These positive examples in recent years must not mask the dangerous consequences of failing to meet the Paris Agreement, the past two decades of relative inaction, the economies and sectors currently lagging behind, and the enormity of the task ahead, which leave achieving the Agreement's aims in a precarious position. Indeed, much of the data presented should serve as a wake-up call to national governments, businesses, civil society, and the health profession. However, as this report demonstrates, the world has already begun to embark on a path to a lowcarbon and healthier world. Whilst the pace of action must greatly accelerate, the direction of travel is set.

Decreasing labour productivity, increased capacity for the transmission of diseases such as dengue fever, malaria, and cholera, and threats to food security provide early warning of compounding negative health and nutrition effects if temperatures continue to rise. Adaptation, planning, and resilience for health Global inertia in adapting to climate change persists, with a mixed response from national governments since the signing of the Paris Agreement in 2015. More than half of global cities surveyed expect climate change to seriously compromise public health infrastructure, either directly, with extremes of weather disrupting crucial services, or indirectly, through the overwhelming of existing services with increased burdens of disease (indicator 2.2). Globally, spending for climate change adaptation remains well below the $100 billion per year commitment made under the Paris Agreement. Within this annual spending, only 3•8% of total development spending committed through formal UN Framework Convention on Climate Change (UNFCCC) mechanisms is dedicated to human health (indicator 2.8). This low investment in Panel 1: Progress towards the recommendations of the 2015 Lancet Commission on health and climate change In 2015, the Lancet Commission made ten policy recommendations. Of these ten recommendations, the Lancet Countdown is measuring progress on the following: Recommendation 1: invest in climate change and public health research Since 2007, the number of published articles on health and climate change in scientific journals has increased by 182% (indicator 5.2). Recommendation 2: scale up financing for climate-resilient health systems Spending on direct health adaptation as a proportion of total adaptation spending increased in 2017 to 4•8% (£11•68 billion), which is an increase in absolute and relative terms from the previous year (indicator 2.7). Health-related adaptation spending (including disaster response and food and agriculture) was estimated at 15•2% of total adaptation spend. Although this national-level spending is increasing, climate financing for mitigation and adaptation remains well below the US$100 billion per year committed in the Paris Agreement (indicator 2.8). Recommendation 3: phase out coal-fired power Coal consumption remains high, but continued to decline in 2017, a trend which is largely driven by China's decreased reliance and continued investment in renewable energy (indicators 3.2 and 3.3). The Powering Past Coal Alliance (an alliance of 23 countries including the UK, Italy, Canada, and France) was launched at the 23rd Conference of the Parties to the UN Framework Convention on Climate Change (UNFCCC) in December, 2017 (COP23), committing to phase out coal use by 2030 or earlier. Recommendation 4: encourage city-level low-carbon transition to reduce urban pollution In 2017, a new milestone was reached, with more than 2 million electric vehicles on the road, and with global per-capita electricity consumption for road transport increasing by 13% from 2013 to 2015 (indicator 3.6). C...

Emerging infectious diseases are economically, socially, medically, and environmentally costly, as evidenced by the H1N1 influenza pandemic. Their broad consequences demand interdisciplinary solutions. One such solution, known as the One Health approach, is a growing global strategy that is being adopted by health organizations and policy makers in response to this need. It recognizes the interconnected nature of human, animal, and environmental health in an attempt to inform health policy, expand scientific knowledge, improve healthcare training and delivery, and address sustainability challenges. Education will play a particularly important role in realizing the One Health concept; however, a shortage of collaborative student programs, insufficient environmental training for health professionals, and a lack of institutional support impede progress. As a group of students from ecology, medicine, veterinary medicine, and global public health, we offer a vision for improving tertiary education to prepare environmental and health professionals to address a changing world. We outline the need for, and challenges facing, One Health and suggest ways to implement a collaborative educational network, both within the US and internationally. We also emphasize training opportunities and highlight potential hotspots of One Health excellence in the US, which are poised to use existing educational resources to train a new generation of One Health professionals.

Issues of global environmental change, global health, emerging disease, and sustainability present some of the most complex challenges of the twenty-first century. Individual disciplines cannot address these issues in isolation. Proactive, innovative, and trans-disciplinary solutions are required. Recognizing the inherent connectedness of humans, animals, plants, and their shared environment, One Health encourages the collaboration of many disciplines-including human and veterinary medicine, public health, social science, public policy, environmental science, and others-to address global and local health challenges. Despite great progress in this shift toward transdisciplinarity, the environmental component of the One Health paradigm remains underrepresented in One Health discourse. Human and animal health issues are commonly discussed under the umbrella of the One Health paradigm, while upstream environmental drivers and solutions are less prominent. We assessed the current integration of environmental issues in One Health publications and leadership. There is room for enhanced integration of environmental knowledge in the implementation of One Health approaches. We discuss the potential benefits from the collaboration between One Health and ecohealth, and explore strategies for increased environmental involvement.