Health—Ecology—Civilization: The Future Value System of Proactive Medicine
Yucong Duan
International Standardization Committee of Networked DIKWPfor Artificial Intelligence Evaluation(DIKWP-SC)
World Academy for Artificial Consciousness(WAAC)
World Artificial Consciousness CIC(WAC)
World Conference on Artificial Consciousness(WCAC)
(Email: duanyucong@hotmail.com)
Introduction
Human civilization is entering an era of dramatic change and coexisting challenges. Globalization has linked the destinies of all countries as never before, but problems such as climate change, biodiversity loss, and emerging infectious diseases are endless, forcing a rethink of traditional development models and health concepts. Health is no longer just an issue for the medical field, but a comprehensive issue spanning society, ecology, and technology. Especially after experiencing global crises such as the COVID-19 pandemic, all sectors have begun to realize that the old paradigm of passively responding to crises is no longer sustainable, and we urgently need a new health governance concept of proactive prevention and cross-border collaboration. "Proactive Medicine" is precisely a future civilizational vision proposed against this backdrop: it advocates for moving medicine from hospitals to society and nature, and reshaping the civilizational value system with health at its core. In this article, we will delve into the six core issues of the future value system of proactive medicine, including: the multidimensional reconstruction of the health civilization view, ecological collaboration and global governance models, the application of digital consciousness fields and information entropy theory, the "Health—Ecology—Technology" triple helix model mechanism, the strategic positioning of proactive medicine in the global civilizational leap, and the unfolding of "Digital Natural Rationality" and the "Dao–De–Ren–Yi–Li" values in the medical field. By combining the latest research progress (especially theories and practices after 2020) for discussion, we aim to depict a new civilizational blueprint based on health and provide academic support and path suggestions for its realization.
Multidimensional Reconstruction of the Health Civilization View
The Evolution of the Connotation of Health: From Biomedicine to Ecological Civilization
Health has always been an important yardstick for measuring civilization, but the understanding of health is constantly expanding and elevating. Traditionally, under the biomedical paradigm, health was primarily regarded as an indicator at the individual physiological level—that is, the absence of disease or normal physical function. However, since the 20th century, with the rise of social medicine trends, people have realized that health is not only related to individual physiology but is also deeply affected by social and environmental factors. As early as 1946, the World Health Organization clearly defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." This definition broke through the previous narrow understanding of health, elevated it to the height of social well-being, and emphasized the socio-economic conditions and cultural-psychological factors that affect health. Similarly, the concept of "health" later integrated dimensions such as mental health and social equity, reflecting the evolution of human health concepts from a biomedical model to a bio-psycho-social medical model.
Entering the 21st century, humanity has once again expanded the extension of health, incorporating the ecological environment into health considerations, forming a new paradigm of "ecological health civilization." Global ecological crises (such as climate change, water pollution) and public health challenges have proven that human health is closely related to the health of ecosystems. As part of the earth's biosphere, human well-being depends on the benign operation of the ecological environment and the stability of the planetary system. For example, global warming is expanding the prevalence of some infectious diseases, and species extinction and ecological imbalance may trigger unpredictable health risks. Under the view of ecological health civilization, health is no longer just an indicator of individual survival status, but is regarded as a comprehensive measure reflecting the level of social governance and ecological civilization. A truly civilized society should simultaneously guarantee individual physical and mental health, social fairness and justice, and ecological environmental sustainability, elevating health to one of the core goals of development.
Planetary Health View and Cosmic Order
Within the vision of ecological civilization, some scholars have further proposed the "Planetary Health" concept, elevating human health to the scale of the earth system and even cosmic order. The concept of planetary health holds that the health of human society is inextricably linked to the rise and fall of the earth's natural systems, and humans must respect the order of the universe and nature, examining health within the framework of a larger community of life. The "cosmic order" mentioned here is not a vague fantasy, but refers to the objective laws by which nature operates and the harmony of large systems. For example, when we damage the earth's support systems such as the atmosphere, water, and soil, it will ultimately harm humanity itself. Traditional Chinese culture has long emphasized the health concept of "unity of man and nature," advocating that the human body, the micro-environment, and the heaven and earth (universe) should maintain energy balance and order consistency. This concept coincides with modern ecological medicine: health is regarded as the embodiment of cosmic order at the level of life, and needs to be maintained at multiple levels: individual, social, and ecological. In short, the new health civilization view incorporates human health into the framework of the earth's overall prosperity and cosmic harmony, emphasizing reverence for and compliance with natural laws. This multidimensional, multi-scale holistic health concept signifies that the status of health civilization is redefined as a comprehensive concept covering individual body and mind, social care, ecological balance, and even reverence for cosmic order.
Specifically, the new health civilization view includes three progressive levels: (1) Biomedical level: Ensuring individual physical and mental health, which is the foundation; (2) Social medicine level: Creating a social environment that supports health, promoting health equity from institutional and cultural aspects; (3) Ecological civilization level: Maintaining the health of the ecosystem, taking environmental sustainability as a prerequisite for long-term human health. These three levels are interdependent and progressively advance, constituting a new coordinate system for health civilization. In this coordinate system, measuring the degree of civilization of a society no longer just looks at economic data or technological achievements, but also at the physical and mental health level of the people, the degree of social justice, and the quality of the ecological environment. Health thus rises from an indicator in the private domain to a core symbol of public affairs and civilizational evolution.
The Significance of Reconstructing the View of Health
The multidimensional reconstruction of the health civilization view has profound significance. First, it prompts us to reflect on the development path of modern civilization: if economic growth comes at the cost of damaging human health and ecology, then such "progress" loses its meaning. The new concept requires asking a question when formulating any policy: "Is this conducive to the health of humans and the ecology?" If the answer is no, it should be carried out with caution or adjusted. Second, this transformation calls for an upgrade of the role of medicine: medicine should not just be a passive role of "treating diseases and mending," but should actively participate in guiding the direction of civilization. That is to say, medicine needs to step out of the hospital and go deep into social governance and environmental protection, becoming an important force in shaping a healthy civilization. For example, prioritizing green spaces and clean air in urban planning to reduce the incidence of chronic diseases and mental illnesses; restricting harmful chemicals and antibiotic abuse in agricultural policies to maintain food safety and microbial ecology. Studies have shown that health-oriented urban design (such as building pedestrian-friendly neighborhoods, increasing parks and green spaces) can effectively improve residents' physical activity levels and health status. The penetration of medical concepts into these fields is equivalent to the practice of "Health in All Policies." This gives medicine a new positioning—as one of the coordinators and knowledge sources for the benign development of society and ecology. When health is included as a core goal of civilizational development, all departments will more consciously incorporate health impacts into their decision-making considerations, just as modern society takes environmental impact assessment as a necessary process.
