Priority Setting in the Context of Planetary Healthcare.

The realities of ecosystem breakdown and climate change pose a significant threat to the health of individuals around the world, disproportionately affecting poor and vulnerable populations. Every sector in society, including healthcare, needs to be engaged in the tremendous collective effort and transformational change needed to limit global warming. We see priority setting as having a key role to play in reallocating existing budgets within healthcare systems whilst at the same time being used to facilitate sustainable and more efficient resource allocation across countries. Priority setting looks to fairly distribute resources with the goal of improving patient and population health outcomes. However, these goals can be broadened to include consideration of environmental impact based on our understanding of the necessity of emissions reduction to address the climate crisis and promote population health. In this paper, we introduce key concepts of priority setting and identify the interplay between priority setting and the realities of resource scarcity in the realm of planetary healthcare. We propose that applying priority-setting principles could serve at least three goals; (1) protect and improve health outcomes; (2) limit unnecessary and marginal care; and (3) facilitate a just transition to a sustainable healthcare system.