navigate complex interdisciplinary and intersectoral spaces.

Moreover, the participants placed emphasis on engaging the youth and local communities, especially the most vulnerable populations, in research and policymaking to ensure direct impact and program sustainability. Dr. KC highlighted the need for different disciplines to come together and listen to the actual needs of communities. Dr. Guinto also stated that universities in low-and-middle income countries (LMIC) may serve as promising models for community-engaged interdisciplinary work, because these institutions are often embedded in the communities they serve and regard them as valuable sources of local knowledge.

Dr. Alay Llamas of UMC Utrecht and Dr. Karen Ceballos of St. Luke’s emphasize the importance of positive framing of planetary health initiatives – for instance, from addressing “biodiversity loss” to creating “nature-positive” solutions.

Overcoming ego with humility

At the start of the event, participants were asked about challenges that they encounter in interdisciplinary and intersectoral work. The top answer to the Slido survey was “ego”, followed by “lack of communication” and “interdisciplinary politics.” After the engaging presentations and rich discussions, the participants were asked what solutions they learned and will take away from the event. The top answers were quite the opposite – “humility”, “communication,” and “partnership.”

Indeed, as Dr. Guinto emphasized during the panel, humility, both personal and professional, is the first step to de-siloization and must be considered a core competency for interdisciplinary scholars. “How can we produce the next generation of humble leaders and scholars who own up to their limits and are open to learn from others?” he asked. He also stated that complementary to humility is courage: “In tackling planetary health challenges, one must not be afraid – be courageous, because in this kind of work, you will be wrestling with a lot of tensions and countervailing forces. The only thing that can build courage is to work together across disciplines, across sectors, and most importantly, across generations”.

Dr. Renzo Guinto taking a ‘groufie’ with the workshop participants – proof that interdisciplinary and intersectoral collaboration can be fun too!

About the Authors

Timothy Carandang, MD is a Research Fellow for Planetary Health at the Planetary and Global Health Program of the St. Luke’s Medical Center College of Medicine. His interests include snakebites in the Philippines, public health education, the nexus of spirituality and health, and clinical epidemiology.

Aaron Joe is a Research Associate for Health Systems at the Planetary and Global Health Program of the St. Luke’s Medical Center College of Medicine. His work involves qualitative research in health, focusing on patient engagement, health systems strengthening and the sociocultural dimensions of health.

Marianne Bongcac is a Research Associate at the Planetary and Global Health Program of the St. Luke’s Medical Center College of Medicine. Her work focuses on strengthening climate resilience of local health systems, as well as the linkage between biodiversity and health.

Karen Ceballos, MD, MBA is a Research Fellow for Climate Change and Health Systems at the Planetary and Global Health Program of the St. Luke’s Medical Center College of Medicine. Her work focuses on building climate-resilient local health systems.

Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.

Discussion
  1. One of the greatest challenges for an effective planetary health action, is to convince the medical authorities of the importance and need of having such a perspective. They may influence politicians to invest public resources on this endeavor. There is a strong clinical view in policies aiming for public health, but even among doctors in LMIC.
    I hope more international funding helps to swith this perspective, enforcing the health sector to invest more in planetary health issues, such as those efforts made in Philippines.

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