Safeguarding planetary health: the contribution of community health workers to climate stability, global equity, and social justice

Planetary health, the interdependence of human health and natural systems, is under severe threat. Climate breakdown, biodiversity loss, and chemical pollution are driving overlapping crises that already undermine health and equity. The Lancet Commission on planetary health warned in 2015 that “human health and human civilisation depend on flourishing natural systems”. Yet, progress remains too slow; land and marine protections are insufficient, global dietary shifts are lagging, and reliance on fossil fuels persists. Public awareness has grown, spurred by influential voices such as those of Sir David Attenborough, who distilled six interconnected actions from scientific consensus: rewilding land and oceans, transitioning to renewable energy, reducing meat consumption, establishing marine reserves, stabilising human population by bringing growth to zero through education and equity, and prioritising wellbeing within ecological limits over the growth of economic output and resource throughput. Community health workers (CHWs) are health-care providers who live in the community they serve and receive less formal education and training than professional health-care workers, such as nurses and doctors. In this Viewpoint, we argue that trusted, hyperlocal, and globally present CHWs are a largely overlooked workforce in tackling the climate crisis, despite already doing work in adapting to and mitigating climate change. By embedding planetary health within their remit, CHWs can link health, justice, and climate resilience in practical ways, offering one of the most feasible pathways to accelerate progress. Redirecting even a small proportion of fossil-fuel subsidies towards strengthening CHWs to improve global health access could close the global health-workforce gap, reduce gender inequities, redress colonial imbalances, and deliver both climate mitigation and adaptation to ensure a liveable future for all.