In short, the redefinition of the status of health civilization lays the ideological foundation for subsequent discussions. Health is expanded from the individual domain to a public value, and elevated from a current state to a goal for future civilization. This marks a more comprehensive and sober understanding of our own development direction by humanity. Below, based on this grand view of health, we will explore how to build an ecologically collaborative health governance model from the perspective of proactive medicine, and further integrate technology and humanistic values to support the transformation of future civilization.
Ecological Collaboration and Global Governance Models
The complexity of health problems requires cross-domain holistic collaboration. Proactive Medicine advocates for the introduction of ecological collaboration and global governance perspectives into medical practice, integrating current major health concepts such as EcoHealth, One Health, and the "community of common health for mankind" to create a multi-helix health governance framework that coordinates humans, animals, and the environment. In this section, we will comparatively analyze the characteristics of these concepts and explain how proactive medicine integrates them to form a more complete health governance model.
EcoHealth: The Holistic Health View of Ecological Medicine
EcoHealth advocates for considering human health within the whole of human-environment symbiosis, emphasizing the interdependent relationship between ecosystems and health. Unlike traditional public health, which mainly focuses on humans, EcoHealth emphasizes how environmental changes (such as climate change, land use, biodiversity changes) affect the health of all life, including humans and animals. Studies show that environmental disturbances often bring health risks: for example, deforestation may expand the breeding range of malaria-carrying mosquitoes, and water pollution can cause outbreaks of intestinal diseases. Therefore, EcoHealth advocates for interdisciplinary cooperation, integrating knowledge from ecology, public health, veterinary medicine, etc., to maintain the "common health of all life." Its value orientation leans more towards eco-centrism, emphasizing the value of biodiversity itself: not only focusing on species beneficial to humans, but even the roles of pathogens, parasites, etc., in the ecological network should be valued. In short, ecological medicine believes that "environmental protection is also medical treatment," and only by protecting the integrity and balance of the entire ecosystem can human health be fundamentally guaranteed.
One Health: Human-Animal-Environment Unified Health
The One Health concept originated from the practice of preventing and controlling zoonotic diseases and has now expanded into a new health paradigm that coordinates humans, animals, and the environment. One Health combines public health with veterinary science and environmental science, based on the fact that humans and animals share the same global ecosystem, and most diseases (especially emerging infectious diseases) can be transmitted between different species. Therefore, it is necessary to break down the barriers between human medicine, veterinary medicine, ecology, and other departments to respond to health threats in a unified manner. For example, the outbreaks of COVID-19, most influenzas, and Ebola all involve cross-species transmission of viruses at the animal-human interface; this requires medical experts, veterinarians, ecologists, and even social scientists to jointly monitor and control. One Health initially focused on maintaining human's own health and safety, and was a "human-centric" strategy. But as understanding deepens, it has also begun to emphasize the importance of animal health and environmental factors, moving towards a more balanced holistic view. Compared to EcoHealth's more eco-centric stance, One Health is seen as a model that "puts human health first, but gradually expands its scope of concern": from focusing on common diseases of humans and animals, to further expanding to focus on the long-term impact of environmental health on humans.
It is worth noting that in recent years, scholars have often mentioned One Health and EcoHealth in the same breath, and even tried to merge the two into a unified framework. But studies point out that there are still differences in their core values, such as One Health placing more emphasis on human and vertebrate health, while EcoHealth places more emphasis on protecting the integrity of the entire ecosystem. Planetary Health is a more recent concept, focusing on the threat of global-scale environmental changes to the survival of human civilization, which is different from the previous two. Overall, One Health and EcoHealth share the conceptual basis of "human-animal-ecology are indivisible," while Planetary Health further elevates the focus to the earth system level. Proactive medicine is precisely drawing on the essence of these concepts.
Community of Common Health for Mankind: A Health Vision for Global Cooperation
The "Community of Common Health for Mankind" is an important initiative proposed by China in the field of global health governance, aiming to respond to common health challenges in the context of globalization. Its core idea is: all countries share a common destiny, work together to build a health defense line without borders, and jointly build and share global health resources. In the COVID-19 pandemic, this concept highlighted its practical significance—for example, by advocating for "Health Silk Road" cooperation, China promoted enhanced coordination among countries in epidemic information reporting, vaccine research and development, and medical material supply. This concept has similarities with One Health, as both emphasize global collaboration and information sharing; but the "Community of Common Health" places more emphasis on political commitment and mechanism building, advocating for the improvement of the public health governance system at the bilateral, regional, and global levels. Specific measures include: establishing transnational epidemic early warning systems, strengthening medical and health infrastructure assistance, and promoting reforms of organizations such as the World Health Organization to fill the leadership deficit in global health governance. It can be said that the "Community of Common Health for Mankind" embodies a spirit of global solidarity: recognizing that infectious diseases and other health threats know no borders, and no country can stand alone; only by sharing responsibility and taking coordinated action can the global health security net be firmly established.
The Ecological Collaboration Framework of Proactive Medicine
The ecological collaboration framework advocated by Proactive Medicine is precisely formed by integrating and transcending the above concepts, attempting to build a grander blueprint for health governance. First, proactive medicine inherits the systems thinking of "human-animal-environment" as one from One Health and EcoHealth. This means that the medical perspective expands from focusing on the individual human body to paying attention to the ecosystem as a whole, and moves the prevention threshold forward to environmental governance and animal health. For example, proactive medicine would support reducing the abuse of antibiotics in agriculture to prevent the spread of drug-resistant bacteria—an important topic for One Health; it also advocates for protecting biodiversity and maintaining ecological balance, regarding ecological protection as a medical behavior—"there can be no human health without a healthy environment," which aligns with the value orientation of EcoHealth.
