Costello, Anthony

Mulcahy, Elaine

Romanello, Marina

Whitmee, Sarah

English

UCL Discovery

23-06207 At COP28 further delays in tackling our greenhouse gas emissions will be an act of negligence   For COP28 see https://unfccc.int/cop28   Driven mostly by the relentless burning of fossil fuels, the continuous rise in greenhouse gas emissions from human activities since the Industrial Revolution has pushed the climate to an unprecedented level of destabilisation. Climate change causes  irreversible human harms, and puts the survival of millions of people at risk, as the latest report of the Lancet Countdown on Health and Climate Change underlines.1  At the current 1·14̊ ⁰C of decadal average heating since pre-industrial times, heat-related deaths in people older than 65 years have increased by 85% since the 1990s, twice the level expected if temperatures had not changed since then. The higher frequency of heatwaves and droughts since 1981–2010 has pushed 127 million more people to moderate or severe food insecurity, and the climate is becoming more suitable for the transmission of vector-borne diseases, increasing the risks of outbreaks and pandemics. As well as the health and social impacts, climate change has economic ramifications. In 2022, extreme heat exposure led to 41% more potential labour hours being lost than in the 1990s, with associated income losses rising to 6% of gross domestic product in countrie classified as having "low”Human Development Index. These losses undermine people’s livelihoods, wellbeing, and health-defining socioeconomic conditions—they ultimately affect the whole economy. At 1·14°C of heating, most countries have failed  to effectively adapt to climate change, and populations face the growing harms unprotected.2 Although the world’s most underserved countries, and those that contributed the least to global greenhouse gas emissions, are being most affected by the health impacts of climate change, no country is immune from rising threats.    The harms of climate change are only an early glimpse into what could become an unliveable future.  27 years of international climate negotiations have failed to deliver meaningful progress to protect people’s lives. Energy-related emissions reached record levels in 2022,3 and existing policies put us on track to almost 3 oC of heating.4 The health hazards could be catastrophic, making adaptation efforts economically unsurmountable and futile.    The COP28 UN Climate Change Conference in Dubai, United Arab Emirates, on Nov 30, 2023, to Dec 12, 2023, will be a negotiation about the survival of millions of people. But the outlook is not encouraging. As pressure to tackle emissions grows, so does the incentive for fossil fuel companies to stall action to reduce the use of fossil fuels. Indeed, the  lobbying investments and efforts of the fossil fuel industry are escalating; in 2022,  a record 636 of  lobbyists for fossil fuel companies  attended COP27.5 Most governments have failed to act at the pace needed to protect their population’s health from the impacts of climate change.6 Fossil fuels were mentioned for the first time only at COP26’s Glasgow Climate Pact in 2021, which called on parties to accelerate “efforts towards the phase down of unabated coal power and phase-out of inefficient fossil fuel subsidies”.7 No further progress was made at COP27. As a result, international negotiations have so far legitimised life-threatening inaction. Without  binding international commitments, countries continue to subsidise fossil fuels; private bank lending to the fossil fuel sector has risen since the Paris Agreement; and the world’s 20 largest oil and gas companies have increased their extraction plans and are on track to surpass their emissions consistent with the Paris Agreement by 173% by 2040—up from 112% in 2022.1  For the 2023 COP28 UN Climate Change Conference, the COP President is the Chief Executive Officer of the Abu Dhabi National Oil Company (ADNOC), the world’s seventh   largest national oil and gas company by market share. The COP28 presidency’s focus on mitigation leans strongly on delaying the fossil fuel phase out, and pursuing carbon capture and storage, a technology that is expensive and unproven at scale. Despite a net-zero centred marketing campaign, ADNOC has expanded its fossil fuel production plans since February 2022to exceed  emissions compatible with 1·5oC, according to its market share, by 188% by 2040.1    Against this backdrop,‘health  will be included for the first time as a key theme in COP28, with the first climate-health ministerial meeting. This is an urgently needed health-promoting transformation, but only if it delivers meaningful action. The COP28 Ministerial Declaration on Climate and Health, must call for an immediate, safe, and people-centred transformation of not only our health systems, but also of the energy, transport, food, and agricultural systems that define people’s health. Critically, this declaration must go beyond calls for health-system strengthening, to include  an urgent appeal for an immediate, just, and equitable transition away from health-harming fossil fuels.   But the health sector’s role does not stop at COP. With direct influence over 11% of the Gross World Product, decarbonising health systems can eliminate the 4·6% of global emissions they contribute to1 and promote decarbonisation of a substantial portion of the global economy.  Much of the transition needed should be driven by the health sector, through public health interventions. The promotion of healthy, low-carbon diets could prevent much of the estimated 9 million annual deaths that are attributable to excessive consumption of carbon-intensive meat and dairy, and under-consumption of nutritious, plant-based foods.1  The promotion of regulation to reduce exposure to air pollution and secure safe access to clean energy can save at least 1·9 million deaths annually from the burning of dirty fuels, and reduce air pollution-driven cardiovascular disease, lung disease, cancer, and adverse birth outcomes.1 A just and equitable transition must also ensure that the benefits delivered by climate mitigation are fully accessible to all, including women and minoritised groups. With almost 1 billion people worldwide still served by health-care facilities that do not have reliable access to energy, and about 800 000 people living without electricity,  equitable and just access to clean renewable energy (now cheaper than fossil fuels) can power sustainable development, access to health and education services, and improve the environmental and socioeconomic conditions on which health depends.    