Abstract
COP28 included, for the first time, health policies and issues in its agenda. Indeed, the relationship between health policies and environmental risks and climate change is multifaceted. On the one hand health systems are still carbon based, on the other hand climate change is a driver for new diseases and for major health problems. The future of humanity also depends on how health systems will be ready to face climate emergencies. This claim is present in the final joint declaration between the Cop28 Presidency and the World Health Organization. The “Cop28 UAE Declaration on Climate and Health” was backed and signed by 123 countries.
This paper provides an overview of the relationships between health and climate and with a summary of discussions it shows what have been the outcomes of COP28 regarding this topic.
Miriam Viscusi (Junior Researcher G.E.O. Environment)
Introduction
The link between health and environment has received a lot of attention in the past few years, despite not being a new issue. Recently this relationship has evolved. On the one side a lot of technological developments have made possible to improve health conditions, on the other side climate change and environmental degradation have brought new challenges to public health. Premises for good health are a safe environment, clean air, sanitation and water access, protection from chemicals and radiation, all elements that are endangered by climate change (WHO). According to the European Environment Agency (EEA), today one in ten premature deaths are still related to pollution. Air quality has been seriously undermined by pollution which, for example, can bring asthma, dehydration, lung and heart diseases (EEA). According to the EEA, even some cancers are linked to environmental issues. For example, exposition to chemical polluting elements (in food, water, garments and products) can be a cause of cancer (EEA). This kind of disease could therefore be predictable and avoidable with most effective environmental policies.
Other factors that influence health are climate extreme events like floods and heatwaves. These events have notable effects on people’s health, and they modify the incidence of specific diseases too (European Climate and Health Observatory). Moreover, climate factors affect the distribution of infectious diseases: when temperature, humidity and precipitation level are modified, the effect is a higher diffusion of diseases. The impact of climate change can also reduce food security and food safety, causing health problems such as malnutrition and problems related to polluted and contaminated food. Land use and climate change increase biodiversity loss, which leads to changes in the presence of bacteria and in zoonotic diseases, emerging or re-emerging (EEA). Such microbial changes and consequent modification are able to affect ecosystems and human health. One example is Covid-19 pandemic which, according to many scientific sources, has been indirectly caused by changes in the ecosystems driven by climate change (WHO).
Health systems around the world are both high carbons based and poorly equipped to face climate emergencies, according to WHO. According to the 2023 report by Cross Dependency Initiative, more than 16.000 hospitals in the world will face in the next years risk of total shortage due to climate events like fires, floods and cyclone wind (Cross Dependency Initiative). Indirect effects highlighted by WHO are, for example, an increasing number of hospital admissions and ambulance call-out if emergencies and natural disasters increase.
The urgence of this topic is why during COP28 the relationship between climate and health has been addressed, making it a top issue on the agenda. The result was a combined effort of the COP28 presidency and World Health Organization and some points that should help nations to include health in their national climate policies. On 12th December 2023, the World Health Organization (WHO) published a document that aims to provide guidance on “how the health sector can systematically and effectively address challenges presented by climate change and transform health systems” (WHO). The goal is to increase the climate resilience of health systems, to ensure care in a changing climate and to protect and improve the health of communities (WHO).
Cop28 outcomes on health and environment
Health day and final declaration main points
COP28 hosted the first Health Day and climate-health ministerial, aiming to build consensus on actions for the health system's response to climate change. The outcome of the discussions has been a joint declaration between the Cop28 presidency and the World Health Organization called “Cop28 UAE Declaration on climate and health” and signed by 123 countries. The purpose of the document is to include health objectives into national climate policies and to increase fundings and cross-sector collaboration. A further outcome was the financing commitment from various stakeholders for the implementation of effective policies. The declaration lists a series of principles to be followed to transform the health system into a low-carbon, climate-resilient and equitable one.
First of all, the Declaration is a joint effort of countries to include health in their national climate strategies. With cross-sector cooperation, policies that maximize health gains should be prioritized. There is therefore a will to accelerate adaptation and to give priority to interventions that help the health sector and health systems. Examples of this, mentioned in the final Declaration, are housing and urbanization, food systems, energy systems, water and sanitation.
Preventing loss and damage is also a key factor, since it can avoid burdens that hit hospitals like huge numbers of admission requests and ambulance call-outs. This includes also preparing hospitals to climate events, by modifying their structure and response, but also their capacity. The ability to avoid health risks can be reached also through other mentioned tools, like surveillance and information-crossing between health systems and environmental monitoring.
The fragile contexts are also included in the Declaration, like the ones that are particularly vulnerable to climate change and the ones that are in conflict. The psychological aspect has also been mentioned, addressing the links between climate change and mental health, and the one between climate displacements and mental wellbeing.
Sustainable health systems
Low-carbon and climate-resilient health systems are a key objective of the Alliance for Transformative Action on Climate and Health (ATACH), built during COP26 and hold a key role in the discussions about health during COP28. Sustainable health systems should be able to respond to climate emergencies, as well as to adapt and recover from climate shocks. The strategy for this is arranged in blocks of sectors where hospitals should perform. For example, building low carbon infrastructure is one of the goals. Another one is to build informed health programmes that take into account environmental aspects. The management of information and climate disasters, as well as the reduction of health systems emissions, are further elements.
Financial commitment
Around 40 partners have committed up to 40 USD billions for helping health organizations in their mission and to improve finance flows addressed to health systems’ response to climate change. Funds and investments will come from domestic budgets, development banks, philanthropies, bilateral agencies and the private sector. The Declaration encourages investments and synergies, especially for programmes that work in the climate-health nexus. A joint finance between climate projects and health projects is encouraged.
Conclusion
For the first time during a Conference of the Parties, COP28 addressed the topic of health and how it is related to climate change and environment. A lot of links can be found, however the final Declaration (COP28 UAE Declaration on Health and Environment) highlighted in particular the need for countries to accelerate prevention of loss and damage and to include, through cross-sector collaboration, health in national climate policies. Countries agreed to an increase in cooperation and coordination of health and climate policies, by sharing information and conducting evaluations. Some governments and private actors have raised a $40 billion fund in order to help health organizations in their mission. However, the relevance of funds will depend on whether they are actually used. Future challenges will also include how most disadvantaged countries and most fragile contexts will cope with environmental issues and emergencies. The role of hospitals, in particular, has to be noticed. Such structures will be very affected by natural hazards and their planned response is crucial to address climate emergencies.
Bibliography
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