Second, the framework of proactive medicine incorporates a global governance perspective, identifying with the concept of a "Community of Common Health for Mankind." This means that proactive medicine is not an isolated strategy for a certain country or region, but a project for the well-being of all mankind, calling on all countries to collaboratively build a global health security network. For example, countries should share infectious disease intelligence, coordinate vaccine and scientific research resources, and establish transnational public health emergency plans, to achieve "prevention before it arises, and joint prevention and control." The pandemic has shown that without pre-established cooperation mechanisms, acting independently in a crisis will come at a terrible price. There are successful cases in this regard, such as "The Global Fund to Fight AIDS, Tuberculosis and Malaria," which pools resources from governments, civil society, and the private sector to actively fund high-burden countries to take interventions and has achieved significant results. Proactive medicine advocates for the promotion of such multi-stakeholder cooperation models to broader issues, such as antimicrobial resistance, food safety, environmental health, etc., to truly weave a safety net for the community of common health destiny.
In summary, the ecological collaboration framework from the perspective of proactive medicine has the following characteristics:
·Holism: Regards the health of humans, animals, and the environment as an indivisible whole. Medical decisions must assess the impact on the ecology, and ecological policies also need to consider health benefits.
·Multi-sectoral Collaboration: Breaks down the barriers between medical, public health, agricultural, environmental protection, and other departments, establishes cross-domain cooperation mechanisms, and shares data and knowledge.
·Prevention First: Focuses on the ecological and social roots of diseases, and intervenes in risk factors in advance. For example, preventing cross-species epidemics through wildlife disease surveillance, and reducing chronic diseases and pollution exposure by improving the urban environment.
·Global Solidarity: Emphasizes that health is a global public good, and all countries should share responsibility and act together, enhancing dialogue and trust.
Such a multi-helix ecological collaboration framework superimposes the "human-animal-environment" biological helix of One Health with the collaboration helix of government-society-international. Proactive medicine, as the guiding ideology, allows actions at all levels to form a synergy. For example, in response to the health threats of climate change: the medical community studies the impact of climate change on the disease spectrum and proposes health strategies; the environmental protection department controls greenhouse gas emissions to maintain ecosystem resilience; the government issues policies to protect vulnerable populations from climate-related health risks; the international community raises funds to help underdeveloped regions build climate-adaptive health systems. Through multi-party collaboration, a win-win symbiosis of ecosystem health and population health is ultimately achieved.
It needs to be emphasized that the development of digital technology provides unprecedented support for the above ecological collaboration. In Chapter 8 of this book, we discussed how digital disease surveillance, telemedicine, etc., help achieve this collaboration. And in the following, we will further introduce the "Digital Consciousness Field" and Information Entropy theory, to explain how technology and ideology can advance the collaboration of health and ecology to new heights.
Digital Consciousness Field and Information Entropy: The Theoretical Foundation of the Proactive Health System
Contemporary civilization is undergoing a deep integration of biology, society, and technology. Proactive medicine proposes a "Health—Ecology—Technology" Triple Helix Model to understand the co-evolution of these three, introducing two new concepts: the "Digital Consciousness Field" and "Entropy Reduction Structure," to explain the role of technological progress and human consciousness in maintaining the health and ecological system. This section will explain the Digital Consciousness Field and Information Entropy theory, their application and theoretical basis in the proactive health system, and analyze the operational mechanism of the triple helix model.
The "Health—Ecology—Technology" Triple Helix Model
The Triple Helix Model uses the analogy of the DNA double helix structure to describe how the three major elements—the health system, the ecological system, and the technology system—achieve a spiraling upward co-evolution through feedback coupling. Among them:
·Health System: Includes individual health and the public health system.
·Ecological System: Includes the natural environment and the various communities of life within it.
·Technology System: Mainly refers to digital technology and the human social information network it constructs.
The three do not develop in isolation, but are closely coupled and co-evolve through the feedback loops of information and energy. For example, society's demand for a higher level of health will drive innovation in medical technology and related digital technologies, and new technologies, in turn, empower health management and ecological protection, forming a positive feedback; another example, a good ecological environment reduces the burden of disease, allowing society to have more resources to invest in technology and health, which is also a supporting role. Conversely, when a major health or ecological crisis occurs (such as an epidemic outbreak, environmental disaster), it will expose the deficiencies of technology and governance, thus forcing social innovation and change. This pressure can ultimately be transformed into the driving force for the upward spiral.
To reveal the internal stability mechanism of this model, we specially introduce two concepts: Digital Consciousness Field and Entropy Reduction Structure. The former focuses on the connection at the information and consciousness level, and the latter focuses on the maintenance of the system's orderliness. The two are similar to the base bonds and the replication/repair mechanism in the DNA helix: the digital consciousness field is like the information bond connecting the three strands of the helix, allowing human mind, technology network, and natural environment to interact; the entropy reduction structure is like the DNA's replication/correction process, ensuring the triple helix continues to evolve in an orderly direction. Below are detailed explanations of each:
Digital Consciousness Field: Collective Intelligence in the Digital Age
The Digital Consciousness Field is a figurative description of the collective consciousness form of humanity in the digital age. With the popularization of the Internet, the Internet of Things, and artificial intelligence, billions of people around the world are connected into a dense network as never before. Various kinds of information are transmitted globally at nearly the speed of light. Human society has actually formed a structure similar to a "brain's neural network." Some thinkers call this global information network the "Global Brain," believing that the highly interconnected ICT (Information and Communication Technology) network is becoming the "consciousness carrier" of the earth, undertaking information processing and coordination functions. The so-called digital consciousness field can be understood as a collective consciousness layer or information field converged from all human activities and interactions in the digital space. It is embodied in internet public opinion, group psychology on social media, and the group behavior patterns influenced by artificial intelligence participating in decision-making. This consciousness field is not some mysterious supernatural entity, but a product of the spontaneous emergence of a complex system.
The digital consciousness field is already playing a significant role in the fields of health and ecology. For example, when researchers from all over the world share disease gene sequences through online collaboration platforms and update prevention and control strategies in real time, a "digital collective consciousness" in the global health field is formed, accelerating the response to emerging diseases. Another example, countries sharing environmental monitoring data, and the public disseminating environmental protection concepts through social networks, also constitute a digital consciousness field in the field of environmental protection. On the positive side, the digital consciousness field can quickly converge and transmit knowledge about health and the environment, improving the cognitive level and action synchronization of the whole society. For example, through big data monitoring and social media, the public can be timely informed of an epidemic outbreak or pollution accident somewhere, so as to quickly take protective measures—during the 2019 COVID-19 pandemic, the global scientific community used digital platforms to share virus information, vaccine research and development progress, and prevention and control experience at an unprecedented speed, which is a model of the digital consciousness field playing a role in the health field.