By engaging with city authorities, health professionals can play a major part in supporting a shift away from fossil-fuel based modes of transport in favour of safe modes of active travel (cycling, walking, electric buses, and trains). Well-designed actions in the transport sector can improve equity, allowing women to travel safely, and can reduce road accidents (the main cause of deaths of children older than 5 years),8 avoid over half a million deaths each year from transport-derived air pollution,1 and prevent millions of annual deaths arising from sedentary lifestyles.9 Simultaneously, health professionals must support an increase in safe urban green spaces, and the benefits they provide to air quality, tackling the urban heat island effect, and to physical and mental health outcomes.10 Green prescribing can also ensure these benefits are maximised  The integration of actions across sectors is essential to achieve climate resilient net-zero development and improve health. At present, however, most implemented actions are not fully capitalising on the potential health benefits that could be theoretically achieved and pledges to cut emissions are not being turned into action at the scale needed to meet climate targets, and protect people’s health.11  Health authorities must ensure all health professionals are educated about climate change, and the risks of rising emissions for our health. The health sector must lead the call for what could be the most important public health intervention of our time—the phase out of fossil fuels, to ensure  growing hazards do not exceed the capacity of our health systems.  Failing to address the root cause of the climate crisis would result in health-washing of international negotiations, a failure to protect people’s future, and tarnish the health community’s credibility with the same political roadblocks that have hindered global international climate negotiations.  At COP28 and beyond,  further delays in tackling emissions reductions will be an act of negligence.   MR and AC are authors of the 2023 report of the Lancet Countdown on Health and Climate Change1 and MR is the is the Executive Director of the Lancet Countdown. MR and AC report a grant. from the Wellcome Trust (number209734/Z/17/Z). MR also reports fundingfrom the UK Research and Innovation for the IDAlert Project (UK Research and Innovation project reference no. 10056533). SW reports a Wellcome Trust grant (number 221284/Z/20/Z) and a grant from the Oak Foundation (number OFIL-20-093) for the Pathfinder Initiative. EM is the Director of the UK Health Alliance on Climate Change.  AC reports support from WHO attend a meeting on climate change.   *Marina Romanello, Sarah Withmee, Elaine Mulcahy, Anthony Costello m.romanello@ucl.ac.uk  UCL Institute for Global Health, University College London, London WC1E 6BT, UK (MR, AC); Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK (SW); UK Health Alliance on Climate Change, London, UK (EM)  1 Romanello M, di Napoli C, Green C, et al. The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms. Lancet 2023; published online Nov 14. https://doi.org/10.1016/S0140-6736(23)01859-7. . 2 UN Environment Programme. Adaptation gap report 2023: underfinanced. underprepared: inadequate investment and planning on climate adaptation leaves world exposed. Nairobi: UN Environment Programme, 2023. 3 International Energy Agency. CO2 Emissions in 2022. 2023. https://www.iea.org/reports/co2-emissions-in-2022 (accessed Nov 16, 2023). 4 The Climate Action Tracker. The CAT Thermometer. . 2022.https://climateactiontracker.org/global/cat-thermometer/ (accessed Nov 16, 2023).  5 Global Witness. Over 100 more fossil fuel lobbyists than last year, flooding crucial COP climate talks. Nov 10, 2022. https://www.globalwitness.org/en/press-releases/over-100-more-fossil-fuel-lobbyists-last-year-flooding-crucial-cop-climate-talks/ (accessed Nov 12, 2023). 6 UN Framework Convention on Climate Change. Technical dialogue of the first global stocktake. Synthesis report by the co-facilitators on the technical dialogue. 2023 https://unfccc.int/documents/631600 (accessed Nov 16, 2023). 7 UN Framework Convention on Climate Change. Glasgow–Sharm el-Sheikh work programme on the global goal on adaptation. 2023. https://unfccc.int/topics/adaptation-and-resilience/workstreams/glasgow-sharm-el-sheikh-WP-GGGA#tab_home (accessed Nov 16, 2023). 8 WHO. Road traffic injuries. 2022. https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries (accessed Nov 16, 2023). 9 WHO. The Global Health Observatoy. Physical inactivity. 2023. https://www.who.int/data/gho/indicatormetadata-%0Aregistry/imr-details/3416#:~:text=Insufficient %0Aphysical activity is the,attributable to %0Ainsufficient physical activity (accessed Nov 12, 2023). 10 Rojas-Rueda D, Nieuwenhuijsen MJ, Gascon M, Perez-Leon D, Mudu P. Green spaces and mortality: a systematic review and meta-analysis of cohort studies. Lancet Planet Heal 2019; 3: e469–77. 11 Whitmee S, Green R, Belesova K, et al. Pathways to a healthy net-zero future: report of the Lancet Pathfinder Commission. Lancet 2023; published online Nov 20.  https://doi.org/10.1016/S0140-6736(23)02466-2.   

Further delays in tackling greenhouse gas emissions at COP28 will be an act of negligence

https://discovery.ucl.ac.uk/id/eprint/10187637/1/Romanello_23-06207Nov16jpclean_MR.pdf

Further delays in tackling greenhouse gas emissions at COP28 will be an act of negligence

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