
The Great Transition will be a fundamental shift in how we live on Earth … how we produce and consume food, energy, and manufactured goods; how we construct and live in our cities; and how we consider and measure growth, progress, and development, and govern ourselves.
The above extract is from the 'Roadmap and Action Plan of the Planetary Health Alliance'. What is the Planetary Health Alliance, how was it formed, and what is its role in global society?
The Planetary Health Alliance
The Planetary Health Alliance is a "consortium of over 480 universities, non-governmental organizations, research institutes, and government entities from 80+ countries around the world". Its origins can be traced to 2015, when The Rockefeller Foundation-Lancet Commission on Planetary Health published its report 'Safeguarding Human Health in the Anthropocene Epoch' in The Lancet. The Rockefeller Foundation-Lancet Commission’s report defines "Anthropocene" as a "proposed name for a new geological epoch demarcated as the time when human activities began to have a substantial global effect on the Earth’s systems". In the executive summary, the report authors stress that:
By unsustainably exploiting nature’s resources, human civilisation has flourished but now risks substantial health effects from the degradation of nature’s life support systems in the future. Health effects from changes to the environment including climatic change, ocean acidification, land degradation, water scarcity, over-exploitation of fisheries, and biodiversity loss pose serious challenges to the global health gains of the past several decades and are likely to become increasingly dominant during the second half of this century and beyond.
It should not be surprising to discover this report referencing the fact that The Rockefeller-Lancet Commission on Planetary Health "builds on previous work, including that of the Brundtland Commission (formerly known as the World Commission on Environment and Development), the International Plant Protection Convention (IPCC), the Millennium Ecosystem Assessment (MEA), and the Convention on Biological Diversity (CBD)".
Alternative Scenarios of Future Development
According to the report’s authors, reasons for hope include "the advent of the Sustainable Development Goals (SDGs) and the post-2015 development agenda [which] provide an important opportunity to address these trends and to tackle health, social, and environmental challenges in an integrated way". The report discusses "four alternative scenarios of future development that exemplify alternative worlds that might emerge from the present". The first two scenarios, "represent an evolution of conventional world views". For example, "Market Forces exemplifies market-centred growth-oriented globalisation, whereas Policy Reform tells of a government-led redirection of growth toward sustainability goals". The alternative scenarios presented in the Rockefeller Foundation-Lancet Commission report "envision a fundamental restructuring of the global order: authoritarianism and fragmentation in Fortress World and positive transformation in Great Transition in which material consumption is reduced [emphasis added] but is more equitable than the present". A condensed definition of the Great Transition future scenario can be found within the São Paulo Declaration on Planetary Health. It states:
We need a fundamental shift in how we live on Earth, what we are calling the Great Transition. Achieving the Great Transition will require rapid and deep structural changes across most dimensions of human activity. This includes how we produce and consume food, energy, and manufactured goods; how we construct and live in our cities; and how we consider and measure growth, progress and development, and govern ourselves … it will take practitioners, scholars, and policy makers across every dimension of human activity working together.

For more information about scenarios thinking, see the 2012 paper 'Scenario Archetypes: Converging Rather Than Diverging Themes', which was published in the academic journal Sustainability. The stated purpose of the article was "to investigate (based on qualitative detailing) the robustness of a set of archetypes first proposed by the Global Scenarios Group (GSG) in 1997".
Where Are We Now?
Recent UK Governments have been following a Policy Reform approach evidenced by savage increases in direct and indirect taxation combined with a policy-driven shift towards "Net Zero". This has led to savage increases in energy prices and a reduction in energy supply due to an over-reliance on solar- and wind-generated power, which are inconsistent. Another consequence is that energy-intensive UK businesses have become less competitive due to these higher cost burdens.
Criticism of the Use of Gross Domestic Product (GDP) to Measure National Progress
This 2015 report of The Rockefeller Foundation-Lancet Commission on Planetary Health is highly critical of the focus on Gross Domestic Product (GDP) as a measure of human progress. It references the fact that in 2011, the UN General Assembly adopted Resolution 65/309, inviting member states to "pursue the elaboration of additional measures that better capture the importance of the pursuit of happiness and well-being in development with a view to guiding their public policies".