However, the digital consciousness field has also brought challenges. For example, false information and conspiracy theories can also spread rapidly through social media, interfering with public health actions. This highlights the importance of cultivating "digital immunity." Therefore, under the framework of proactive medicine, we need to shape a positive digital health culture, use artificial intelligence to filter rumors, and guide rational and scientific public awareness, so that the digital consciousness field becomes a force for promoting health and ecological good, rather than a factor that adds entropy and chaos. Just as the "Noosphere" concept, foreseen by the French philosopher Teilhard de Chardin and the Russian scholar Vladimir Vernadsky in the 20th century, predicted: the collective wisdom of mankind is becoming a new layer enveloping the earth after the biosphere. When we make good use of the global "brain" constructed by digital technology to serve health and ecology, we are expected to break through the limitations of national borders and respond to the complex challenges of the 21st century with holistic rationality.
Entropy Reduction Structure: The Mechanism for Maintaining Health and Ecological Order
Entropy is a concept in thermodynamics that measures the degree of disorder in a system. According to the second law of thermodynamics, the entropy of an isolated system always tends to increase, which means that without external intervention, any system will spontaneously move towards disorder and chaos. Analogously to society, if there is a lack of effective governance, public health, social order, and the ecological environment may also move towards disorder (entropy increase) under various disturbances. However, life and civilization are able to emerge and persist precisely because we have the ability to reduce entropy in local areas: by continuously obtaining energy and information from the outside world to maintain and create ordered structures. In biology, Schrödinger, in his book What is Life?, proposed that "life feeds on negative entropy," i.e., organisms continuously ingest low-entropy nutrients and information to combat their own tendency toward entropy increase. The same is true for human society—education, technology, medicine, law, and other institutional constructions are, in fact, inputting information and energy into the social system, reducing disorder, and maintaining order.
An Entropy Reduction Structure refers to those mechanisms and devices that can effectively reduce the entropy increase of a system and maintain its orderly development. In the health-Ecology system, proactive medicine can be seen as a process of designing entropy reduction structures: through prevention and intervention, the uncertainty (entropy) of diseases and risks is minimized to maintain the benign order of the human-ecological system. For example, the surveillance network of public health can detect signs of an epidemic early, resolving a potential large-scale outbreak (a high-entropy event) in its embryonic stage. Another example, large-scale vaccination and health education greatly reduce the population's susceptibility to diseases, which is equivalent to actively inputting useful information and energy to maintain health order. In the ecological field, measures such as establishing nature reserves and maintaining ecological diversity are also reducing the entropy increase of the ecosystem through human planning (such as preventing the ecological simplification risk brought by monoculture agriculture) and maintaining ecological balance.
Digital technology plays a key role in constructing entropy reduction structures. Today, we can achieve unprecedented perception and control over health and environmental systems with the help of IoT sensors, satellite remote sensing, AI predictive models, etc. This is equivalent to adding feedback regulation loops to the complex system, allowing us to invest "negative entropy" efforts more effectively and offset various interferences. For example, the construction of global digital health infrastructure enables countries to share knowledge and coordinate actions, reducing information asymmetry and decision-making blindness. As advocated by the World Health Organization in the Global Strategy on Digital Health 2020-2025, countries should strengthen digital health cooperation, achieve interconnection of data and services, and use digital technology to enhance early warning and response capabilities. Studies have shown that if a unified global digital disease surveillance network and knowledge sharing platform are established, the proactive prevention capability against high-entropy events such as epidemics will be greatly improved.
Through digital empowerment, humanity is building a global health and ecological entropy reduction system: for example, smart cities deploy health monitoring and environmental sensing networks to achieve real-time monitoring and response to air quality, infectious diseases, and climate events, which can control potential chaos in its embryonic stage. A 2024 study compared the consistency of different countries' digital health strategies with the WHO's global strategy, emphasizing the importance of digital infrastructure for enhancing health system resilience. The widespread establishment of these entropy reduction structures allows our health-ecological system to evolve towards a higher degree of order, and also provides a robust buffer for global civilization in the face of complex risks.
The Co-evolution Mechanism of the Triple Helix
In the "Health—Ecology—Technology" triple helix model, the three subsystems promote each other and co-evolve through multiple mechanisms, forming a co-evolution mechanism:
1.Health Needs Drive Technological Development: Society's higher demands for health and well-being will stimulate innovation in medical technology and related digital technologies. For example, the need to meet chronic disease management has given rise to wearable health devices and mobile health apps; the need to cope with emerging infectious diseases has given rise to big data epidemiological analysis and new vaccine technologies. These technological advances are in turn applied to improve population health, forming a positive feedback loop.
2.Technological Progress Empowers Ecological Protection and Health Management: The development of digital technology provides powerful tools for environmental monitoring and health management. For example, IoT sensors and AI models allow us to monitor the impact of air, water quality, and climate change on diseases more finely, so as to take public health measures in advance. The intervention of technology improves humanity's ability to maintain health and ecology, realizing a "Smart+" management model.
3.A Benign Ecology Promotes Health and Well-being: A stable and good ecological environment (clean water, suitable climate, diverse species) helps reduce disease risks, improve quality of life, and make the population healthier and society more productive. This, in turn, provides good conditions for technological innovation and health system construction, which can be described as "ecology nourishing health and technology." A healthy population is also more willing and able to invest in environmental protection, achieving a virtuous cycle.
4.Crises Force Technological and Governance Changes: When major health or ecological crises occur, they will expose the deficiencies of existing technology and governance models, thus forcing society to reform and innovate. For example, the London smog event in the mid-20th century prompted the birth of environmental legislation and pollution control technology; the 2019 COVID-19 pandemic accelerated the development of biotechnology such as mRNA vaccines, as well as telemedicine and digital disease control platforms. The high-entropy impact brought by the crisis is ultimately transformed into a driving force for the upward spiral through human learning and adaptation.
