Birungi, C

Stevenson, O

Watts, N

English

UCL Discovery

Briefing for the global health communityUCL BRIEFING - JUNE 2015AUTHORSCharles Birungicharles.birungi.14@ucl.ac.ukPhD candidate, UCL Institute for Global HealthDr Olivia Stevenson  o.stevenson@ucl.ac.uk(Acting) Head of UCL Public PolicyNick Watts  nicholas.watts.12@ucl.ac.ukHead of Project, Lancet Commission on Health and Climate Change: Emergency Actions to Protect Human HealthUCL PUBLIC POLICYKEY MESSAGES •	 Climate change threatens to undermine the last half century of advances in global health - potentially affecting many of the social and environmental determinants of health, including clean air, safe drinking water, sufficient food and secure shelter.•	 Tackling climate change could be one of the greatest global health opportunities of the 21st century, with many of the responses identified as low cost and “no-regret” interventions, bringing unprecedented ancillary benefits to global human health as well as the health of the planet.•	 The global health community has a vital role to play in ensuring that climate change policies also improve public health and accelerate poverty reduction. To achieve this, global health institutions and interest groups must have the necessary expertise and political support to fully engage across all aspects of climate change and sustainable development.•	 Enhanced collaboration between sectors is required in order to ensure a comprehensive response to climate change. A siloed approach to protecting human health from climate change will not work. Mechanisms that facilitate inter-sectoral policy development and implementation at the global level are needed.What are the impacts of climate change for global health?This brief draws on findings from the 2015 Lancet Commission on Health and Climate Change. Conceived in a multilateral context, the Commission contributes to emerging debates on climate change and health, and outlines how progress on a range of issues might be made over the short- and long-term.Around the world variations in climate affect the air people breathe, the food they eat and the water they drink. Without mitigation, this results in a loss of capacity to sustain healthy human life. The global scientific consensus on climate change is unequivocal, with high confidence that the net effect of anthropogenic activity since 1750 has been that of warming the planet. After only 0.85°C warming, many anticipated threats have already become real-world impacts, involving every global region. Climate change poses a range of threats to human health and survival in multiple, interacting ways. Specifically, effects of climate change are experienced directly through extreme weather and hazards (e.g. heatwaves, storms, forest fires, floods, or droughts); indirectly, mediated through changes in the biosphere (e.g. in the burden and distribution of disease vectors, or food availability); and enacted through economic and social processes (leading, for instance, to migration and conflict). Why should the global health community act?Crucially, these effects are not evenly distributed. Women, children, the elderly, and the poor often experience the worst effects, exacerbating existing inequalities. The interaction and combination of these impacts is most concerning, with multi-hit scenarios threatening to undermine much of the progress made in global health over the last half century. In light of this, it is apparent that the relationship between climate and health deserves greater recognition, with the the benefits of action, and the consequences of inaction, are becoming ever clearer.Given the unacceptably high risk and potentially catastrophic effects of climate change on human health, maintaining the status quo is not an option. The drive for sustainable development must be complementary to, and integrated with the drive to address climate change. Delivering opportunities with mutual benefits, including poverty eradication, improved health, universal education, better food and energy security, underlines the case for intersectoral action. Many mitigation and adaptation responses to climate change are ‘no-regret’ options. Although this does not make a strong global agreement automatic or easy, through serious multilateral processes and actions climate change can be tackled whilst simultaneously contributing to the achievement of other Sustainable Development Goals (SDGs). We can turn the greatest threat into the greatest global health opportunity of the 21st century, but only if we act quickly, collectively and for the long term. coverage (UHC) will be won or lost depending on how quickly the world can comprehensively responds to climate change. Integrating commitment to climate change across all departments and sectors in global health institutions will help build the necessary health expertise and capacity needed to respond to climate change.2. Support and encourage an international agreement on climate change, which protects public health. Whilst the international climate negotiations are very complex, their goals are very simple: agree on ambitious and enforceable global mitigation targets, on adaptation finance to protect countries’ rights to sustainable development, and on the policies and mechanisms that enable these measures. In line with WHO recommendations, this should include additional financing to strengthen health systems and health adaptation, and early prioritisation for mitigation technologies having the potential to improve public health.3. Invest in climate change and public health research, monitoring and surveillance to ensure a better understanding of the adaptation needs and potential co-benefits of climate mitigation. National policymakers require locally relevant data to support decision-making, an effort which should be supported by and driven in collaboration with the global health community.4. Strengthen health systems as a priority area for adaptation to climate change. Additional international finance is required to ensure that health systems are equipped to respond to the worst effects of climate change and can protect the most vulnerable in society. With adequate investment, health systems and healthcare facilities could act as anchors of community resilience, reducing poverty and improving health equity.5. Communicate the links between climate