• sustainability
• clinical leadership
• health system
• improvement
• public health

Healthcare professionals have always cared for the well-being of the patients they serve. Since a healthy ecosystem is foundational to human health, its care is also critical to the work of anyone caring for human health.

In recent decades, numerous scientific disciplines have made tremendous strides towards understanding the limits of our planet to maintain resilience as a host for life. Earth system science has progressed towards ever-greater precision in understanding the specific planetary boundaries we need to strive to live within in order to maintain planetary health. This work began to formalise in 2009, with a planetary boundaries framework emerging as a means for quantifying these limits.1 In 2012, economist Raworth2 added social dimensions to the framework, creating a ‘doughnut economics’ model balancing resource use with human needs. In 2020, McKimm and McLean3 coined the term ‘eco-ethical’ leadership as a highly relevant approach in relation to the planetary health emergency. In 2021, MacNeill et al 4 introduced the notion of ‘Planetary Health Care’ to describe health systems’ responsibilities for pursuing operations consistent with preserving planetary health.

As the science progresses, pressure is increasing on health leaders to incorporate a planetary health lens into their decision-making. National and global surveys of health professionals document widespread awareness of the impact climate change is having on human health5 and a demand that health system employers respond accordingly.6 In 2021, 50 countries committed to develop climate-resilient and low-carbon health systems during the United Nations’ COP26 meetings.7 More countries have followed this commitment, with 75 now signed up.8 In 2023, the International Hospital Federation formally recognised sustainability as part of its revised leadership competency model.9 Its recently established Geneva Sustainability Centre collaborated with Joint Commission International on sustainability accreditation standards that will go into effect in January 2026.10 The health sector is increasingly called on to lead broader advocacy work beyond health facility decarbonisation, including framing fossil fuel policy as a dominant commercial determinant of health and to advocate for systemic legislative reform.11

With all of the above as context, in 2024 BMJ Leader formally recognised the need for a focus on planetary health, hiring two new associate editors to lead this charge. This editorial lays out our call to action, acknowledging the climate crisis is a health crisis placing substantial demands on health leaders. But it is also a profound leadership opportunity.

While we make planetary health leadership a priority area, it is worth acknowledging the work BMJ Leader holds so far in this space. From papers exploring the role of environmentally sustainable digital solutions12 to engaging clinicians in sustainable procurement,13 along with appraising UK health professional standards through a planetary health lens,14 all of which shine a light on the varied ways leadership can show up in this work. Personal leadership reflections have also been shared,15 along with our Greener Leader blog series, which offers thought-provoking stories of leadership in this space. Here at BMJ Leader, we are also reviewing our internal practices to ensure we strive for operational consistency, recognising the importance of leading by example.

As we build on the existing work in this arena and strengthen our own commitment to this space, we invite submissions that explore what planetary health and sustainability leadership really mean for health and healthcare. We aim to widen the sphere of discussion and hear from those doing the work but also create space to platform the voices of those most affected—internationally, societally and generationally—by the climate and ecological crisis and its implications for health.

There are a multitude of questions that submissions can address. Just a few of these, which we are curious to better understand include: What innovation and inspiration already exists internationally and how can we most effectively measure success in this space? What can health leaders do to incorporate an environmental lens into existing workstreams and how can they best support environmental resilience in the communities they serve? What is the role of education and training and how is student leadership taking shape in this work? What are the barriers to pursuing planet-friendly healthcare—and how might they be overcome? What does good leadership or followership look like in this, and how might we be bolder in our approach? What role should healthcare leadership take in shaping and advocating for government policy and where, and with whom, does and should the accountability lie? How might leaders be looking after themselves and what can we learn about strengthening our collective resilience in this work?

These are not easy questions, and we expect the publications in BMJ Leader will shine a spotlight on the existing progress being made, while also highlighting the work there is still to do. We welcome original research, commentaries, reviews and perspective papers about the role of leadership in planetary health from our international healthcare leadership, educational and research community. And we hope it will provide experienced and emerging leaders with the space and the courage to think differently about their ability to deliver care with both people and planet in mind. This call for papers could also be seen as a call to action; one that aims to frame planetary health leadership as a solution to current problems rather than yet another new problem to solve. It also aims to breed a community where the dialogue remains open, where the hope is very much alive and where we remember that we can all be leaders in this space. After all, if we are not leading for planetary health, what on Earth are we leading for?