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Five breakthroughs on climate and health at COP28 – and what comes next

COP28 was a breakthrough moment for climate and health, highlighting the importance of the health sector in driving climate action, according to an advisor to the COP28 Presidency, Arthur Wyns.

His article below was first published by ClimaHealth, and is republished with permission.


Arthur Wyns writes:

Health has long been absent from United Nations climate summits — a major oversight given climate change is already affecting the health of people and communities around the world. The health impacts of climate change range from air pollution to heat waves, infectious diseases, food and water insecurity, mental health, and more.

As 2023 shattered climate records, the COP28 UN climate conference in Dubai in December 2023 shined a spotlight on the health impacts of climate change by hosting a dedicated ‘Health Day’, supported by a series of health initiatives to help drive transformational change for health and healthcare.

Here are five key areas of progress on climate and health that came out of COP28.

1. Over 100 countries signed the COP28 Declaration on Climate and Health

At COP28, 147 countries endorsed the COP28 Declaration on Climate and Health. This number represents more than 75 percent of the global population, global emissions and global GDP. A climate-health ministerial meeting on 3 December – the COP28 Health Day – was attended by senior delegates from 110 countries, including nearly 50 Ministers of Health, who shared their national priorities on climate and health.

The COP28 Declaration on Climate and Health represents a shared action agenda and commits countries to scale up both mitigation and adaptation actions to better protect and promote the health of people and communities in the face of a changing climate, including by: transforming health systems to be climate-ready and climate-friendly; by increasing finance for climate and health solutions; and by integrating health considerations into climate plans and policies.

Critically, the declaration commits countries to take health into account in their national climate plans, known as Nationally Determined Contributions or NDCs. The vast majority of NDCs already include health targets, and further strengthening and improving these health targets could drive more ambitious climate action and speed up the implementation of existing commitments.

For example, by prioritising actions that both improve health and cut emissions – such as promoting the shift to sustainable healthy diets or replacing fossil fuel transport with walking and cycling – countries and communities can reap health benefits which outweigh the initial financial investments necessary to mitigate climate change.

The next round of NDCs are due in 2025, ahead of COP30 in Brazil. This provides countries with a clear timeline to turn the health commitments they made at COP28 into action.

The Declaration has built strong political momentum for more action on climate and health. This is expected to translate in continued prominence of climate change in global health fora, including at the 2024 G7 and G20 meetings, and through the adoption of a resolution on climate and health at the seventy-seventh World Health Assembly in May 2024.

2. More than $1bn was promised for climate and health solutions

Health-specific climate action remains extremely underfunded, with only two percent of adaptation funding and 0.5 percent of multilateral climate funding currently allocated to projects that explicitly aim to protect or improve human health.

COP28 made significant progress in closing this finance gap, with US$1 billion of funding announced for climate and health. Finance commitments were made by a range of partners, and included $500 million by the Global Fund to support low- and middle-income countries in addressing health impacts of climate change over 2024 – 2026; a new $30 million clean air initiative by Bloomberg Philanthropies, Clean Air Fund and C40 Cities, and a $100 million commitment to advancing climate and health solutions by the Rockefeller Foundation.

In addition, COP28 launched a set of guiding principles for financing climate and health solutions, intended to foster innovation and collaboration in the climate and health finance landscape.

The Guiding Principles have been endorsed by over 40 financing institutions, governments and implementation partners, including: the World Bank Group; the Green Climate Fund; the governments of Norway and the United Kingdom; the Wellcome Trust; and others.

The shared principles signal the growing momentum and collaboration across funders to support climate and health solutions. 2024 will see more funding going to the testing and scaling of climate and health solutions, alongside improvements in transparency and the tracking of progress.

3. Health was a driving force for ambition at the UN climate negotiations

COP28 saw the adoption of the first-ever Global Stocktake  which assessed the world’s progress on climate action to date and set a roadmap for the future. The outcome included a commitment by all countries to transition away from fossil fuels, following yearlong advocacy efforts by scientists, health professionals and others. It represented the first time the term ‘fossil fuels’ was included in the formal outcome of a COP since UN climate negotiations began 31 years ago, and is now widely seen as representing the “beginning of the end” for fossil fuels.