One option put forward in the report is the Happy Planet Index, which "measures the extent that countries deliver long, happy, sustainable lives for the people that live in them". Alternative solutions put forward include "redefinition of prosperity to focus on the enhancement of quality of life and delivery of improved health for all, together with respect for the integrity of natural systems".

The Rockefeller Foundation-Lancet Commission on Planetary Health’s report also recommends the promotion of "transformative change through combinations of different approaches using a range of regulatory, fiscal, and tax policies; mass media campaigns; and individual behaviour change interventions [emphasis added]". Nowhere is this shift, via Policy Reform, more obvious than in the new car market, where penalty charges can be levied against vehicle manufacturers failing to hit quotas specified by the Zero Emission Vehicle Mandate. In addition, Clean Air Zones, Low Emission Zones, and the London ULEZ are all policies designed to impact owners of conventional Internal Combustion Engine (ICE) vehicles.
In relation to behaviour change interventions, we discovered the following on the website of the Behavioural Insights Team (aka The Nudge Unit):
- Driving and Accelerating the Adoption of Electric Vehicles in the UK.
- How to Build a Net Zero Society - Using Behavioural Insights to Decarbonise Home Energy, Transport, Food, and Material Consumption.
- The Role of Behaviour Change in the Race to Net Zero.
These initiatives have so far failed to direct significant numbers of private motorists in the UK towards electric vehicle ownership.
Among key stakeholders who are envisaged to have significant roles in promoting planetary health are health professionals: "Using their voice individually and collectively, through advocacy and outreach, they can help mobilise a wide community of actors". To justify this shift in focus from human health to planetary health, the report authors point out that "health professionals need to become well-informed about the dangers posed by global environmental change to the health of those they serve and the potential for health co-benefits from policies to prevent damage to natural systems". If health professionals are to have an influential role in promoting planetary health, how can this be achieved in practice?
The São Paulo Declaration on Planetary Health
UK Column researchers can reveal that the São Paulo Declaration on Planetary Health is a multi-stakeholder call to action co-created by the global Planetary Health community. It outlines the "actions necessary for us to achieve the Great Transition [emphasis added], a just transformation to a world that optimizes the health & well-being of all people and the planet".
It was launched by the United Nations Development Programme (UNDP) in partnership with the University of São Paulo, the Planetary Health Alliance, and Harvard University. The published declaration is dated October 2021. Within its introductory text, it stresses: "The COVID-19 pandemic is the most recent in a series of distress signals ringing around the world". We have all noticed that since the Covid lockdowns, there have been significant changes in the way our institutions have been functioning, and we now appear to live in an age of inverted reality. The Declaration makes it clear that:
We need a fundamental shift in how we live on Earth, what we are calling the Great Transition. Achieving the Great Transition will require rapid and deep structural changes across most dimensions of human activity [emphasis added]. This includes how we produce and consume food, energy, and manufactured goods; how we construct and live in our cities; and how we consider and measure growth, progress and development, and govern ourselves.
This declaration is not simply directed at health professionals; it is directed at all sectors of 21st century global society. To provide just two examples, the key messages for the health sector and for schools follows.
Key message for the health sector
"Reorient all aspects of health systems toward planetary health--from procurement, energy sources, healthcare efficiency, to waste reduction. Commit to achieving a Nature-positive, carbon neutral healthcare system before 2040". This will be of no comfort to those patients languishing on hospital waiting lists nor those struggling to arrange a face-to-face appointment with their local GP.
Key message for schools
"Teach planetary health education from an early age. Advance universal education and embed planetary health throughout primary and secondary school levels". The long-used political slogan of Build Back Better logically means that before re-building, we have to destroy the old ways of doing things and undermine the existing institutions of our society. Of course, the United Kingdom’s newly elected Prime Minister repeatedly tells us that he and his government are fixing the foundations.
The Royal College of General Practitioners (RCGP) and the São Paulo Declaration
The conclusion of the Declaration provides a loud signal in relation to the degree of change accelerating towards every one of us:
We, the planetary health community, call upon all stakeholders to take urgent and decisive action to achieve the Great Transition. Our recommendations and list of stakeholders are not exhaustive. Rather, they are a compass guiding us towards the most promising pathways to support a more just and resilient post-pandemic world. We cannot work or live in silos: catalyzing and implementing fundamental shifts in how we live on Earth will require systemic partnerships across all of human society. While everyone has their own unique role, only by working together as a global community, rooted in planetary health principles, can we co-create to achieve the Great Transition.
