The problem of Public Health raised by the increase of chronic respiratory diseases in large urban centres cannot be dealt solely by health systems: a multidisciplinary approach is vital, with measures to be taken at regional, national and global level in order to promote the connection between population and environment, and the restoration of the primacy of nature. This is the main axis, around which is developed “Helsinki by nature: The Nature Step to Respiratory Health” – a document of reflection and strategy on the causes of chronic respiratory diseases at world level and the measures to fight them, which was elaborated by 48 specialists from all over the world. The document stems from the 12 th general assembly of the Global Alliance against Chronic Respiratory Diseases (GARD) , organized by Finland Ministry of Health and hold in Helsinki, in August 2018, with the presence of specialists (pictured above) from 30 countries, including Brazil, Cape Verde, Mozambique and Portugal. The document has just been published in “Clinical and Translational Allergy” (scientific journal of the European Academy of Allergy and Clinical Immunology) and one of its authors is José Rosado-Pinto – immunoallergologist at Hospital da Luz Lisboa and advisor to the Health General Direction, who was the national coordinator and member of GARD executive commission, an alliance sponsored by the World Health Organization (based in Geneva). “Helsinki by nature: The Nature Step to Respiratory Health” These are some of the points for reflection in the document: “New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs)”. “Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs “The world is urbanizing faster than ever and the United Nations predicts that 68% of all human populations live in cities by 2050. At the same time, many chronic conditions including respiratory, allergic, autoimmune, metabolic and mental diseases are on the increase worldwide in urban environments. The human immune system has run into an adaptation crisis not having had time to adjust to the rapidly changing environment and lifestyles”. “Urban living in asphalt-covered environments with little green space may not provide us with the diverse microbial stimulation necessary for the development of a balanced immune function. This is augmented by the use of highly processed food, salty and fatty food, sugary drinks and alcohol and the lack of physical activity. Several chronic diseases mentioned above are linked to alteration in our indigenous microbiota and the disappearance of ancient species from these commensal communities”. “Action at planetary scale is necessary and urgent , in order to fight climate change and the progressive global warming”.
