The search for sustainable solutions that are within the planetary boundaries needs to be intensified and the
understanding of how these can be implemented improved, to avoid catastrophic consequences for human health
and survival. New approaches towards sustainable development can produce benefits but occasionally can also have potentially adverse effects on terrestrial ecosystems or on human health. One example of possible harmful effects is the construction and operation of on- and off-shore windparks for the provision of renewable energy, which might
adversely impact the environment and affect species through construction noise and noise pollution, respectively.

Such effects need to be continuously explored and assessed year-round, including increasing understanding of the
species that frequent the area of installation, such as marine mammals and sea birds, and possible long-term impacts.
Other examples include possible effects of fracking and of bio- and geo-prospecting (discovery and commercialization
of new products based on biological resources), which can be linked to the exploitative use of indigenous knowledge
for commercial profit and land use and possible relocation of communities.

Most challenging, however, is the need to “rethink our relationship with the planet, combining philosophical, ethical,
literary, medical, and other perspectives, ideally creating a positive vision which can energise the so-called Great
Transformation of human societies globally, which we so urgently need” (10). Inclusive citizen science describes the
participation of the general public in the generation of scientific knowledge, which strengthens science communication
and access to scientific knowledge as well as trust. Inclusive citizen science and social innovation programmes can
improve the interface between human health and terrestrial ecosystems and lead to greater awareness among the
general public of urgent and relevant issues in relation to the environment, life on land and human healthThe linkages between biodiversity, ecosystem services and human health are complex, and environmental changes caused by human actions can affect human health through a number of pathways (7).

Natural ecosystems can be considered in four service areas: support services such as soil formation, pollination and nutrient cycling; provision services, which provide goods or services such as raw materials for construction and energy, food, water, timber, fibre, medicinal compounds and genetic resources; regulating services, which directly or indirectly affect health through climate, floods and water quality; and cultural services, which cover recreation and the aesthetic enjoyment and fulfilment that nature provides.

Each of these affects human health and well-being, from basic functions such as nutrient cycling, provision of food and shelter, and regulation of water quality through to the spiritual and recreational components. Taken together, these not only link directly with physical andmental health but also support broader aspects of human well-being such as earning an income and having a cultural identity.

The term planetary health covers a new multidisciplinary approach to understanding the interconnections between environmental and human health. It calls for exceptional action that respects planetary boundaries (the quantitative boundaries within which humanity can continue to develop and thrive and does not destabilize planetary systems beyond critical tipping points.