PCLM-D-25-00049

Planetary health security?: critical scoping review of conceptual linkages between ‘health security’ and ‘planetary health’

PLOS Climate

Dear Dr. Howard,

Thank you for submitting your manuscript to PLOS Climate. After careful consideration, we feel that it has merit but does not fully meet PLOS Climate’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jun 27 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at climate@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pclm/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Shah Md Atiqul Haq

Academic Editor

PLOS Climate

Journal Requirements:

Additional Editor Comments (if provided):

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does this manuscript meet PLOS Climate’s publication criteria?>

Reviewer #1: No

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?-->?>

Reviewer #1: I don't know

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)??>

The PLOS Data policy

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: Thank you for the opportunity to read this article.

There are several points that question the scientific validity of the article.

- The article enters into the discussion without any introduction.

- The structure of the article is not like the structure of a scientific article and is more like a commentary.

- Grammatical points are seen in the article.

- There is no innovation in the article as the essence of a scientific article.

- It seems that the article cannot attract many readers.

- The article follows without any research schema and conceptual model.

I think it is appropriate to rewrite the article with the help of the authors.

With respect

Reviewer #2: TITLE

Planetary Health Security?: A Critical Scoping Review of Conceptual Linkages Between ‘Health Security’ and ‘Planetary Health’

Abstract

• Background:

The concepts of health security (framing health within security contexts) and planetary health (human health impacts due to ecosystem degradation) have gained prominence in recent decades, yet there is limited literature critically connecting both frameworks.

• Methods:

Scoping review following the Arksey and O’Malley methodology and its subsequent refinements, combined with Braun and Clarke’s thematic analysis.

• Results:

Five key themes were identified:

1. Environmental health as a security issue.

2. Biosecurity and non-traditional security.

3. Institutional linkages.

4. Militarization and environmental health.

5. Emerging technologies and risk management methods.

The dominant health security approach emphasizes control of emerging infectious diseases, rather than prevention or broader health frameworks.

• Conclusion:

Both frameworks use the language of security, but this may lead to asymmetric health experiences, privileging certain populations while leaving others at risk or “sacrificed.”

Critical Evaluation

1. Conceptual Clarity:

The manuscript offers solid definitions of the main concepts—health security and planetary health—and demonstrates critical understanding of both. The incorporation of criticality as a conscious epistemological stance strengthens the theoretical clarity. However, some sections feature dense language that could benefit from more direct writing, especially for interdisciplinary audiences.

Suggestion: Simplify parts of the theoretical framework to enhance accessibility without sacrificing rigor.

2. Coherence of Analysis:

The analysis is well-structured, following a robust and recognized methodology (Arksey & O’Malley + Braun & Clarke). The review identifies consistent and well-argued thematic patterns.

Still, while the findings are clearly presented, the connection between themes and their implications could be more explicitly developed in the final discussion. For instance, the text references “tacit commitments to protecting some lives over others” but does not explore specific empirical examples of these inequalities.

Suggestion: Include illustrative cases or examples to strengthen arguments on power asymmetries.

3. Relevance of Approach:

The approach is highly relevant. This work addresses a significant gap in the literature by connecting two fields that are often studied separately. The attention to the language of security and its political and ethical implications in public and environmental health is particularly timely.

Value Added: The integration of critical frameworks from security studies and political ecology enhances the theoretical value of the analysis.

4. Quality of Sources and Argumentation:

The selection of sources is extensive, up-to-date (through 2024), and multidisciplinary, covering academic, critical, and technical literature. Key references are relevant and well used (e.g., PRISMA, Braun & Clarke, Global Health Security Agenda).

However, some citations could benefit from deeper contextualization. For example, the discussion on “security imperialism” could be better integrated with empirical data or specific case studies.

Suggestion: Reinforce with examples how security narratives have been instrumentalized in concrete contexts (e.g., COVID-19, climate change, migration crises).