Below are eight examples from a long list of signatories:
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine.
- Doctors for Extinction Rebellion (UK).
- International Universities Climate Alliance.
- The Planetary Emergency Partnership (initiated by the Club of Rome).
- The Royal College of General Practitioners (RCGP).
- World Federation of Public Health Associations.
- World Organization of Family Doctors (WONCA); the RCGP is a member.
- ICLEI Local Governments for Sustainability.
The Royal College of General Practitioners (RCGP) and the São Paulo Declaration

The RCGP "are the professional membership body for GPs in the UK". An inspection of the RCGP’s website revealed that:
In September 2019, the RCGP formally acknowledged the climate crisis and the catastrophic effect on human health of not acting decisively and urgently on climate change. The College accepted its duty to provide leadership and urgently escalate its action at local, regional, and national level to decarbonise and promote environmental sustainability.

On the same page, the RCGP lists some of the lobbying actions they have taken as a result of being signatories to the São Paulo Declaration. The RCGP are also a founding member of the UK Health Alliance for Climate Change (UKHACC), which "works to raise awareness, empower people and influence change related to the links between health and climate change". Who else is in this Alliance, and what is its purpose?
UK Health Alliance for Climate Change (UKHACC)
UKHACC is "an alliance of UK-based health organisations representing about one million health professionals". Most members of the professional bodies having membership in the UKHACC will be employees of the NHS. In a 2013 report, The NHS Common Purpose: Towards a Million Change Agents, UK Column referenced the fact that "Helen Bevan, the former Chief of Service Transformation at the NHS Institute for Innovation and Improvement, co-authored a research document entitled Towards a Million Change Agents, a Review of the Social Movements Literature: Implications for Large Scale Change in the NHS”. Six examples of the professional bodies with membership in UKHACC are:
- The Association of Surgeons of Great Britain and Ireland.
- British Medical Association.
- Faculty of Public Health.
- Royal College of Nursing.
- Royal College of Physicians.
- Royal College of Anaesthetists.
We also noted the membership of The Lancet. As a reminder, it was The Rockefeller Foundation–Lancet Commission on Planetary Health that produced the 2015 report which was to ultimately lead to the São Paulo Declaration and the Planetary Health Alliances.
Listed as an ambassador for UKHACC is David Pencheon. Pencheon "was the founder Director of the Sustainable Development Unit (SDU) for NHS England and Public Health England, established in 2007, which has now morphed into the Greener NHS".

The NHS Sustainable Development Unit took part in the Rio+20 Global UN Conference on Sustainable Development via a pre-recorded film, presented by Dr David Pencheon. Pencheon was, until recently, a Commissioner for the Food, Farming and Countryside Commission.
The Food, Farming and Countryside Commission
The Food, Farming and Countryside Commission (FFCC) is "an independent charity … set up in 2017 to help shape the future of food and farming, land use and the countryside". Their report Farming for Change - Charting a Course That Works for All promotes the view that "farming can be a force for change, with a transition to agroecology by 2030". This report postulates that:
Phasing out synthetic pesticides and mineral fertilizers and redeploying natural grasslands showed that with the widespread adoption of healthier diets (fewer animal products, more fruit and vegetables), the adoption of agroecological practices across Europe could meet several challenges at once. Agroecology could supply enough food for 530 million Europeans, while maintaining export capacity, reducing agricultural Greenhouse Gas Emissions GHG emissions by 47% compared to 2010.
When compared to the FFCC Farming for Change Report, the published policy reports of the UKHACC promote a similar vision for the future.
The Policy Reports of the UKHACC
The report Plant-powered Planet: Building a Healthy & Sustainable Food System, published in October 2024, contains the following recommendations for the UK Government and devolved nations:
- Drive sustainable agricultural transformation. This would involve providing "support for farmers to transition to producing more fruits, vegetables, whole grains, legumes and other horticultural products through effective subsidies, grants and low-interest loans. Implement stronger legislation to regulate and ban intensive livestock farming operations in the UK".