Through the above mechanisms, the three forces of health, ecology, and technology are tightly wound and spiral upward like a triple helix, promoting the continuous evolution of civilization. This model is similar to the concept of the "Triple Helix Model" (University—Industry—Government) in the field of knowledge innovation, except that the triple helix of proactive medicine does not refer to social roles but to systemic domains. When the three fields of health, ecology, and technology form a strategic synergy, we can promote innovation in health and sustainable development just as we promote economic innovation.
It needs to be pointed out that achieving the co-evolution of the triple helix requires interdisciplinary research and action paths. This means that public health experts need to collaborate with ecologists, engineers, data scientists, etc., and adopt the perspective of complex systems science to analyze the health-ecology network; policymakers need to integrate medical knowledge, environmental governance, and technology assessment, and design interventions with systems thinking. This is precisely the global rationality advocated by proactive medicine: breaking through disciplinary and departmental barriers, and responding to complex health and ecological problems with a holistic view.
The Strategic Positioning of Proactive Medicine in the Global Civilizational Leap
Human civilization is at an important leaping point: on the one hand, globalization and digitalization connect the world closely, forming a "global village"; on the other hand, challenges such as the climate crisis and global infectious disease pandemics are frequent, exposing the fragility of the existing governance system. Proactive medicine advocates for building a new paradigm of proactive health governance in the context of the great transformation of global civilization, allowing the improvement of health and well-being to lead the leap and sublimation of civilization. This new paradigm includes the innovation of the global health governance system, the rise of proactive health cities, and the global collaboration of digital health infrastructure as three major pillars.
Paradigm Shift in the Global Health Governance System
Traditional global health governance mainly relies on national governments and international organizations such as the World Health Organization (WHO) to coordinate actions through international regulations and agreements. However, under the new challenges of the 21st century, this passive and fragmented response method is increasingly stretched. Taking the COVID-19 pandemic as an example, in the early stages of the epidemic, there was a lack of a unified information sharing and resource allocation mechanism globally. Many countries acted independently, missing the opportunity to curb the spread. Some researchers point out that the current global health system is facing a superposition of complex threats (geopolitical fragmentation, climate crisis, technological shocks, false information, etc.). If fundamental reforms are not carried out, it may be overwhelmed by the endless crises. Therefore, we need to shift from "fragmented, passive crisis management" to "coordinated, proactive risk governance," and build a more resilient and equitable global health architecture.
Proactive medicine advocates for a structural innovation of global health governance, the core of which is to shift from passive crisis response to proactive risk management and prevention-priority. Specific measures include: strengthening the implementation capacity of the International Health Regulations (IHR), giving the WHO greater coordination and intervention powers in emergencies; establishing a global rapid response mechanism and reserve team for epidemics, ensuring that action can be taken quickly as soon as there is any sign of trouble; promoting countries to improve transparency, publishing epidemic and health data in a timely manner, while the international community provides corresponding assistance and incentives, replacing the previous situation of non-transparent information and mutual blame-shifting. This model is similar to building a composite global health security net, pre-architecting a joint prevention and control mechanism in normal times, to achieve "prevention before it arises, and being prepared." As scholars such as Kuili Zhang et al. have called for, a paradigm shift is needed to build a more resilient global health architecture, to achieve the strategic shift from downstream treatment to upstream prevention.
At the same time, proactive health governance emphasizes the broad participation of multiple stakeholders. Modern health challenges are intricate and complex, and it is difficult for governments to cope alone. It is necessary to mobilize the private sector, cities and communities, as well as international organizations and non-governmental organizations to work together. For example, major cities around the world can form alliances to share public health policies and experiences; pharmaceutical companies and technology enterprises can form epidemic response alliances under the WHO framework to accelerate the research, development, and fair distribution of vaccines and drugs; grassroots community organizations can assist in promoting health projects locally and supervising policy implementation. Researchers point out that a "Whole-of-Government, Whole-of-Society" collaborative model is the key to achieving proactive health governance. In this model, all stakeholders share responsibility and are jointly committed to improving national health. The effect is to weave a multi-center, multi-level health governance network at the global level, to make up for the lack of capacity of a single country or institution. For example, in the global fight against the epidemic, the "COVID-19 Vaccines Global Access" (COVAX) is a product of cooperation between governments, international organizations, enterprises, and foundations, and has played an important role in providing vaccines for low-income countries.
It is foreseeable that future global health treaties (such as the "International Pandemic Treaty" currently under discussion) will strengthen the obligations of all countries in infectious disease surveillance and reporting, emergency response, etc., and establish accountability mechanisms for non-compliance. If these institutional innovations can be implemented, they will greatly enhance the proactiveness and coordination of global health governance, making humanity more composed when the next crisis arrives.
Proactive Health Cities: Urban Governance Guided by Health
Cities are the forefront of civilizational leap and also the key arena for health governance. As early as 1986, the WHO launched the "Healthy Cities" project in Europe, advocating for the integration of health into the core of urban planning and policy. The Healthy Cities movement emphasizes: a healthy city not only needs medical and health infrastructure, but more importantly, needs to create a social and physical environment that supports health, including good quality of life, hygienic living conditions, and accessible medical services for all. The realization of a healthy city depends on the commitment and collaboration of all urban departments, and requires establishing necessary connections in political, economic, social, and other fields. In other words, urban health is not just a matter for the health department, but a common goal of urban governance.
Nowadays, the concept of a Proactive Health City has emerged, becoming the continuation and upgrade of the Healthy Cities movement in the digital age. A proactive health city emphasizes the use of smart city technology and health-centered governance to build the city into an engine for promoting health and sustainable development. In a proactive health city, all functional departments will take health as an important dimension of policy consideration. For example:
·The urban planning department encourages residents' daily physical activity and reduces the risk of chronic diseases by building pedestrian-friendly communities and park greenways. Studies have shown that increasing community walkability can lead to higher levels of physical activity, which in turn improves residents' cardiovascular and mental health.
·The transportation department promotes public transport and clean energy travel, reduces air pollution and greenhouse gas emissions, and reduces the incidence of respiratory diseases.
·The education department conducts health literacy courses in schools, cultivating adolescents' proactive health awareness and basic health skills.
