Climate change: a health emergency

On December 3, the recently concluded United Nations Climate Conference (COP28) in Dubai marked the celebration of the inaugural ‘Health Day’. This is the first time that the conference has included a day focusing on health as one of the key issues in the global climate agenda.

This has been followed by the endorsement of the ‘Declaration of Climate and Health’ by 124 countries, along with the announcement of a funding commitment of $1 billion. The funding will be used to strengthen and implement health-focused climate activities in countries that are vulnerable to climate change.

For a long time, climate scientists and health professionals across the world have been sounding the alarm about the knock-on effects of climate change on human health. The Intergovernmental Panel on Climate Change (IPCC), in its fact sheet issued on health in the Sixth Assessment Report 2023 (AR6), warns that climate change has adversely affected the physical health and mental well-being of people worldwide.

It also adds that extreme events will significantly increase ill-health and premature deaths from the near to long term. It is projected that climate change will lead to an excess of 250,000 deaths per year by 2050, attributed to heat, undernutrition, malaria, and diarrheal disease. The burdens of several climate-sensitive foodborne, waterborne, and vector-borne diseases are projected to increase under climate change, assuming no additional adaptation.

The report further mentions the mental health impacts that are expected to arise from exposure to extreme weather events, displacement, migration, famine, malnutrition, degradation or destruction of health and social care systems, as well as climate-related economic and social losses. It also includes anxiety and distress associated with worry about climate change.

Numerous studies have shown that prolonged and intensified stresses from climate disasters increase the risks of preterm birth, premature rupture of membranes, low birth weight, and stillbirth. Children born to mothers experiencing high levels of stress are at a greater risk of stunted growth, being underweight, and experiencing slower brain development. Extreme weather events can also increase the risk of postpartum depression and post-traumatic stress disorder, which can negatively impact the quality of care that mothers provide to their children.

Similarly, the data compiled by the UN during the 2022 floods in Pakistan indicates that around 650,000 expectant mothers faced severe and potentially life-threatening circumstances. In the aftermath of the disaster, various communities, including children and women, are facing ongoing challenges in dealing with the prevalence of diseases such as cholera and malaria. These health issues are further aggravated by the disruption of weather patterns resulting from the phenomenon of global warming.

According to the World Health Organization (WHO), air pollution-related health issues cause the deaths of at least seven million people worldwide annually. Likewise, the Air Quality Life Index reveals that air pollution in Pakistan decreases the average life expectancy by 3.9 years; Lahore is the most heavily impacted by air pollution, resulting in a decrease in life expectancy in the city by seven years.

It took decades for climate scientists and practitioners to successfully persuade political leaders to recognize the correlation between climate and health, as well as the gravity of the issue. The health ministers of G20 countries reached a significant milestone in August of this year by collectively agreeing to the inaugural set of high-level principles for health and climate action.

However, the endorsement of this declaration by a large number of countries underscores the severe health implications of climate change and the urgent need to address the connections between climate change and human health and well-being. By adopting the declaration, the countries that signed the Paris Agreement in 2015 have committed to promoting climate-resilient development, strengthening health systems, and building resilient and prosperous communities for the benefit of current and future generations.

The declaration calls for efforts to be made towards achieving improved health outcomes, which includes transforming health systems to be climate-resilient, low-carbon, sustainable, and equitable. The countries have committed to pursuing common objectives, which include strengthening the development and implementation of policies that maximize the health gains from mitigation and adaptation actions, as well as preventing worsening health impacts from climate change.

To attain the shared objective, it places significant emphasis on fostering strong collaborations with indigenous populations, local communities, women and girls, children and youth, healthcare professionals, and individuals with disabilities. The concept of the ‘One Health’ approach, as stated in the declaration, highlights the significance of addressing environmental factors that influence health.

This entails enhancing research on the interconnections between environmental and climatic factors and antimicrobial resistance, along with intensifying endeavors for the timely identification of zoonotic spill-overs. These measures serve as effective strategies for preventing, preparing for, and responding to pandemics.

Upon initial analysis, the declaration demonstrates a comprehensive and all-encompassing approach towards addressing health and climate issues, rendering it a highly holistic document. The enhancement of healthcare systems’ capacity to anticipate and implement adaptation measures in response to climate-related diseases and health hazards.

This involves improving climate-health information services, surveillance, early warning and response systems, along with cultivating a proficient climate-ready health workforce and resilient health facilities capable of withstanding climate-related disruptions. Promoting initiatives aimed at mitigating emissions and minimizing waste within the healthcare sector, establishing decarbonization objectives at the national level, and enforcing procurement criteria for national health systems with resilient supply chains.

The document emphasizes the importance of enhancing transdisciplinary and interdisciplinary research, conducting climate vulnerability assessments of health facilities, fostering cross-sectoral collaboration, exchanging best practices, and monitoring advancements at the nexus of climate and health. The attainment of this objective can be facilitated by implementing initiatives like the Alliance for Transformative Action on Climate and Health (ATACH), which is led by the WHO.

Several new initiatives were announced during COP28 to address the challenges in accessing finance for healthcare and improve the efficiency and effectiveness of financial flows from domestic and external sources. The Asian Development Bank (ADB) has spearheaded the creation of the Joint Development Bank working group to address climate-health financing.

Despite the positive advancements, achieving health justice for global communities necessitates genuine stewardship from world leaders, governments, health professionals, the private sector, and civil society. The long persistent obstacles in governance and the lack of coherent policies play a crucial role in determining the resilience of health systems and the successful integration of health considerations into climate policy processes, and vice versa. It is imperative to integrate climate considerations into health programmes as part of the national adaptation plan (NAP) and nationally determined contributions (NDCs).

One of the primary catalysts behind this paradigm shift is the establishment of a comprehensive global health education system, the enhancement of healthcare practitioners’ competencies, and the incorporation of cutting-edge technology to foster innovative healthcare solutions. The incorporation of digitization, artificial intelligence, integrated risk monitoring, and data-driven decision-making can play a crucial role in the transformation of healthcare systems.

The WHO’s ‘Operational framework for building climate resilient health systems’ provides a comprehensive guidance on how the health sector and its operational basis in health systems can systematically and effectively address the challenges increasingly presented by climate variability and change.

The writer is a climate governance expert who works for global development organizations in the fields of research, advisory, policy analysis, and legislative reforms. He can be reached at X: @razashafqat