Achieving a cleaner, more sustainable and healthier future
Dr Margaret Chan
Director-General of the World Health Organization
In 2009, as countries prepared to negotiate a global climate treaty in Copenhagen, Denmark, the front cover of the first Lancet Commission on health and climate change issued a stark warning: “Climate change is the greatest health threat of the 21st Century”. This warning was not heeded: the overall agreement fell short of the necessary ambition, and health was noticeable by its absence from the negotiations. However, over the longer term, the Commission made its mark, contributing to a gradual but increasing engagement of the health community. As countries prepare again to reach a global deal on climate change, in Paris, France in December 2015, the health voice is louder, clearer, and increasingly listened to by our colleagues leading the negotiations.
The launch of the second Lancet Commission is therefore very timely. It is welcome not just for the summary of the evidence, but also for the wider scope, which makes connections between climate, health, economics, and energy decisions. I also congratulate the Commission for a comprehensive, ambitious, and forward looking set of recommendations, and encourage national Ministries of Health, and all health professionals, to consider each of them carefully. I would like to single out three of them where WHO will make a direct and specific contribution.
The first is the Commission’s recommendation to scale-up financing for climate-resilient health systems worldwide. WHO has estimated, considering only a few of the associated health risks, and assuming continued progress in economic growth and health protection, that climate change would still be likely to cause approximately 250 000 additional deaths per year by the 2030s. The best defence is the same one that will protect us from outbreaks of infectious disease, and the mounting burden of non-communicable disease: strong, flexible, and resilient health systems. In February of this year, the WHO Executive Board endorsed a new workplan on climate change and health. A central goal is to scale-up a systematic approach to strengthening health systems, to include specific measures to adapt to a changing climate, such as early-warning systems for more frequent and severe heatwaves, and protection of water, sanitation, and hygiene services against floods and droughts. As doing so will require additional resources, health needs to receive appropriate support from existing international climate finance mechanisms, which has not yet been the case.
- Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s
- Health and the environment: climate and health: outcome of the WHO Conference on Health and Climate
The second area is the set of recommendations on assessing the health implications of energy systems, and ensuring that these are factored in to overall government policies. Last year WHO documented that over seven million deaths every year are attributable to air pollution. This makes it one of the most important health risk factors globally, comparable to tobacco smoking, and the largest killer in some countries. Globally, 88% of the world’s population breathes air that does not meet WHO’s air quality guidelines. This is partly due to poverty and lack of access to clean energy—but it is also a result of policy choices. The health impacts of air pollution are not reflected in the price of the fuels that cause them, so that the cost is instead borne in lost lives, and health system expenditure. A recent report by researchers at the International Monetary Fund identifies the omission of health damages from polluting fuels as the largest of the subsidies provided to global energy production and use, , which will total US$5.3 trillion in 2015. This is larger than total health spending by all of the world’s governments. I am pleased to report that in May of this year, the World Health Assembly passed its first resolution on air pollution. This calls on countries, and the WHO Secretariat, to scale-up their response to this major health issue, strengthening the health sector’s contribution to decision making across sectors at local and national levels to clean the air and maximise health benefits. It also underscores opportunities to achieve co-benefits from actions that reduce emissions of warming climate-altering pollutants and at the same time improve health. We will indeed address the challenge of air pollution, and help guide countries to, wherever possible, make choices that also help to achieve climate change goals.
Burden of disease from the joint effects of Household and Ambient Air Pollution for 2012
- Air quality deteriorating in many of the world’s cities
How Large Are Global Energy Subsidies?
Health and the environment: addressing the health impact of air pollution
Thirdly, the Commission highlights the need for monitoring and assessment of progress, similar to the Countdown 2015 initiative that has helped to drive progress on reducing maternal and child mortality. This is critical: what gets measured gets done. Last year, at the first WHO global Conference on Health and Climate, the Executive-Secretary of the UNFCCC Secretariat and I committed to produce country-specific profiles on health and climate change in advance of the Paris climate change conference. These compile the best available evidence on climate risks to health, on the opportunities to improve health while reducing greenhouse gas emissions, and on the status of country policies. These can also serve as the baseline for monitoring future progress.
Finally, I draw attention to the Commission’s message that the health community has a vital role to play in accelerating progress to tackle climate change. To quote UN Secretary-General Ban Ki-Moon: “There is no plan B; there is no planet B”. Health professionals have been at the forefront of social changes, such as those that have gradually made smoking increasingly unacceptable, driving down smoking rates—and saving many lives. I endorse the call for the health community to support the growing movement for a cleaner, more sustainable, and healthier future.