This comes not a moment too soon, with new research concluding that air pollution from the burning of fossil fuels is responsible for five million premature deaths a year, while the 2023 report of the Lancet Countdown revealed the rising health toll of a changing climate.

Another crucial outcome for health at the UN climate negotiations at COP28 was the adoption of a Global Goal on Adaptation, representing a framework for the global response to rising climate impacts. The Goal’s overarching target is health-focused, calling on countries to prioritise the collective well-being of people, the protection of livelihoods and economies, and the preservation and regeneration of nature when designing and implementing climate adaptation plans. It also captures a series of global adaptation targets for specific themes and sectors, such as health, water, food and infrastructure.

Throughout 2024 and 2025, climate negotiations will agree on a series of more granular indicators to support the monitoring of country progress towards building more adaptive and resilient societies and communities. The health and wellbeing of people will be used as a guiding compass in these efforts.

4. Climate action in the healthcare sector is picking up pace

The healthcare sector accounts for roughly five percent of net global emissions, 84 percent of which derives from fossil fuel combustion. As a major part of the global economy, health systems have an important role to play in transitioning the world away from fossil fuels and towards zero emissions.

COP28 saw the momentum behind healthcare climate action growing, with 81 countries now part of the WHO-hosted Alliance for Action on Climate Change and Health (ATACH), an initiative committed to building climate-resilient and sustainable health systems. In 2023, the ATACH initiative also launched a community of practice, capturing resources, guidance and best practices from around the world.

The role of private sector healthcare actors is steadily growing; over 14,000 hospitals and health centres in 26 countries have committed to net zero emissions by joining the UN Framework Convention on Climate Change (UNFCCC) Race to Zero; some of the largest healthcare companies are breaking new ground towards net zero healthcare as part of the Sustainable Market Initiative’s Health Systems Task Force; while the World Economic Forum established a climate and health initiative to further strengthen public-private partnership.

2024 will likely see private healthcare partners stepping up in a big way to decarbonise their industry, while a growing number of national governments will be able to show tangible results after taking the first steps to build more climate-resilient and sustainable health systems.

5. A global movement for climate and health

The global health community has been advocating for stronger action on climate for many years, with a growing number of medical bodies and organisations taking action and participating in the UN climate conferences.

This momentum accelerated significantly in 2023, with many new health organisations developing climate programmes, an increase in media coverage, and the establishment of a dedicated climate and health network. Ahead of COP28, organisations representing over 46 million health care workers from 135 countries called for the phasing out of oil, coal, and gas by signing a COP28 Open Letter on Fossil Fuels.

Health day at COP28 reflected this growing momentum in a rich and diverse programme of events, talks and art installations on 3rd December. A dedicated Health Pavilion offered a two-week programme of events showcasing evidence, initiatives and solutions to maximise the health benefits of tackling climate change.

COP28 was a breakthrough moment for climate and health. However, it will be the actions by governments, financial institutions, the private sector and other actors in the next two years that will determine whether COP28 did indeed move the needle in addressing the climate crisis as the greatest threat to human health we face.

• Arthur Wyns is Climate & Health Advisor to the WHO and COP28 presidency, and an Honorary fellow, Melbourne Climate Futures, Melbourne School of Population and Global Health, The University of Melbourne. This article was first published by ClimaHealth, a global open-access platform was developed by the  World Health Organization (WHO) and World Meteorological Organization (WMO) to serve as a technical reference point for users of interdisciplinary health, environmental, and climate science. It is managed and maintained by the WHO/WMO Joint Office for Climate and Health in Geneva, Switzerland, and is supported by funding from the Wellcome Trust.

Further reading

See this report by Arthur Wyns, from COP27 in 2022, when he was representing the Climate and Health Alliance: In the spirit of “stubborn optimism”, what does COP27 mean for our health?


Follow Croakey’s #HealthyCOP28 coverage.

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