I am a member and one of the founding members of the Laudato sì Association, an alliance for climate, Earth and social justice, founded in 2015, immediately after the publication of Pope Francis' encyclical of the same name. What we believe constitutes the core of this encyclical, which we consider the most important political document of this century, is the indissoluble link that is drawn there between social justice and environmental justice.

Justice is not stillness, but struggle, conflict or initiative.

What is social justice? It is the respect for the inalienable rights of every human being, which presupposes an all-out struggle against the macroscopic inequalities that characterise today's society everywhere. And what is environmental justice? It is respect for the rights of nature, or rather of creation and every single creature, that is, of what we secularists call the world. These rights correspond to the conditions that make possible the perpetuation and regeneration of each living species and its physical, climatic and biological habitat, given the interconnection that links all living beings and these with a human life worthy of the name.

This interconnectedness is also the basis of the One Planet One Health principle, which signals the continuity between the health of human beings and that of the rest of the living world and the planet as a whole. But it is also a principle that emphasises the fact that the boundaries of the human person do not coincide with his or her epidermis; that our self, our us, extends far beyond our bodies, intersecting directly or indirectly with everything that surrounds us; while the geological substratum that sustains us, the air we breathe, the water of which we are largely composed and the existence of all living beings, starting with the bacteria in our bodies and passing through the food that the earth produces, penetrate deeply into our organisms.

If the true and healthiest of medicines is prevention, this necessarily passes through the health of the environment in which we are immersed. One cannot be healthy in a sick world, Francis had reminded us; while the health (but at this point I would say, especially the mental health) of human beings, who are the custodians of creation, is an indispensable condition of a healthy environment: both locally and planetary.

This continuity between the human being and the world around him entails a major cultural revolution compared to the worldview that came with modernity, which is a delicate term for capitalism. With it, in fact, as theorised by Descartes, there is a radical discontinuity between the human being and the rest of the world; between the spirit, the prerogative of the dominant man (implicitly white, male and European), and the inert matter, to which all other beings that populate the earth, including the 'savages', i.e. the indigenous peoples of the new colonies and women, were reduced.

That dichotomy is now overcome by the sensibility, even before the thought, of the anti-speciesism culture, which is increasingly widespread among a substantial part of the new generations, such as Greta's. But its historicization, i.e. its placement within the limits of Western culture and of a specific phase of human history, is an acquisition of contemporary anthropology, which has obviously found support and legitimacy in the study of numerous indigenous cultures that are still very much tied to the natural environment in which they developed.

These are cultures, especially those of Latin America, which in part also inspired the encyclical Laudato sì; something made explicit by Pope Francis' role in the synod on the Amazon.

And it is obviously overcome, that dichotomy, also by the One Planet One Health principle; but certainly not by most current medical practices. To an outsider to the medical world as I am, the gap between the concept of One Health and current medicine still seems abysmal.

The persistence of a culture that separates man from the environment, the human body from nature, is probably at the origin of the focus of modern medical science on therapy, on the treatment of the sick body, to the detriment of prevention, the treatment of what maintains or alters 'from the outside' the conditions of a healthy body: starting with food, water and air, topics mostly relegated to other disciplines.

With this, the medicine of modernity has also renounced the search in the natural environment for the many remedies used by traditional healing methods, a prerogative for centuries of women's knowledge that was crushed with and at the same time as the witch hunts that raged for several centuries in the West. Today, the urge to seek in natural processes the means to deal with discomforts and illnesses reappears in certain theories and practices of natural or traditional medicine that have been marginalised, badly tolerated or outright execrated and banned by official medicine.

But industrial pharmacology, with its undoubted successes, has come to assume a near-monopoly over much of medical practice, which is often reduced to nothing more than the prescription of drugs designed, developed, manufactured and sold by a handful of companies powerful enough to dictate most therapeutic protocols, which are now referred to by the accusatory term of Big Pharma.

The isolation of the human body from its environment has also meant that the most complex medical practices have been concentrated in ever-larger and more technological hospitals, which are also substantially isolated from the territory and increasingly in the hands of the manufacturers of the relevant equipment, while territorial medicine, that is in contact with the community and which could therefore know better the risks of each individual environment, has been progressively downsized and de-professionalised.

But this is the model of health care that makes it possible and promotes privatisation, while a territorial and environmental medicine would need, in order to develop, direct community control, which is only possible in a public context.

The pandemic has brought the consequences of this drift out into the open: the initial failures, undoubtedly attributable to a lack of the virus knowledge, concentrated medical interventions in hospitals, often turning them into hotbeds of contagion to which many doctors and nurses also paid a heavy price. But in order to fight the virus, important structural solutions such as acquiring more open space, ventilating premises, increasing transport, staggering shifts, etc. were discarded, and extemporaneous measures such as masks and lock-downs were imposed, without taking into account their consequences on the psychophysical balance, especially of children and adolescents.