- Fuel innovation by investing in a sustainable, plant-powered food future.
- Develop a new national food strategy with plant-based food at the core.
- Revolutionise school meals by promoting health and sustainability with plant-based choices for the next generation.
- Subsidise and incentivise plant-based choices and cut red meat and dairy by 30% by 2030.
According to this UKHACC report, "the transition to a plant-based food system also has latent carbon mitigation potential. For instance, moving away from animal farming can free up 75% of farmland globally and in the UK, which can be returned to nature and used to store carbon" [emphasis added]. A second UKHACC report, A Just Energy Transition for the Good of Health, lists the following amongst its many recommendations for the UK Government and devolved nations:
- End government subsidies, investments, new licences and consent for fossil fuel exploration, extraction and sales.
- Deliver a revised, strengthened net-zero strategy with robust policies to achieve significant emissions reductions across all sectors of the economy.
- Provide sufficient capital investment and funding to decarbonise NHS infrastructure estates, and services, accelerate the transition to electrification of the NHS fleet, and deliver public transport and active travel routes to NHS sites for staff, patients and visitors.
- Implement targets to reduce motorised road traffic in line with net zero targets and upscale investment in high-quality infrastructure to enable and promote walking, wheeling, cycling [emphasis added], and public and shared community transport use.
Ironically, in September 2024, we learned that the "Welsh government spent £218m to get more people walking and cycling but it's not working".
What Might the Future Bring?
Firstly, whilst it would appear that all members of professional bodies operating in the health sector are acting as change agents, we do not necessarily believe this to be the case. However, the majority of health sector workers will be reluctant to speak out against the stated position of their respective professional bodies for the following reasons. Firstly, they may have a fear of potential loss of employment together with the consequential loss of salary and pension rights. Secondly, they may have a fear of being alienated from their peers.
Professional body signatories to declarations such as the São Paulo Declaration on Planetary Health also has the effect of artificially exaggerating the levels of public support of their stated aims. The strategic direction of travel of a multitude of organisations together with various global and local networks has a single focus which is driven by International Climate Change Policy Agreements.
However, if we add to this mix the fact that newly inaugurated President Trump signed an Executive Order directing the United States’ withdrawal from the Paris Climate Agreement, the future becomes less certain. What impact President Trump’s action will have on the climate policies of other nations such as the UK is presently unclear.
What is clear, however, is that the UK is at a tipping point. The decarbonising of the electricity grid had shown in January 2025 how vulnerable the system is in calm weather. Recent near-zero wind speeds and low temperatures left the UK dependent on France, Norway, Belgium and Denmark to keep the lights on. Decarbonising our energy generating capacity whilst simultaneously seeking to accelerate the adoption of electric vehicles and a buildout of data centres to turbocharge AI can only lead us to inevitable blackouts.
In addition to the above perceived threats, we have been able to identify another on the horizon. The International Maritime Organization (IMO) "is the United Nations specialised agency with responsibility for the safety and security of shipping and the prevention of marine and atmospheric pollution by ships". The IMO’s 2023 Strategy on Reduction of GHG Emissions from Ships "envisages a reduction in carbon intensity of international shipping (to reduce CO2 emissions per transport work), as an average across international shipping, by at least 40% by 2030". As expected, the UK Chamber of Shipping has already produced "a roadmap for the UK shipping industry to reach net zero by 2050".
In addition, major changes to Global Shipping Alliances in 2025 signal a broader transformation in the global container shipping industry. What impact this will have on global supply chains in the short, medium and longer terms isn’t difficult to predict. In light of Charles Malet’s article 'Farmers’ Protests: the Wrong Target?', any disruption to food imports, in addition to potential reductions in UK food production, would soon become noticeable when items go missing from supermarket shelves.
In effect, the Captain and Officers of HMS United Kingdom have deliberately charted a course through turbulent seas. During the journey, lookout shouts, "Danger. Rocks ahead". Captain Calmer responds, "There are no rocks on my charts, maintain speed and steer the same course". Within less than two minutes, lookout bellows the same warning. First Officer Rubber-Band repeats the order whilst putting on his lifejacket and suddenly diving overboard. In this analogy, unless the ship immediately changes course, it is likely to collide with the rocks named Net Zero.