·Community and civil affairs departments establish neighborhood mutual aid networks, paying special attention to the health needs of vulnerable groups such as the elderly living alone and people with disabilities, embodying social care.
Through the above measures, the city intervenes in health promotion in a "Whole-of-Government + Whole-of-Society" manner, integrating medical prevention and health support into all aspects of citizens' lives. Health thus becomes an urban governance culture: municipal construction focuses on green and sports spaces, social policies focus on fairness and health opportunities, and national participation creates a healthy atmosphere.
Digital technology is an important support for a proactive health city. The sensor networks deployed in smart cities can monitor environmental and population health-related indicators in real time, such as air quality, water quality, noise levels, infectious disease reports, etc., providing evidence-based data support for governance. Big data and artificial intelligence help city managers predict health trends, discover hidden dangers, and optimize resource allocation. For example, by using machine learning to analyze urban medical data, it may be found that the high incidence of chronic diseases in some communities may be related to food supply or building layout, thus guiding targeted interventions. Another example, cities can establish digital health records and service platforms, integrating data from hospitals, family doctors, fitness institutions, environmental monitoring, etc., to provide personalized health services for each citizen, including risk warnings, lifestyle guidance, and tracking follow-up. These all improve the efficiency of medical services, empowering individuals to manage their own health more proactively, and realizing the vision of "the city is the hospital, and health is everywhere."
It needs to be emphasized that technology is not a panacea. When promoting digital governance, proactive health cities must be escorted by ethical guidelines and legal policies to ensure the protection of personal privacy, the bridging of the digital divide, and the guarantee of civil rights. For example, during the COVID-19 pandemic, some smart cities used health codes and location tracking apps to control the spread of the epidemic, but this also raised concerns about privacy and fairness. This reminds us: digital systems should aim to enhance human well-being, rather than replace human-to-human care. To this end, cities need to formulate digital health governance norms, clarify data use boundaries, strengthen network security, and ensure that technology applications are in line with public opinion and ethical requirements through public participation.
In summary, a proactive health city combines traditional healthy city concepts with modern technological means, putting "Health in All Urban Policies" into practice. In the future, health and happiness indices will be as important as economic indicators in measuring the success of a city. Urban governors will also increasingly be like "Chief Health Officers," taking the protection of citizens' health as one of their primary responsibilities.
Collaboration on Global Digital Health Infrastructure
In the digital age, another key to achieving a leap in global health and well-being is to build a collaboratively efficient Global Digital Health Infrastructure. This means that all countries strengthen cooperation in the digital health field, promoting the interconnection and interoperability of data, technology, and services. In 2020, the WHO officially released the Global Strategy on Digital Health 2020-2025, calling on all countries to strengthen digital health cooperation, promote knowledge transfer, and capacity building. Proactive medicine highly identifies with this strategy: only by jointly building a global digital health platform can the concept of proactive health governance be truly implemented in global action.
First, all countries need to jointly formulate data standards and interoperability specifications for digital health. For example, format standards for electronic health records, data exchange protocols, privacy and security standards, etc. If the data systems of different countries and institutions can be compatibly connected, then in the future, goals such as a "single network" for global epidemic surveillance and seamless access to medical information for cross-border medical treatment can be achieved. This is particularly important for the real-time surveillance and early warning of infectious diseases: any abnormal health event occurring anywhere can be quickly reported and analyzed through the global network, buying valuable reaction time. At the same time, developed countries and large technology companies should support developing countries in improving their digital infrastructure, narrowing the "digital divide," and avoiding digital technology reinforcing rather than reducing global health inequalities.
Second, global digital health cooperation also includes knowledge sharing and talent cultivation. International organizations can take the lead in establishing a global digital health knowledge base or collaborative community, gathering best practices, innovative applications, and lessons learned from various countries. This is similar to the open-source community model, promoting "open science" in the medical and public health fields, and accelerating technology diffusion and upgrading. For example, sharing infectious disease AI early warning algorithms, telemedicine solutions, etc., developed by various countries on a global platform, and encouraging countries to improve them according to local conditions. Another example, carrying out transnational digital health talent training programs, such as jointly cultivating emerging professional talents like digital epidemiologists, medical AI engineers, etc., to make up for the manpower shortage in some countries. These measures will all help to improve the overall level of the global digital health ecosystem.
One can imagine a scenario: in the future, when an unknown disease appears somewhere, the local doctor uploads the case data to a global sharing platform. AI analyzes it in real time and finds that there are sporadic similar cases in other countries, immediately triggering a global warning through the WHO network, and disease control centers in all countries receive the information simultaneously. Subsequently, experts from various countries consult online, share the pathogen gene sequence in a cloud laboratory, and quickly develop diagnostic tools. Throughout the process, the global digital health infrastructure ensures the smooth flow of information and efficient collaboration. A disease that might have spread into a pandemic is "detected early, responded to early, and contained early" by all countries, which precisely reflects the power of proactive health governance. Of course, all this relies on all countries reaching a cooperation consensus on systems and technology in advance, and investing resources to build the necessary platforms and networks.
The new governance paradigm advocated by proactive medicine runs through a spirit of being "proactive": proactive layout, cross-border cooperation, system integration, and human-centricity. This marks that global civilization is transforming from passively responding to diseases to actively creating health, and from acting independently to sharing a common destiny. As the Shanghai Declaration (2016) pointed out, in the era of sustainable development, it is necessary to improve national health literacy through multi-sectoral cooperation, and health is both an indicator of development and a driving force for development. The global strategy of proactive medicine is the concrete unfolding and deepening of this concept. When the idea of proactive medicine is integrated into national policies, urban governance, and public daily life, we are expected to usher in a new era of "health as the foundation of civilization."
The Medical Unfolding of "Digital Natural Rationality" and "Dao–De–Ren–Yi–Li"
The progress of technology and institutions ultimately needs the guidance of civilizational concepts and value systems as its soul. What proactive medicine attempts to build is not only a practical and efficient health system, but also a new form of civilization with moral height and philosophical depth. In this section, we will integrate traditional Eastern wisdom and Western rational philosophy, propose the framework of "Digital Natural Rationality", and explore the possibility and significance of embedding the five-dimensional values of "Dao–De–Ren–Yi–Li" (Tao–Virtue–Humaneness–Righteousness–Ritual) into the civilization of proactive medicine.