change and global health to ensure that the risks and opportunities are understood by the general public and all parts of the health profession globally. Public awareness of the health risks of climate change, even from heatwaves and other extreme weather events, is currently low. Innovative media strategies are needed to enhance awareness of such risks and improve public adaptive skills and effectiveness. Health professionals, being knowledgeable and trusted, are in a strong position to communicate the risks posed by climate change and the benefits of adaptation.6. To support the implementation of these recommendations, the Lancet Commission on Health and Climate Change has developed a “Countdown to 2030: Global Health and Climate Action”. This is an international, multidisciplinary coalition of experts, building off the work of the Commission. It will monitor and report on a range of indicators in health and climate change, focusing on health system adaptation and the implementation of the health co-benefits of mitigation. The Countdown will build a unique partnership of academics, national and local policymakers, global health institutions, and civil society.In principal, since climate change and human health issues both transcend national borders, there are concomitant needs amongst states to coordinate policy responses and financing mechanisms - both to adapt to climate change and to invest in low carbon economic pathways.  This in turn demands an active search for positive balanced outcomes. 2015 provides a crucial opportunity to align development goals with action on climate change, but in order for the realisation of the SDGs, the Paris COP21 CLIMATE CHANGE LEGISLATION Increasing knowledge of climate change impacts has prompted extensive responses from governments, business and civil society. Many countries have developed comprehensive legislation on climate. For example in 2008 the UK set statutory targets for emissions reduction via the Climate Change Act. Mexico now has a General Law on Climate Change and Nigeria has a National Climate Change Policy and Response Strategy. 66 countries, which represent around 88 per cent of global emissions, now have climate legislation in place1. However, health often only features as part of packages and isn’t always integrated across policy areas within country frameworks.  HEALTH CO-BENEFITS OF MITIGATION The Sustainable Development Goals (SDGs) have emphasised the role that Sustainable Energy for All plays in securing a sustainable future for a global population of 9 billion by 2050. Affordable renewable energy will have huge benefits for the poorest. A recent WHO report suggests that in 11 sub-Saharan African countries, 26% of health facilities had no power supply at all and only 33% of hospitals had what could be described as “reliable electricity provision”, defined as no outages of more than 2 hours in the past week. Solar power is proposed as an ideal alternative energy solution, providing reliable energy that doesn’t harm cardiovascular or respiratory health in the same way that diesel generators do. These technologies can be decentralised, which is ideal in settings without access to reliable power grids.1 GLOBE International, January 2014. GLOBE climate legislation study, fourth edition: review of climate change legislation in 66 countries.Responding to climate change: Opportunities and responsibilities for global healthA successful response needs input and support from all sectors, particularly from the health sector. A number of key policy recommendations emerge from the Commission’s report:1. Ensure that climate change and sustainable development are integrated across all aspects of global health. Amongst the portfolio of activities the World Health Organization (WHO) leads, there is recognition that health should be at the heart of climate change planning, policies and actions. Nevertheless, given multiple legitimate priorities in health policy, the global health community has been slow to mount appropriate responses to climate change. Similarly, as leaders in public health, the WHO needs to strengthen its commitment to tackling climate change, integrating sustainability considerations across all aspects of the Organization. Post-2015, efforts to attain the highest standards of health for populations as well as universal health agreement will depend on an equitable consensus on achieving these goals, for which global health organisations should advocate. ConclusionThe 2015 Lancet Commission on Health and Climate Change suggests that promoting a health agenda may help accelerate responses to climate change, in the process significantly benefiting the health and wellbeing of our families, communities and countries. Leveraging this opportunity and rapidly implementing actions will ensure that gaps in prosperity - which would otherwise threaten national, global, and planetary stability - are bridged. In the spirit of shared responsibility, smart investments in climate action today will yield high returns, and serve as a pathfinder to sustainable development. Noting that global health equity, sustainable development and the international response to climate change are inseparable, simultaneously addressing these will help to realise the greatest global health opportunity of the 21st century.2015 LANCET COMMISSION ON HEALTH AND CLIMATE CHANGEThe Commission is an international, independent collaboration of academic experts, formed to map out justification for policy responses to climate change. It exists as a collaboration between European and Chinese climate scientists, geographers, social and environmental scientists, biodiversity experts, engineers, energy policy experts, economists, political scientists and public policy experts, and health professionals – all seeking a response to climate change which is designed to protect and promote human health. Administrative, communications, and design personnel also support this Commission. For more information, visit www.thelancet.com/commissions/climate-change

2015 Lancet Commission on Health and Climate: Briefing for the global health community

https://discovery.ucl.ac.uk/id/eprint/1469621/1/LancetGlobalHealth.%20final.pdf

2015 Lancet Commission on Health and Climate: Briefing for the global health community

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