- Email: [email protected]
Tony McMichael: a visionary of the environment–health interface
Perspectives
Profile Tony McMichael: a visionary of the environment–health interface When Tony McMichael became chair of epidemiology at the UK’s London School of Hygiene and Tropical Medicine (LSHTM) in 1994, his belief in the relevance of epidemiological research on the health risks of climate change “bemused” senior colleagues. The year before had seen the publication of McMichael’s prescient book, Planetary Overload, in which he explored the consequences to human health of ozone depletion, temperature increases, loss of genetic diversity through species extinctions, and other large-scale environmental degradation. But like many farsighted scientists, one of McMichael’s biggest challenges was convincing others of his idea. McMichael’s own career up to that time had led him to appreciate how the environment could interact with human health. Research in occupational epidemiology at the University of North Carolina’s School of Public Health was followed by investigations of the dietary causes of disease, as head of epidemiology in the Division of Human Nutrition of Australia’s Commonwealth Scientific and Industrial Organisation (CSIRO). During the 1980s, including time spent at Adelaide University, McMichael and colleagues undertook a 15-year follow-up study of newborn babies in Port Pirie, a lead smelter city. Their documentation of the adverse effects of lead exposure on child intellectual development “had far-reaching impacts on environmental exposure standards”, he says. By the time McMichael arrived at the LSHTM, he was convinced about the health implications of global environmental change. But it was only by the late 1990s that scientific interest and political will began to galvanise research in this area, partly because of McMichael’s own pioneering work in this area. Despite the health risks of climate change, and its headlinegrabbing potential, McMichael is reluctant to focus on it exclusively. He views the link between the environment and health through a wide-angle lens. “If we treat climate change, ecosystem damage, and acidification of soils and oceans as just a few more itemised environmental problems then we miss the point”, he says. The point being that through our environmental tunnel vision, we are “overloading the biosphere’s capacity to absorb, replenish, cleanse, and stabilise”. Indeed, he believes that “to change the world’s climate is to shake the foundations of Earth’s life support systems”. While altered infectious disease patterns are one danger, indirect threats to health could result from impaired food yields, social disruption, and population displacement. As well as his ongoing work for the UN’s Intergovernmental Panel on Climate Change (IPCC), McMichael has in the past 5 years contributed to the international Millennium Ecosystem Assessment. Governments have not yet understood the importance of this assessment’s findings www.thelancet.com Vol 368 July 1, 2006
says McMichael. And, “attuned to simple high-school models of science, with clear-cut cause-effect relations, most of us are yet to grasp the risks to human societies and health from these escalating changes to the world’s complex nonlinear systems, whether climate system or ecosystems”. Nor have most nations got to grips with the far-reaching consequences of their environmentally unfriendly actions, he adds. The USA and Australia, for example, are assuming that climate change is merely a “technical-fix problem”. Others, including rapidly industrialising countries such as Brazil, China, and India, naturally want to expand their economies as did western countries in the past two centuries. “As many terminal human societies have done in the past, we are mortgaging the future to pay for the present”, he warns. Since 2001 he has been Director of the National Centre for Epidemiology and Population Health, at the Australian National University, and is exploring other links between the environment and health. McMichael and his co-workers are undertaking a national multicentre, case-control study of environmental and viral-exposure factors in the aetiology of multiple sclerosis. The incidence of such autoimmune diseases increases with distance from the equator. The team postulate that the immune-suppressive effect of solar ultraviolet rays may reduce the risk of this disease. Raising awareness of the potentially disastrous health effects from environmental degradation—and helping catapult sustainable living onto the global to-do list—will probably be McMichael’s most enduring legacy. Robert Beaglehole, WHO’s director of Chronic Diseases and Health Promotion, said that “McMichael deserves huge credit for his leading role in placing the critically important health effects of environmental change, especially climate change, on the global development agenda.” This hard-won legacy has also required challenging the status quo of “development strategies based heavily on fossil fuel consumption and the exploitation of finite resources”, says Andy Haines, director of the LSHTM, who has worked with McMichael on the IPCC. Sustainability, now a buzzword in global policy, figures prominently in McMichael’s thinking. “Our current, outdated, system of nation-states competitively pursuing self-interest poses a serious risk to achieving a sustainable way of living. As we crank up markets, ‘free’ trade, patent protection, and the primacy of profits, we risk doing continuing damage to our social and natural environments.” And that, as McMichael argues, would be missing the point of sustainability: “the prime role of societies is to create enduring conditions that promote the population’s wellbeing and health”.