Basically, everything has been reduced first to waiting for and then administering vaccines. In other words, drugs produced 'at the last minute', never sufficiently tested, of which the manufacturing companies disposed as much and as they wished, both in economic terms, negotiating prices, quantities and destinations in secret - and discriminating against states unable to pay for them - and in terms of information, neglecting, to the point of wasting other drugs already purchased, research, experimentation and the practice of pharmacological solutions other than the vaccine that were also proving successful.

Thus, it took two years to learn that those drugs did not protect against either active or passive contagion (as recently confirmed in the European Parliament by a senior executive of Pfizer, what would have rendered the institution of the green pass completely useless), that their efficacy was only a few months and that they only protected against the more serious forms of the disease, some of which could be avoided if tackled in time. And without ever launching an epidemiological survey to measure their efficacy and adverse reactions, of which, moreover, the majority of physicians are driven in various ways not to take note. 

The ostracism towards the non-vaccinated, especially if they were doctors, also ended up consolidating the vaccine monopoly at the expense of other therapies that had been validated in the meantime.

There is, however, a term that unites attention to the conditions that characterise the well-being of human beings, which is the very concept of health, and those that characterise a healthy environment, that is, its capacity to reproduce and regenerate itself. That term is ‘care’. It is a term that does not only refer to the activities to which doctors are professionally entrusted, because it includes above all those to which women have been relegated since the dawn of time; so much so that care is very often equated with so-called 'reproductive work', as opposed to productive work - that which produces goods, value, profit.

But that concept includes not only the largely unacknowledged activities related to the reproduction of life and the family, but also those even more unacknowledged, which consist in holding a community together through a series of informal ties that are only realised when they disappear.

As happens, for example, in those territories where a massive emigration of women - to be employed to care for distant families as domestic helpers or carers - deprives the community of that help that kept it on its feet: the men who remain, mostly in conditions of dependency and marginalisation, do not know how to maintain it; they do not know how to take care of it.

Now, in the face of the climate and environmental crisis that looms over all humanity, what is the care for the planet to which those who intend to fight to stop this drift must dedicate themselves? That cure is ecological conversion: a concept introduced into the political lexicon by Alex Langer almost thirty years ago and taken up forcefully by Pope Francis in his encyclical Laudato sì.

Mind you, the terms transition and conversion are not equivalent, even when both bear the same adjective - ecological - and are often used interchangeably.

Ecological transition (as understood by Roberto Cingolani) is a transition intended to 'save', i.e. preserve as much as possible, not only the current production apparatus - and, consequently, also its productions, including the increasingly important one of weapons - by reducing its impact on the environment. Of course, with renewables; but above all with carbon capture, continuing to use fossil fuels, and with nuclear power, which put everyone's health at high risk. Waiting for the phoenix of fusion, which 'one day', admittedly still a long way off, will provide us with all the energy we need, without waste and without damage, as the sun does, allowing civilisation to continue its course along the already marked path of growth, development and progress.

Ecological conversion is something else: more difficult to conceive and even more to achieve, but more realistic, because it reckons with the limits of our planet and does not only call into question the need to abandon a series of productions that are bad for those who work on them, for those who suffer their impacts and for those who use them. But it also imposes a different lifestyle, marked by sobriety in consumption, the sharing of common goods and the primacy given to the quality of relationships, not only with our human neighbours, but also with the territory and all the animal and vegetable living beings that inhabit it: in other words, the pursuit of health, in the broad sense of an overall well-being.

Of course, as Alex Langer taught, for ecological conversion to take hold it must become socially desirable. And the dominant culture does not facilitate this change of perspective. But the alternative put forward by the supporters of ecological transition will also be less and less desirable, and even less so by the supporters of the status quo, deniers of the climate and environmental crisis in practice when not also in theory.

Because by now it is clear, and will become increasingly so, that the alternative to ecological conversion is not a 'well-being' based on growing and widespread consumption and an ever-increasing GDP, but is an increasingly discriminatory regime of 'austerity', growing unemployment and precariousness. And then, war.

Yes, because instead of ecological conversion or rather, in order to accelerate the pace of the climate crisis, whose tipping point, i.e. the threshold of irreversibility, has been set by the experts at 2030, i.e. in four years' time - and perhaps to anticipate it with a nuclear carnage - to the commitments made at the Paris summit and badly confirmed at the Glasgow one, the 'Greats of the Earth', i.e. our rulers, have decided to resort to the oldest, and today the most destructive, system to attack our health, our well-being, our lives: war.

See, Se la medicina è prevenzione