Digital Natural Rationality: The Way of Heaven and Earth in the Digital Age
The 17th-century philosopher Baruch Spinoza proposed the pantheistic proposition "Deus sive Natura" (God or Nature), advocating that all things in the universe are essentially one, and their operation follows necessary natural laws and rational principles. He believed that through reason, we can understand the "Dao" (Way) of nature, and based on this, achieve the harmonious unity of man and all things in heaven and earth. This idea coincides with the "unity of man and nature" in Chinese Daoist philosophy: the "Dao" is regarded as the fundamental law and way of operation of the universe, and man should conform to the natural Dao to maintain physical and mental health and social harmony.
In the digital age, we have unprecedented tools to recognize and simulate natural laws, which is equivalent to using "digital rationality" to map "natural rationality." We call this Digital Natural Rationality, which means using technical means such as big data and artificial intelligence to enhance human collective rationality, so as to understand the operating mechanisms of nature (including the human body, biological communities, and the earth system) more deeply, and based on this, make decisions consistent with the "Dao." In other words, digital natural rationality is a whole set of architecture that applies the pursuit of natural rationality advocated by Spinoza in the digital space to health and social governance. This can be regarded as a modern version of "unity of knowledge and action": "knowledge" is to recognize the laws of all things through digital technology, and "action" is to apply this cognition to practice to promote the harmony between man and nature.
Specifically, we can imagine building a "Digital Spinozan Dao" that integrates Digital Technology–Artificial Intelligence–Natural Law. In this architecture, humans, AI, and nature coexist and interact, jointly maintaining an orderly and rational state of health. For example, we can set artificial intelligence to follow the highest criterion of "reducing entropy increase, promoting order," allowing it to aim at maintaining overall harmony when dealing with health and ecological problems. When human decisions deviate from natural laws ("Dao"), AI can act like a "rational sprite" to propose optimization plans for correction. For example, when industrial development conflicts with public health, an AI system with digital natural rationality can comprehensively analyze and propose a compromise plan that ensures economic development while also taking into account health and environmental protection; another example, when individual over-consumption leads to health and environmental problems, an intelligent assistant can issue health-rational suggestions. These are all based on pre-built principles in the digital architecture, similar to the Three Laws of Robotics for robot ethics, but expanding the scope to the entire field of health and ecological governance.
As Laozi said: "Man follows Earth, Earth follows Heaven, Heaven follows the Dao, and the Dao follows Nature." Ideally, human behavior should imitate and conform to nature. In the digital age, we use AI to simulate complex ecological and social systems, making it possible to better find solutions that conform to the "Way of Heaven." For example, AI can simulate the complex impact of climate change on disease transmission, helping to formulate health strategies that conform to ecological laws; big data analysis can reveal human behavior patterns, guiding public health interventions to conform to human nature and group psychology. Through these means, we hope to achieve a kind of "Heaven rewards the diligent" with digital assistance: that is, policies and actions all follow the true order of life and nature, and at the same time, continuously correct deviations through digital rationality, approaching the state of supreme good that Spinoza called "knowing the necessary causes of all things in God (Nature)."
"Dao–De–Ren–Yi–Li": The Value Cornerstone of Medical Civilization
"Dao, De, Ren, Yi, Li" (Tao, Virtue, Humaneness, Righteousness, Ritual) are the core value categories of traditional Chinese culture, each with rich connotations. In the civilizational framework of proactive medicine, we attempt to give them new medical interpretations, so that they complement digital natural rationality and jointly constitute the value cornerstone of health civilization.
·Dao (Tao): Dao refers to the laws of the universe and nature, and the ultimate care for truth. In medical civilization, "Dao" is embodied as respect for the laws of life and the establishment of a holistic view. For example, traditional Chinese medicine emphasizes the "correspondence between man and nature," and modern medicine should also respect the balance of the human body-environment system, and not violate the underlying laws of biological evolution and the ecosystem. If medical decisions violate the "Dao"—such as the overuse of antibiotics to destroy the microbial ecology, or the abuse of medical resources to damage the natural environment—they will ultimately often trigger side effects or "retaliatory" rebounds. Therefore, "Dao" reminds us that medicine must be humbly placed in the sequence of great nature, seeking the way of symbiosis with heaven and earth. This is also the highest criterion that digital natural rationality must follow.
·De (Virtue): De can be understood as the inherent quality and external behavior that arises from conforming to the "Dao." Laozi said: "The Dao gives them life, De (Virtue) nurses them," meaning that all things are born of the Dao and nurtured by De. In the civilization of proactive medicine, "De" is embodied as the moral integrity and sense of mission of medical practitioners and the entire health system. For example, a doctor's benevolent heart and saving the dying are the virtue of medicine; scientific research integrity and not doing things that harm others for one's own benefit are also the virtue of medicine. In addition, "De" also refers to the responsibility and grace that medicine bears towards society and nature. The virtue of medicine requires us to adhere to ethics when pursuing technological progress, and not do things that are contrary to human ethics; to uphold justice when formulating policies, and pay attention to the health rights and interests of vulnerable groups. Only with noble virtue can medicine win public trust, gather social synergy, and truly exert its moral appeal of protecting life.
·Ren (Humaneness): Ren is the core of Confucian ethics, meaning a broad love that extends from oneself to others, emphasizing loving others as oneself. For medical civilization, "Ren" is especially embodied as a patient-centered, people's health-first value orientation, and a heart of care and love for life. Specific manifestations include empathy and care in the doctor-patient relationship, not abandoning vulnerable groups in public health, and the humanitarian spirit shown in global health cooperation. For example, in major epidemics or disasters, extending a helping hand to other countries and regions, providing medical assistance and materials, is precisely an "act of great benevolence," which fits the concept of a "community of common health for mankind." Without the support of "benevolence," even the most brilliant technology may be reduced to a cold or even cruel tool; only when a benevolent heart is popularized in medical practice can we nurture a truly human-centric health civilization.