Priya Shetty [email protected]
21
Profile Tony McMichael: a visionary of the environment–health interface When Tony McMichael became chair of epidemiology at the UK’s London School of Hygiene and Tropical Medicine (LSHTM) in 1994, his belief in the relevance of epidemiological research on the health risks of climate change “bemused” senior colleagues. The year before had seen the publication of McMichael’s prescient book, Planetary Overload, in which he explored the consequences to human health of ozone depletion, temperature increases, loss of genetic diversity through species extinctions, and other large-scale environmental degradation. But like many farsighted scientists, one of McMichael’s biggest challenges was convincing others of his idea. McMichael’s own career up to that time had led him to appreciate how the environment could interact with human health. Research in occupational epidemiology at the University of North Carolina’s School of Public Health was followed by investigations of the dietary causes of disease, as head of epidemiology in the Division of Human Nutrition of Australia’s Commonwealth Scientific and Industrial Organisation (CSIRO). During the 1980s, including time spent at Adelaide University, McMichael and colleagues undertook a 15-year follow-up study of newborn babies in Port Pirie, a lead smelter city. Their documentation of the adverse effects of lead exposure on child intellectual development “had far-reaching impacts on environmental exposure standards”, he says. By the time McMichael arrived at the LSHTM, he was convinced about the health implications of global environmental change. But it was only by the late 1990s that scientific interest and political will began to galvanise research in this area, partly because of McMichael’s own pioneering work in this area. Despite the health risks of climate change, and its headlinegrabbing potential, McMichael is reluctant to focus on it exclusively. He views the link between the environment and health through a wide-angle lens. “If we treat climate change, ecosystem damage, and acidification of soils and oceans as just a few more itemised environmental problems then we miss the point”, he says. The point being that through our environmental tunnel vision, we are “overloading the biosphere’s capacity to absorb, replenish, cleanse, and stabilise”. Indeed, he believes that “to change the world’s climate is to shake the foundations of Earth’s life support systems”. While altered infectious disease patterns are one danger, indirect threats to health could result from impaired food yields, social disruption, and population displacement. As well as his ongoing work for the UN’s Intergovernmental Panel on Climate Change (IPCC), McMichael has in the past 5 years contributed to the international Millennium Ecosystem Assessment. Governments have not yet understood the importance of this assessment’s findings www.thelancet.com Vol 368 July 1, 2006
says McMichael. And, “attuned to simple high-school models of science, with clear-cut cause-effect relations, most of us are yet to grasp the risks to human societies and health from these escalating changes to the world’s complex nonlinear systems, whether climate system or ecosystems”. Nor have most nations got to grips with the far-reaching consequences of their environmentally unfriendly actions, he adds. The USA and Australia, for example, are assuming that climate change is merely a “technical-fix problem”. Others, including rapidly industrialising countries such as Brazil, China, and India, naturally want to expand their economies as did western countries in the past two centuries. “As many terminal human societies have done in the past, we are mortgaging the future to pay for the present”, he warns. Since 2001 he has been Director of the National Centre for Epidemiology and Population Health, at the Australian National University, and is exploring other links between the environment and health. McMichael and his co-workers are undertaking a national multicentre, case-control study of environmental and viral-exposure factors in the aetiology of multiple sclerosis. The incidence of such autoimmune diseases increases with distance from the equator. The team postulate that the immune-suppressive effect of solar ultraviolet rays may reduce the risk of this disease. Raising awareness of the potentially disastrous health effects from environmental degradation—and helping catapult sustainable living onto the global to-do list—will probably be McMichael’s most enduring legacy. Robert Beaglehole, WHO’s director of Chronic Diseases and Health Promotion, said that “McMichael deserves huge credit for his leading role in placing the critically important health effects of environmental change, especially climate change, on the global development agenda.” This hard-won legacy has also required challenging the status quo of “development strategies based heavily on fossil fuel consumption and the exploitation of finite resources”, says Andy Haines, director of the LSHTM, who has worked with McMichael on the IPCC. Sustainability, now a buzzword in global policy, figures prominently in McMichael’s thinking. “Our current, outdated, system of nation-states competitively pursuing self-interest poses a serious risk to achieving a sustainable way of living. As we crank up markets, ‘free’ trade, patent protection, and the primacy of profits, we risk doing continuing damage to our social and natural environments.” And that, as McMichael argues, would be missing the point of sustainability: “the prime role of societies is to create enduring conditions that promote the population’s wellbeing and health”.
Priya Shetty [email protected]
21