Overall Reviewer Conclusion

This article represents an original, relevant, and theoretically grounded contribution to the contemporary discussion on global health. Its critical approach to the intersection of health security and planetary health is both necessary and timely. Biometeorology is an emerging topic and could be further developed, even if it is a lesser-known field.

Recommendation: Minor revision before publication. The manuscript is well developed but would benefit from:

• Clearer exposition in dense sections.

• More concrete empirical examples.

• A more explicit conclusion on the ethical-political implications of the findings.

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Reviewer #1: No

Reviewer #2: Yes:  Lluís Francés Martínez

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While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PCLM-D-25-00049R1

Planetary health security?: critical scoping review of conceptual linkages between ‘health security’ and ‘planetary health’ fields

PLOS Climate

Dear Dr. Howard,

Thank you for submitting your manuscript to PLOS Climate. After careful consideration, we feel that it has merit but does not fully meet PLOS Climate’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Sep 20 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at climate@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pclm/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Shah Md Atiqul Haq

Academic Editor

PLOS Climate

Journal Requirements:

1. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. 

2. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments (if provided):

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: (No Response)

Reviewer #3: (No Response)

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publication criteria?>

Reviewer #1: No

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?-->?>

Reviewer #1: No

Reviewer #3: N/A

**********

4. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)??>

The PLOS Data policy

Reviewer #1: No

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: No

Reviewer #3: Yes

**********

Reviewer #1: Thank you for the opportunity to review the article again.

Unfortunately, the authors were unable to make full corrections to the article and I am forced to reject it.

Sincerely,

Reviewer #3: Dear Authors,

Thank you for the opportunity to review this thoughtful and much-needed manuscript. It’s clear from the outset that this work is driven by sincere scholarly curiosity and a strong sense of social and ecological responsibility.

I want to begin by acknowledging the many strengths of this manuscript before offering some gentle, minor suggestions for refinement. The goal is not to critique for the sake of critique, but to help elevate an already excellent piece into one that can speak more clearly and powerfully to a wide range of readers.

Strength of this Manuscript

This is a brilliantly constructed scoping review that shows academic integrity and conceptual bravery. The authors have undertaken the massive task of not only mapping a conceptual landscape that remains fragmented, but also of holding up a critical lens to the underlying assumptions of securitisation in health discourse. The review demonstrates a deep engagement with critical theories, from political ecology to postcolonial critiques, and unpacks them in a way that doesn’t feel merely theoretical. Your discussion around how “some geographies and populations are rendered ‘sacrificial’ in their health risks” resonates deeply and critiques how power and inequity run through the framing of global health responses. Your methodological transparency, especially in your synthesis using Braun and Clarke’s thematic analysis, is a model for others doing interdisciplinary work. The five themes that emerge are coherent, richly illustrated, and provide a framework that future researchers will find useful.

Suggestions for Minor Revision

1. Clarify Core Concepts Earlier in the Narrative

Early in the manuscript, readers are introduced to complex concepts like health security, planetary health, and political ecology, but the definitions are tucked away in a later table (Table 1). Bringing those definitions closer to the first few paragraphs would ease reader entry into the topic.

Original (Page 1): “...understanding how ‘health security’ and ‘planetary health’ co-exist, co-produce, and contradict each other is particularly important.”

You might consider adding: “‘Health security’ is broadly defined as efforts to protect populations from acute health threats, often framed through a geopolitical lens, while ‘planetary health’ refers to a more holistic, ecological framework linking environmental degradation to human well-being. Placing these in dialogue allows us to ask: who benefits, who is protected, and what forms of life are prioritized?” This kind of early definitional clarity will support readers not already familiar with these frameworks.

2. Refine and Tighten the Abstract for Readability

The abstract is rich in detail but could benefit from simplifying the presentation of your five themes. Readers scanning quickly may miss your powerful findings.

Original (Abstract): “We generated five themes across these literatures: (1) environmental health as security issue; (2) biosecurity and non-traditional security; (3) institutional connections...”

