COP28 and health

In December last year, world leaders gathered in Dubai to attend COP28. The key highlight of the conference was the leaders’ commitment to finding a solution to climate change-induced health challenges across the world.

The Intergovernmental Panel on Climate Change (IPCC) says that around 3.5 billion people are living in highly vulnerable regions. The World Health Organization (WHO) suggests that 23 per cent of premature deaths globally are linked to climate change and that by 2030, an additional death count of 250,000 will result from a surge in air pollution, food insecurity, and vector-borne diseases, all fuelled by human-induced climate change.

This was the first time that the effects of climate change on health were studied and discussed. Leaders signed a health declaration titled ‘COP28 UAE Declaration on Climate and Health’, which secured signatures from over 123 countries. This document talks about climate action, adaptation measures, and climate-resilient and low-carbon health systems. It also suggests integrating climate change and health curricula into education and degree programmes.

The document also emphasizes the inclusion of climate change and health to nationally determined contributions (NDCs), national communications (NCs), and climate policies. The upcoming NDCs, due in 2025, provide a clear timeline for countries to implement health commitments made at COP28. The declaration also focuses on early warning and response systems along with climate-ready health workforce and infrastructure. Countries have pledged $1.777 billion so far to meet these targets.

Around 81 countries have also joined the WHO’s Alliance for Transformative Action on Climate and Health (ATACH), which is committed to achieving the goals set at COP26. The collective efforts of WHO stakeholders and member states aim to foster sustainable and climate-resilient health systems, with a specific emphasis on determining financing needs. During the World Climate Action Summit at COP28, a joint initiative, led by the WHO, Green Climate Fund (GCF), and United Nations Development Programme (UNDP), announced to provide support to developing nations in addressing climate change and health. Focused on 14 countries across Asia, southeastern Europe and Africa, this initiative signifies a powerful commitment to addressing the nexus of climate change and health.

COP28 concluded by signalling the ‘beginning of the end’ of the era of fossil fuels, a message reiterated throughout the conference. The key outcome of COP28 centred around the first global stocktake, and despite the ambitious language backed up by 100 countries, a complete phase-out of fossil fuels did not occur leading to only a phase-down of unabated coal power. Nonetheless, even a gradual phase-down of coal holds significant health co-benefits which can protect lives affected by pollution and extreme heat.

In a conversation with us, WHO adviser Mazen Malkawi emphasized, “Although some regions emit fewer greenhouse gases, they experience faster changes in temperatures and other climatic hazards compared to the rest of the world. Climatic hazards are fuelling environmental degradation, natural disasters, weather extremes, food and water insecurity, economic disruption and conflicts.

“The consequences for health are substantial and include more deadly extreme weather events, increasing cases of noncommunicable diseases and increased emergence and spread of infectious diseases.”

Pakistan is dealing with a plethora of health crises arising from climate change; since it is a signatory to the landmark health declaration, it can reap several benefits including capacity building and securing finance through global support.

Pakistan has developed a framework of action for climate-resilient health systems. A way forward for the country is to focus on targeting and implementing the necessary measures of a climate-resilient health system to curb emissions using WHO guidelines and tools. The reduction in the impacts of climate change on health can occur through dedicated research and projects for which Pakistan needs to hunt global funds through diplomacy.

Pakistan plays a responsible role in global communication in the form of NDCs and NCs with some basic discussion on climate change and health. However, despite their substantive role in international dialogue, these reports do not directly translate into executable measures. This is because of the lack of Pakistan’s capacity to meet the goals and the non-disbursement of the funds committed by rich nations.

Pakistan must opt for conditional steps towards a climate-resilient and low-carbon health system aligned with the principles outlined in the declaration, underscoring Pakistan’s commitment. In the climate change policy, Pakistan must include practical actions and doable steps to properly address climate change and health.

All stakeholders should set up a joint venture, incorporating strong coordination on the provincial and federal levels supported by the higher officials of the participating organizations. These stakeholders are the ministries of climate change, environment, and health, health organizations, non-governmental organizations (NGOs), public health universities, and public- and private-sector health entities.

These entities must work together to create an environment substantiated by evidence-based actions that involve comprehensive research on climate change and health with the potential topics of health impacts due to extreme weather events, vector-borne diseases, tropical diseases, malnutrition, food insecurity, air quality issues, and waterborne diseases, all contributing to health insecurity in the region.

Upon our inquiry, Director of Research at Canada’s SickKids Hospital Dr Zulfiqar A Bhutta said, “As a first-ever health day at COP28, the convening was key in underscoring the importance of integrating climate actions within our current population-level adaptation strategies, but clearly much more needs to be done!”

While COP28’s health declaration illuminates a path towards a future where health and climate action are intertwined, the realization of this vision hinges on sustained advocacy, a commitment to environmental justice, and a unified global resolve to confront the multifaceted challenges posed by climate change.

Dr Shaukat Ali works at the Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada and can be reached at pirshauki@gmail.com

Tehreem Rasheed and KM Kainat Bangash are research assistants working under the supervision of Dr Shaukat Ali.