There’s no doubt that tackling climate change is one of the greatest challenges we face – and as the impacts of a shifting global climate become apparent, so too do the trickle-down effects on the global population.
One of those is the effect on health – which is already impacting millions of people around the world, both now and into the future.
In 2022, Pakistan was hit by the worst flooding the country has ever seen. More than 1,700 people were killed, and almost 13,000 people injured. Beyond the immediate toll on human life, an ongoing crisis emerged.
About 10% of hospitals and medical centres were damaged or destroyed, leaving more than 8 million people in urgent need of treatment or healthcare. Essential medical supplies and equipment were also lost, reducing the capacity of Pakistan’s healthcare system to respond to health needs, both immediately and in years to come.
It’s a situation that has played out in similar natural disasters time and time again. In 2012, Hurricane Sandy damaged equipment and caused power outages in the New York City area, delaying critical radiation treatment for cancer patients.
Access to radiation treatment was also limited in Puerto Rico after Hurricane Maria hit in 2018 – which also forced the closure of a factory that manufactured essential IV fluids, causing shortages that impacted cancer patients across the US.
Floods from Hurricane Harvey in 2017 inundated contaminated sites, chemical plants and oil refineries, releasing large amounts of carcinogens and hindering cancer prevention efforts in the Houston, Texas community.
These examples point to a growing trend, and a fundamental point we can’t ignore: a healthy population needs a healthy planet.
The “double crisis” challenging our people and planet
From cancer to heart disease and diabetes, non-communicable diseases have also become a health crisis we can’t ignore, with one person under 70 dying every two seconds from an NCD. In the words of Dr Bente Mikkelsen, Director of the WHO’s NCD Department, climate change and NCDs have come together to create a “double crisis” and it needs urgent action.
According to the WHO, climate change is the world’s single biggest health threat. Almost 14 million deaths per year are linked to the environment, and 1.8 million of those deaths are from cancer – making it the third leading cause of death linked to the environment.
Extreme weather events like heatwaves, droughts and floods can worsen pre-existing NCDs, particularly cardiovascular diseases, diabetes and chronic respiratory diseases, and people undergoing treatments such as chemotherapy are likely to be more vulnerable to their negative health impacts. Climate change also disrupts food systems, leading to food insecurity and malnutrition, which contributes to the development of NCDs.
Air pollution accounts for 6.7 million deaths per year worldwide, with chronic lung diseases, lung cancer and acute respiratory infections accounting for the largest share of these deaths. Climate change dramatically exacerbates the impacts of air pollution – in many cases, the same pollutants that are driving climate change are also harming health. Bushfires are becoming more frequent and active due to climate change as well, creating damaging levels of air pollution.
These extreme weather events threaten the capacity of healthcare systems to respond effectively. Floods and storms can cause power outages, damage healthcare infrastructure, disrupt supply chains and the delivery of health services.
This of course impacts immediate health needs, but when it comes to NCDs like cancer, it can also interrupt screening and treatment, and put more financial pressure on health services, leading to poorer outcomes.
A global solution for a global problem
While climate change and NCDs demand a global response due to their transboundary nature, health concerns have historically been absent from international climate talks.
COP28, the last Conference of the Parties to the UN Framework Convention on Climate Change in 2023, represented a significant step in addressing this gap, and resulted in the following key health outcomes:
- The inaugural Climate-Health Ministerial meeting was held on the first-ever Health Day, which culminated in a new Declaration on Climate and Health endorsed by over 140 countries. While non-binding, the Declaration is an important political commitment that recognises the benefits of addressing climate change, including “lower air pollution, active mobility, and shifts to sustainable healthy diets”. US$1 billion in funding was also announced on Health Day for climate-health initiatives.
- A new Declaration on Sustainable Agriculture, Resilient Food Systems and Climate Action. More than 150 countries endorsed the Declaration, recognising the threat of climate change to agri-food systems, the potential of these systems to respond to climate change and committing to integrate them into national 2025 climate plans.
- A number of health-focused side events were hosted, including a two-week program of events at the Health Pavilion. The side event ‘Unbearable Heat and Unbreathable Air: Finding Win-Win Solutions for Climate and Health’ discussed how climate change contributes to the growing NCD burden, solutions that can address both issues, and the need to integrate health into the international climate change agenda.
- The launch of several health initiatives, such as WHO EURO’s Diet Impact Assessment modelling tool modelling tool, which helps countries analyse the health and environmental impacts of diets, including those related to NCDs and climate change.
- The conclusion of the first global stocktake, a five-year review of Parties’ collective progress towards meeting the Paris Agreement. In response to findings that current progress is off track, Parties agreed to transition away from fossil fuels. Though this was the first COP decision to mention fossil fuels, it has drawn criticism for not including “phase out” language. This omission perpetuates multiple health threats, including from air pollution caused by continued fossil fuel combustion.
While COP28’s recognition of the climate-health nexus is a welcome development, countries must now translate this into national action. Here are some practical ways that countries can use law and policy to address climate change and NCDs at the national level:
- Set air quality and emissions standards to regulate the release of pollutants from various sources such as vehicles and industry.
- Phase out polluting products and activities in favour of cleaner alternatives (e.g., transition away from polluting cooking stoves and wood heaters to reduce indoor air pollution).
- Establish suitable separation distances between land uses that diminish air quality (e.g., commercial, industrial and transportation activities) and sensitive land uses (e.g., residential areas, schools and healthcare facilities).
- Promote public and active transportation options and integrate green spaces and shade into urban planning.
- Develop policies to encourage sustainable and healthy food systems.
- Address the environmental impact of NCD risk factors, including by implementing Article 18 of the WHO Framework Convention on Tobacco Control – which requires Parties to consider the environmental and health impacts of tobacco cultivation and manufacture – and the recent decision of its COP on tobacco and the environment.
- Adopt fiscal policies that address both climate and health, like carbon taxes that can discourage emissions and generate revenue for health investments; or redirect subsidies away from environmentally harmful sectors to support health initiatives and sustainable practices.
- Establish governance frameworks to facilitate coordination between health and climate-related agencies on shared priorities.
- Safeguard law and policy-making processes by implementing measures such as conflict-of-interest laws to prevent undue influence from commercial interests.
- Provide avenues for affected communities to participate in law and policy-making processes and hold decision-makers to account, such as through public interest litigation.
- Encourage the healthcare sector to reduce its carbon footprint, while ensuring patient safety and quality of care. This could include prioritising energy-efficient facilities and reducing unnecessary testing or treatment.
- Continually address the social determinants of health, such as income and social protection, education, food insecurity, and access to housing and basic amenities, to ensure the benefits of a clean environment are shared equitably.
We’re still in the early stages of understanding the complex links between climate change and NCDs, and how to address these. Yet, one thing is clear: there’s no silver bullet solution to these worsening crises. A range of concrete legal and policy actions are needed at the international, national and local levels to protect health and improve quality of life.
We welcome the growing momentum for action at the international level – with the World Health Assembly recently passing a landmark resolution on Climate Change and Health, and the WHO announcing that Second Global Conference on Air Pollution and Health will be held in Colombia next year.
By tackling these issues together, co-benefits for health and the environment, such as cleaner air, reduced exposure to pollutants, healthier diets and increased physical activity, can be realised.
By Anasha Flintoff, Legal Research Officer, with thanks to the considerable assistance of the McCabe team