Time to align climate & health policies
THE annual round of climate negotiations has begun in Baku, Azerbaijan, with a note of warning. The World Meteorological Organisation, in its annual assessment, has reported that 2024 is well on its way to become the warmest year on record, with the global average temperature between January and September hovering around 1.54°C above pre-industrial levels. It is a dire warning because the rise is above the threshold of 1.5°C that scientists had fixed and the world community had agreed to achieve through emission reduction.
The Paris Agreement goal is to keep the long-term global average surface temperature increase below 2°C compared to pre-industrial levels and pursue efforts to limit the warming to 1.5°C. While the warming this year may be due to the La Nina phase, there is no getting away from the fact that there is a continued rise in the carbon dioxide concentration in the atmosphere that causes temperatures to rise.
Besides catastrophic consequences like extreme rainfall and flooding, intense tropical cyclones, deadly heat, droughts and wildfires, the temperature rise is causing deeper impacts. As United Nations Secretary-General António Guterres has articulated, the climate catastrophe is “hammering health, widening inequalities, harming sustainable development and rocking the foundations of peace”. This is the real danger facing the world, irrespective of the outcome of climate talks on finance, adaptation and mitigation.
The way out is to build climate-resilient health systems and adapt. But this is a challenging task.
The health impacts of climate change are wide-ranging. In its recent report, The Lancet Countdown on health and climate change pointed out that “people in every country now face threats to their health and survival as climate hazards increase”. Among the major health impacts are those related to increasing exposure to heat. In 2023, people were exposed, on average, to 50 more days of health-threatening heat than expected without climate change. This resulted in 167 per cent more annual deaths of adults older than 65 years than in the 1990s. The survey found that 31 countries experienced at least 100 more days of health-threatening heat than would have been expected with no climate change.
Heat exposure is adversely affecting physical activity and sleep quality, in turn affecting physical and mental health. Workers who work outdoors or in non–cooled indoor environments face health risks and their productivity is affected. This is a huge loss because an estimated 1.6 billion people or 25.9 per cent of the working-age population work outdoors globally. This includes agricultural workers, people working on construction and infrastructure projects as well as those engaged in the informal sector.
Another major effect of climate change on health is the increasing risk of water-borne, vector-borne, food-borne and air-borne disease transmission. Increased heat, extreme rainfall and droughts, along with changes in land use and human movement, are adding to this risk. For example, the world is witnessing more cases of dengue. In the past 20 years, the global burden of dengue has risen rapidly due to more suitable climatic conditions (for vectors) and rising human mobility and urbanisation. In 2023, some five million cases of dengue were reported globally, driven by the changing distribution of mosquito vectors like Aedes aegypti. The length of the transmission season for malaria has also changed in recent decades with temperature rise. An additional 17 per cent of the global land area became suitable for the transmission of malarial parasites like P falciparum. The change in temperature and salinity of water bodies is resulting in higher transmission of water-borne diseases.
The world can’t wait indefinitely for political leaders and policymakers to come to a consensus on taking decisive steps to cut greenhouse emissions and slow down climate change. The annual climate change talks have been reduced to efforts to safeguard national and regional economic interests and devise ways to delay action rather than expedite it. Therefore, the way out is to develop climate-resilient health systems and adapt. This, too, is a challenging task. For instance, increasing the adaption of air-conditioning is not a sustainable solution to rising heat stress. It is expensive, energy-intensive and contributes to emissions. In urban areas, greater use of air-conditioners in commercial and residential buildings contributes to the ‘heat island’ effect. Therefore, we need air-conditioning powered by renewable energy as well as innovative low-energy cooling technologies.
For challenges like dengue, we need to implement interventions to reduce vulnerability, integrated vector control measures and greater response capacity within health systems. In addition, the health sector will also have to cut its emissions — currently, the global healthcare sector accounts for 5 per cent of the greenhouse emissions. The World Health Organisation (WHO), in a report released ahead of COP29, has pointed out that focusing on cities is necessary to mitigate climate change impacts on health. Urban policies directly influence public health through their effects on air quality, transport, energy use, urban design, green spaces, housing and food access. The delay in the transition to low-carbon and clean energy systems, therefore, will harm human health in significant ways.
All remedial actions to minimise the health impacts of climate change boil down to funding needed for adaptation and transition to healthier options. Billions of dollars of additional funding, which the developed world has been promising, has hardly materialised. Climate finance is a vexing issue that will, hopefully, make a meaningful headway in Baku. However, this is unlikely as top world leaders, including those from the US, China, Russia, France and Brazil, have decided to stay away from the summit segment of the talks.
As the WHO has said, climate finance is ultimately health finance. Funding for climate action can help protect systems necessary for human health and survival while reducing the direct and indirect impacts of climate change on health and yielding interconnected benefits. Currently, there is a huge funding gap and available funds (loans, debt etc.) are also being renamed as climate funding. The developing and poor countries need additional funding for climate adaptation, specifically for health adaptation. It is time to align climate and health policies as human health is closely linked to planetary health.
