Planetary Health Systems Success is Everyone’s Business

Climate change exerts escalating strain on healthcare systems, while simultaneously, these systems contribute to the exacerbation of climate change. Health systems globally face the challenge of optimizing population health while managing rising non-communicable diseases and climate-related risks like extreme weather and biodiversity loss. Reframing performance metrics to address these issues can create resilient and sustainable systems that promote both human and ecological well-being, supporting Sustainable Development Goals 3 and 13. Current health system performance frameworks, like WHO's indicators and OECD statistics, focus on clinical metrics while neglecting planetary boundaries such as healthcare's carbon footprint and ecosystem dependencies. This narrow approach fails to connect population health inequities with environmental degradation, hindering comprehensive accountability. Planetary health is acutely under threat in the Anthropocene, with the causes and impacts of this threat inequitably distributed. Roughly 9 million premature deaths annually are linked to exposure to air and water pollution, 3·2 billion people are affected by land degradation, and many millions are affected by zoonotic disease, rising temperatures, and extreme weather events. The purpose of this review is to sensitize on an enhanced health system performance framework that effectively integrates indicators of population health, such as life expectancy and disease burden, with planetary health metrics, including emissions and resource utilization. Additionally, this study will propose mechanisms for real-time monitoring and policy adaptation aimed at aligning population indicators, such as Disability-Adjusted Life Years and Universal Health Coverage with ecological metrics. PRISMA guidelines and a formal meta-analysis were applied among 250+ publications (2016–2026) on health-planetary linkages. The study identified five core domains: resilience, equity, efficiency, sustainability, and adaptability, along with 20 trackable indicators, such as disability-adjusted life years per ton of CO2 emitted. The piloting phase revealed correlations of 15–25% between high-emission regions and adverse population outcomes. The dashboard's feasibility allowed for 30% faster anomaly detection, thereby reducing response times to environmental health threats, such as flood-related outbreaks, particularly in low- and middle- income countries. Additionally, outcomes for tuberculosis and malaria improved by 5-10% in low- carbon pilots that implemented solar energy solutions. An unbiased healthy and safe planet is fundamental to human existence. Good health, encompassing both physical and mental well-being, constitutes a basic human right and is central to the Sustainable Development Goals. Promoting a healthy planet for all requires improved health governance and policies within an Earth-system justice framework. This ensures the protection of crucial Earth functions, enhances human health and well-being, and meets the essential needs of everyone, enabling them to thrive.