Dr Paul Raskin and His Global Influence
Dr Paul Raskin is the founding director of the Tellus Institute, which was established in 1976. He also founded the Global Scenario Group in 1995, the Stockholm Environment Institute’s North American Center in 1989, and the Great Transition Initiative in 2003. Raskin and his colleagues published Great Transition: The Promise and Lure of the Times Ahead in 2002.
Major funding was provided to the Global Scenario Group by the Nippon Foundation, the Stockholm Environment Institute, the United Nations Environment Programme, the Rockefeller Foundation, and the Global Industrial and Social Progress Research Institute. Over many decades, his work has been "envisioning a holistic shift to a sustainable and livable civilization—and the paths for getting there". In fact, the scenarios presented in The Rockefeller-Lancet Commission report (2015) can all be found within Raskin’s earlier work.
We were therefore surprised by the fact that, after many decades of work in the development and modelling of various future scenarios, Raskin is only briefly mentioned in footnote 378 of The Rockefeller-Lancet Commission’s report. In addition, we have double-checked the list of signatories of the São Paulo Declaration on Planetary Health and can confirm that neither Dr Paul Raskin nor the name of any of the researchers listed as members of the Global Scenario Group can be found.
In 'The Century Ahead: Searching for Sustainability', published in 2010, Raskin postulates that:
a long and tenacious process of proactive adjustments in policy and technology—as embodied in the Policy Reform scenario—could, in principle, redirect world development toward sustainability. However, this approach confronts the daunting challenge of marshalling the massive globally-coordinated interventions at the pace and magnitude required. If the strategy of incremental change fails, and crises mount, the global trajectory could swerve toward the authoritarian order of Fortress World, or even the collapse of organized institutions [emphasis added].
The Consequences When Scientific Predictions Are Wrong
We should always remember that scientists such as those involved in the modelling of the future scenarios discussed above have sometimes been found to be completely wrong with their predictions. In such circumstances the outcome can be truly catastrophic.
One classic example is the work of the infamous Professor Neil Ferguson of Imperial College London. In his report Impact of Non-Pharmaceutical Interventions (NPIs) to Reduce COVID-19 Mortality and Healthcare Demand, dated 16 March 2020, he claimed that, "In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB". Following publication of his report, Covid lockdowns were introduced, with non-essential businesses and schools closed. The practical effects on people’s livelihoods, the financial consequences of the furlough scheme, impacts on mental health, and disruption to the education of our children are still being felt today. He was also responsible for disputed research that resulted in the mass culling of farm animals during the foot-and-mouth outbreak of 2001. Previously, he was also criticised for flawed research when predicting that up to 150,000 people could die from bovine spongiform encephalopathy (BSE, or mad cow disease).
In each of the examples above, the forecasting methodology employed by Ferguson turned out to have no greater accuracy than simple crystal-ball gazing. Similarly, if the mathematical models used by scientists to predict climate change-driven events also turn out to be fatally flawed, then we have a major problem. For if the predictions based upon perceived future threats are wrong, how high will the cost be to global society of introducing unnecessary measures to mitigate those non-materialising future threats?
United Nations General Assembly (UNGA)’s High-Level 2024 Event – 'Summit of the Future'
On 16 September 2024, fellow UK Column researcher Dr Diane Rasmussen McAdie presented the findings of her research to viewers and listeners in her report on the meeting of the United Nations General Assembly (UNGA) that took place in New York last year. Included in the UNGA programme was a high-level event called “Summit of the Future”. Working backwards in time from 2024, Dr Rasmussen McAdie’s research also identified the fact that Dr Raskin’s work had significantly contributed to the development of future scenarios thinking. She also highlighted the fact that the perceived threats posed by climate change had first been publicised in the following reports of the Club of Rome:
- The Limits to Growth (1972)
- Mankind at the Turning Point (1975)
We can reveal that a search of the Internet Archive shows that Dr Paul Raskin was previously a member of the Club of Rome. According to his biography page on the archived Club of Rome website, Raskin was previously "a lead author on the Intergovernmental Panel on Climate Change, the Millennium Ecosystem Assessment, the UNEP Global Environment Outlook and the Earth Charter".