·Yi (Righteousness): Yi refers to the principles of fairness, justice, and appropriateness. Confucianism says, "Righteousness is the substance," emphasizing that one's actions in society should conform to justice and morality. In medical civilization, "Yi" means the fair and reasonable allocation of medical resources, the justice of institutional design, and the ethical conformity of the decision-making process. For example, in organ transplant allocation or formulating medical insurance policies, social justice should be reflected, and poor and weak groups should not be left without medical treatment due to cost issues—this is a requirement of medical "Yi." Similarly, on a global scale, the accessibility of vaccines and new drugs should also follow "Yi": there should be no distinction between high and low life values because of the wealth gap between countries. "Yi" ensures that the direction of medical development always points to the public interest, rather than being swayed by private interests or power. Proactive medicine promotes the establishment of a civilization centered on health, precisely to correct the past tendency of sacrificing the health rights and interests of the weak for the sake of GDP or technology-supremacy, to implant the consideration of "Yi" in decision-making, and to make health and hygiene an important yardstick of social justice.
·Li (Ritual): Li refers broadly to social norms, institutional etiquette, and the rules of order for people to get along with each other and with the environment. Li is to Ren and Yi what institutions are to values, and is the guarantee for implementing moral principles into daily behavior and social structure. Under the civilization of proactive medicine, "Li" can correspond to good medical behavior norms and public health institutional arrangements. For example, doctors' practice guidelines, ethical norms such as informed consent, etiquette in doctor-patient communication, hygiene etiquette in public places (such as wearing a mask when coughing, civilized dining, not spitting), community environmental hygiene conventions, and etiquette in international health exchanges (such as the obligation to report epidemic information in a timely manner), etc., all belong to the category of "Li" in a broad sense. The important role of Li is to transform the world through cultivation: through long-term education and institutional constraints, health concepts are transformed into the habits and customs of the masses, thereby improving the civility of the whole society. When people have internalized these "Li" of paying attention to hygiene, emphasizing prevention, caring for the environment, and observing medical ethics, the health level of the entire civilization will naturally rise, forming a virtuous cycle.
In order to integrate the five constant ways of "Dao–De–Ren–Yi–Li" into the medical system of the digital age, we need a combination of theoretical innovation and practical exploration. For example, one can imagine building a Digital Confucian Medicine Platform: using AI to conduct real-time ethical review and reminders of doctors' diagnosis and treatment behaviors, which is equivalent to digital "Li" supervision; using big data to discover the injustice in medical resource allocation, providing a basis for decision-makers, to achieve the maintenance of "Yi"; enhancing understanding and trust through online doctor-patient communities, and promoting the atmosphere of "Ren"; disseminating health values through online courses and science popularization, allowing the public to comprehend the meaning of "Dao" and "De." These attempts are all combinations of traditional ethical wisdom and modern technology, to form a unique digital humanistic medicine, making up for the deficiencies of pure technical rationality. As some scholars have pointed out, many difficult problems facing today's information society (such as privacy leakage, algorithmic discrimination, etc.) can be examined and solved by drawing on Spinoza's ethical view. Similarly, our integration of traditional ethics such as Confucianism/Daoism into AI and big data governance can inject warmth and soul into the medical practice of the digital age.
It is worth noting that the reason why we emphasize the medical unfolding of philosophical values is that what proactive medicine advocates is a medicalized civilizational vision—that is, to let the medical spirit transcend hospitals and disease treatment, penetrate into all aspects of civilizational order, and lead moral trends and development directions. This is not to replace other fields with medicine, but to emphasize that the spirit of benevolence, human-centricity, and scientific rationality contained in medicine should become one of the cornerstones of future civilization. In the long river of history, human society has experienced "theocracy" religious civilization and "commerce-dominated" economic civilization. Today, we look forward to a new "health-led" civilizational leap: in this civilization, a basic question must be asked when evaluating all policies and behaviors—"Is this conducive to the health of humans and nature?" If the answer is no, it should be carried out with caution or revised. In this sense, health (in the broad sense of physical-mental-social-ecological health) will rise to become one of the core value measures of civilization.
This reconstruction of value measures relies on the full unfolding of "Dao–De–Ren–Yi–Li" in the medical field: Dao provides the macroscopic laws of life and a holistic view, De ensures that practitioners and institutions have moral integrity, Ren gives a heart of care and compassion, Yi guides the practice of fairness and justice, and Li solidifies into daily norms and institutional culture. These five dimensions work together to make health civilization an organic whole that has both soul and form, is both far-sighted and practical for daily use.
Spinoza, in his Ethics, pursued "knowing the necessary causes of all things in God (Nature)," and believed that from this, one could achieve peace of mind and the supreme good life. Applying this line of thought, in the civilization of proactive medicine, we come to know the "Dao" of health through digital natural rationality, and at the same time regulate our behavior through the practice of Ren, Yi, Li, and De. Thus, the individual obtains physical and mental peace, society achieves harmony and order, and civilization realizes sustainable development. This is precisely a contemporary "state of supreme good." Some thinkers point out that humanity must embrace this concept of holistic unity in order to survive on a planet full of wars and disasters; when we acknowledge "all things are one" and put it into action, we will naturally love others and things as we love ourselves—this resonates with the Confucian "love all, and be close to the benevolent," and is also consistent with the concept of "respect for all life" emphasized by ecological ethics.
Conclusion
Throughout the full text, we have depicted an ideal yet solid and feasible blueprint for a future health civilization: empowered by digital technology and navigated by humanities, humanity will achieve unprecedented health, well-being, and ecological harmony. This is a correction and sublimation of the direction of civilizational development. From the multidimensional reconstruction of the definition of health, which clarifies the new goals of civilization; to the ecological collaborative governance framework and the triple helix model, which provide us with implementation paths; and then to the implantation of the value system, which ensures we do not lose our way on the road forward. Proactive medicine, as a concept, runs through it all, guiding us to firmly hold on to the original intention of "human-centricity and unity of man and nature" while technology advances rapidly. When this concept is integrated into national policies, urban governance, and public awareness, and when digital natural rationality and the "five constant" virtues are deeply rooted in the hearts of the people, we may witness the arrival of a new era of "health as the foundation of civilization."
In this new era, medicine will no longer be just a technique to fight disease, but a way of wisdom that coordinates human happiness and the prosperity of the earth. As Spinoza said: "Man is part of an eternal existence." When we truly practice this—treating nature with reverence, treating life with love and compassion, and illuminating the road ahead with the light of reason—the brilliance of health civilization will surely shine on the world, pushing human society towards a higher level of harmony and prosperity.
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