Suggested Revision: “We identified five key themes: how environmental degradation is framed as a security threat; the role of biosecurity and broader ‘non-traditional’ threats; institutional ties between health and environmental governance; the environmental costs of militarised health responses; and the rise of new technologies for managing planetary risks.” This preserves your meaning while making the content more approachable and vivid.

3. Smoothen the Flow in the Discussion Section

The discussion contains beautifully layered insights, but the flow can feel overwhelming due to the density of critical arguments. You might consider breaking it into 2–3 subsections with guiding sentences to help readers stay oriented.

For example, when introducing the notion of “sacrifice zones,” you could ease the transition:

Original: “Health security logic deems some areas and populations as having no choice but to become ‘sacrifice zones’…”

You could approach with “This logic of containment reflects deeper geopolitical inequalities. As several scholars argue, health security tends to protect those who can afford protection—leaving others in what have been termed ‘sacrifice zones,’ where risk is offloaded onto already vulnerable populations…” This gentle framing should invite readers into your critique and helps them connect emotionally and intellectually.

4. Make Critical Quotes More Accessible with Brief Glosses

Some references—while excellent—may be unfamiliar to readers. Consider adding a short phrase of context before complex quotes. For example:

Original (Page 17): “Yusoff argued that, for many marginalized by today’s world system, ‘to be included in the ‘we’ of the Anthropocene is to be silenced…’”

Suggested Revision: “As Kathryn Yusoff powerfully argues in her work on race and the Anthropocene, ‘to be included in the ‘we’ of the Anthropocene is to be silenced by a claim to a universalism that fails to notice its subjugations’—a warning against framing planetary narratives without acknowledging colonial histories.” This helps broaden the accessibility of your argument without affecting its depth.

5. Consolidate Strong Claims with Gentle Qualifiers

The manuscript uses compelling language, but occasionally the tone may come across as a bit stark or all-encompassing. For example:

Original (Page 18):

“Planetary health also revealed its limitations as field and heuristic…”

Suggested Revision: “Planetary health, while offering a more holistic lens than traditional public health, also shows limitations—particularly in its tendency to prioritize anthropocentric concerns, at times overlooking non-human ecologies and Indigenous worldviews.” This still makes the critique, but with balanced tone and specificity.

6. Polish Minor Language Points for Rhythm and Clarity

Many of the sentences are long and dense—typical of critical writing—but could benefit from slight restructuring for readability.

Original: “Critical perspectives have cross-pollinated even less, despite an emphasis in critical security studies on questioning what goes into the development and application of ‘security’ concepts…”

Suggested Revision: “There has been even less cross-pollination of critical perspectives—despite critical security studies’ long-standing interest in how ‘security’ is defined and applied.” This shortens the sentence and makes it more direct while keeping your intellectual tone.

Acknowledgement

This is a truly valuable manuscript. It is ambitious, critically rigorous, and passionately argued. I hope you feel proud of what you’ve produced—it is evident that much care, thought, and collaboration went into its making.

The suggestions above are intended to enhance clarity, accessibility, and flow, while preserving the rich conceptual contributions you are offering. And the examples are just for guidance, it’s absolutely your decision to make changes where you think it’s necessary. With just a few tweaks to the structure and language, I believe this paper will resonate widely, not just with scholars in global health or environmental studies, but also with policymakers, advocates, students and common people thinking about these urgent issues.

Thank you again for sharing your work—it was an absolute pleasure to read, I myself learned a lot and my critical thinking in this domain of concepts also broadened.

Warm Regards.

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what does this mean? ). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy

Reviewer #1: No

Reviewer #3: Yes:  Dr. Tanvir Ahmed

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Attachments

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Submitted filename: Review on PCLM-D-25-00049R1.docx

Toward 'planetary health security'?: Critical scoping review of conceptual linkages between ‘health security’ and ‘planetary health’ fields

PCLM-D-25-00049R2

Dear Dr. Howard,

We're pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you'll receive an e-mail detailing the required amendments. When these have been addressed, you'll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Shah Md Atiqul Haq

Academic Editor

PLOS Climate

Additional Editor Comments (optional):

Reviewers' comments: