Health and Climate: An Intertwined Crisis

Climate change has already begun to manifest severe health consequences, from the spread of vector-borne diseases like malaria and dengue to the exacerbation of respiratory and cardiovascular illnesses due to poor air quality. According to the World Health Organization (WHO), between 2030 and 2050, climate change is expected to cause an additional 250,000 deaths per year due to heat stress, malnutrition, and diseases such as malaria and diarrhoea. These statistics show that addressing climate change without considering health is a missed opportunity to mitigate its human toll.

At COP29, this realisation is coming to the fore. For the first time, health will have a dedicated day and see the introduction of various health-focused initiatives. Elmar Mammadov, Co-Lead of the COP29 Global and Regional Initiatives and Action Agenda Team, emphasised that the presidency aims to make health a permanent and sustainable focus at future COPs. Mammadov highlighted the intention to form a coalition with the WHO and previous COP presidencies, building on the legacy of the Alliance for Transformative Action on Climate and Health (ATACH), an informal network established at COP26.

Key Health Initiatives at COP29

Several initiatives to enhance the intersection of health and climate resilience will be unveiled at COP29. The Harmonia 4 Climate Resilience Initiative, developed in collaboration with the UN Food and Agriculture Organization (FAO), aims to empower rural communities by integrating climate-resilient farming practices. This initiative recognises food security’s critical role in health outcomes, particularly in low-income regions where climate change threatens to undermine agricultural productivity.

Another major programme, the Baku Initiative on Human Development for Climate Resilience, is a multi-sectoral effort focusing on health, education, employment, and youth empowerment. This initiative addresses the social determinants of health, acknowledging that the effects of climate change are deeply intertwined with economic and educational disparities.

A significant focus of COP29 will be on integrating health into urban planning. Cities are increasingly seen as key battlegrounds in the fight against climate change, as they generate significant global carbon emissions. Mammadov pointed out several events and roundtables will be dedicated to healthy cities and urban agriculture. These discussions will explore how urban landscapes can be reimagined to promote better health outcomes, focusing on reforestation and sustainable urban farming practices.

The Global Health Impact of Climate Change

The WHO’s Director of Environment, Climate Change, and Health, Dr Maria Neira, stressed the importance of collaboration between COP29 and other UN agencies. She pointed out that climate change’s impacts on health are multifaceted, involving physical and mental health. For example, extreme heat and natural disasters, which are becoming more frequent due to climate change, have been linked to increased rates of mental health issues, including anxiety, depression, and post-traumatic stress disorder.

Neira also highlighted the importance of gender equity in climate and health discussions. Women, particularly in low- and middle-income countries, are often disproportionately affected by the health impacts of climate change. They are more likely to suffer from malnutrition and are often primary caregivers, making them more vulnerable to the cascading effects of climate-related health crises. Gender equity will thus be a key topic at COP29, ensuring that climate solutions are inclusive and address the needs of the most vulnerable.

Making COP29 Inclusive and Accessible

In addition to health, another key goal of COP29 is to make the conference more inclusive. Previous COPs have faced criticism for being inaccessible to certain groups, particularly from the Global South, due to high costs, visa issues, and limited opportunities for participation. Mammadov stressed that the presidency would make a concerted effort to ensure that all voices, particularly those from underrepresented regions, are heard. He emphasised that the success of climate action depends on incorporating diverse perspectives, particularly from those most affected by the climate crisis.

The presidency also encourages multilateral development banks and climate funds to invest in health and climate initiatives. By directing financial resources towards these areas, COP29 aims to catalyse tangible action to improve health outcomes and build resilience against future climate shocks.

Call to Action

As the world grapples with the dual crises of climate change and public health, COP29 presents a unique opportunity to align global climate and health policies. The initiatives outlined by the presidency, coupled with the WHO’s expertise, are a promising step towards making health a central component of climate action. However, the success of these efforts will depend on sustained political will, investment, and the involvement of all sectors of society.

The health impacts of climate change are not just a future threat — they are already being felt globally. Dr Neira aptly noted, “We cannot afford to wait until tomorrow to act on health and climate. The time to integrate these two agendas is now, and COP29 will be a critical milestone in this journey”.

By prioritising health at COP29 and beyond, global leaders have the chance to curb emissions and save lives. The challenge now is to ensure that the commitments made in Baku translate into real-world action, benefiting those most vulnerable to the health impacts of our changing climate.

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A discerning analysis of 42 indicators reveals a troubling reality: 41 are not on track to meet their 2030 targets. This revelation paints a sobering picture of the inadequacy characterizing our current approach to climate action. Over half of these indicators face a protracted trajectory, demanding an immediate and twofold acceleration of efforts throughout this crucial decade. The report further underscores the unsettling revelation that six indicators are moving in the wrong direction, posing formidable challenges to the core tenets of climate resilience.

As we navigate the challenge of climate governance, the report spotlights significant setbacks in critical areas. With subsidies nearly doubling, the steep increase in public financing for fossil fuels raises concerns about the sustained financial support underpinning environmentally disastrous practices. Moreover, the marginal increase in global deforestation to 5.8 million hectares in 2022 underscores the formidable challenges in achieving crucial conservation goals, accentuating the uphill battle against rampant deforestation.

Amidst the shadows cast by setbacks, the report unveils promising developments in certain sectors. The exponential growth in the share of electric vehicles in passenger car sales, surging from 1.6% in 2018 to 10% in 2022, illuminates a path toward sustainable transportation. Simultaneously, positive momentum in areas like mandatory corporate climate risk disclosure, electric truck sales, and the electric vehicle share in the passenger car fleet highlights the potential for transformative change, offering glimpses of a sustainable future.

The imperative for immediate and transformative change echoes across diverse sectors:

· Increasing Renewable Energies: A call for a twofold increase in the annual growth rate of solar and wind power, aiming for a 24% share in electricity generation by 2030.

· Coal Phase-Out: A compelling narrative advocates for the expeditious phase-out of coal in electricity generation, seven times faster than current rates.

· Rapid Transit Infrastructure: The report envisages a sixfold expansion in the coverage of rapid transit infrastructure, akin to constructing systems thrice the size of New York City’s network annually.

· Deforestation Reduction: The clarion call calls for a fourfold acceleration in reducing the annual rate of deforestation, corresponding to deforestation of 15 football fields per minute in 2022.

· Sustainable Diets: An eightfold acceleration is championed toward healthier, more sustainable diets, particularly in high-consuming regions.

In the face of unprecedented challenges, the State of Climate Action 2023 stands as an imperative narrative, beckoning global leaders, policymakers, and citizens to endeavor to collectively recalibrate our approach to climate governance. As we navigate this complex terrain, the report underscores the transformative potential embedded within international collaboration, ambitious policy interventions, and a steadfast commitment to forging a sustainable trajectory for the future.

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Attending the ENBEL (Enhancing Belmont Research Action to support EU policy-making on climate change and health) conference in Brussels, which focused on ‘Health Impacts of Climate Change — Advancing the European Adaptation Agenda to 2030,’ profoundly heightened my awareness of the pressing need for more robust financial resources in health adaptation to climate change. The conference unequivocally illuminated that current levels of health adaptation funding for addressing climate-related challenges are woefully inadequate.

New research, funded by ENBEL, provides concerning evidence that only a tiny fraction of international climate adaptation financing has been directed towards health needs over the past decade. Analysing data from 2009–2019, just 4.9% of multilateral and bilateral climate adaptation funds went to health projects globally. This equates to only US$ 1.4 billion out of over US$ 29 billion in total adaptation financing over a ten-year period. Worse still is the pitiful amount for projects with explicit health objectives, just US$ 0.1 billion.

Not only are overall volumes low, but very little targets core health system needs. Projects where health was the primary focus made up only 0.5% of multilateral climate funding, mostly for infectious disease control and surveillance. Vital areas like heat warning systems, climate-resilient health facilities, expanded mental health services, and local community health adaptation still lack investment.

The implications are troubling. As the Lancet Countdown on Health and Climate Change clarifies, climate change already contributes to disease, death, and health inequality worldwide. The Lancet Countdown tracks health financing via an indicator, showing a year-on-year increase in health adaptation spending from 4.6% in 2015–2016 to 5.6% in 2020–2021. However, more is needed to manage the health burden of recent climate events.

Sub-Saharan Africa faces an especially heavy burden yet still needs commensurate international support. The World Bank predicts the region will incur 80% of the global rise in climate-linked malaria and diarrheal disease by 2050. This will further strain overburdened health systems.

Adaptation financing can help change course. Funding water and sanitation systems adapted for climate extremes reduces water-borne illness. Warning systems allow preparation for heat waves and disasters. Resilient clinics maintain health services through storms and floods. We have the knowledge and tools for health adaptation but need the resources to implement them at scale.

Some progress was made at COP27, with a breakthrough agreement on a new “loss and damage” fund to support climate-vulnerable developing countries. But major gaps remain. Health ministries have yet to fully access climate funding opportunities, whilst health benefits often remain assumed, not measured, in many adaptation projects across sectors like agriculture and water. Accurate tracking of health financing is essential to verify where money flows.

Addressing the shortfall in climate funding for health adaptation is a shared responsibility that extends well beyond the donors. It’s imperative for governments in developing countries to prioritise health adaptation in their national climate plans and investments. Health leaders have a role in better articulating the risks and suggesting viable solutions.

Above all, the broader ecosystem of health financing — encompassing governments, global health organisations, and corporations — must internalise that climate resilience is not a separate issue but an integral component of strengthening health systems and achieving universal health coverage. As we ponder the pivotal question raised in the beginning — where will the needed funds come from — it’s clear that our collective health depends on an inclusive, multifaceted approach to financing climate resilience.

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