Over 28,000 people participated in the UN Climate Change conference (COP24) this December in the coal capital of Europe - Katowice, Poland - one of Europe's most air polluted regions. The World Health Organization (WHO) put health in the climate context by launching a COP24 Special Report on Health & Climate Change - a report that should not be forgotten about in the orbit of UN publications. In this special report, the WHO reiterates the strong links between climate and air pollution - which currently has a death toll of approximately 7 million people annually, causing diseases such as strokes, heart disease, lung cancer, and respiratory infections. The report also outlines a framework for addressing climate change and global health goals by laying out a robust set of 7 recommendations for governments and the health sector to maximise the health benefits of tackling climate change and avoid the worst health impacts of this global challenge.
Michal Kurtyka, President of COP24 at the launch event of the WHO Special Report on Health & Climate ChangeImage
Delegations of diverse organisations (coordinated by the Global Climate and Health Alliance) representing doctors, nurses, environmental health professionals, medical students, and policy experts formed a working group for the duration of COP24, demanding that health be at the heart of discussion and policy decisions at the UN climate negotiations. The unofficial thematic day on climate and health at COP24 fell on Saturday 8 December, when a wide array of health sector actors gathered at the Global Climate & Health Summit to address the urgent need for collaboration in the face of what has been described as the greatest health threat and opportunity of the 21st century: climate change.
Speaking at the summit, representatives from the Polish health sector outlined how health professionals are on the front lines when it comes to climate-related disasters and highlighted that the true cost of climate inaction is already being felt in hospitals. The concluding message from the summit: there is no need and absolutely no time left to wait for national governments to put the world on a safe temperature pathway.
Health professionals, as trusted, connected, and committed climate advocates, have an important role to play in achieving wide-scale behavioural change and addressing and reducing the environmental impact of providing care. Organisations like Healthcare Without Harm (HCWH) serve as a platform to connect committed health systems and professionals, and promote solution, to enable the health sector to lead the transition to a low carbon economy, ensuring a sustainable and healthy future for all.
EHCC at the Global Climate & Health Summit - Visionary health systems showing leadership for climate-smart healthcare
At the Global Climate & Health Summit, the HCWH team and members voiced how engagement for newcomers looks like and how hospitals and health systems can lay down the first stones of a pathway that is climate-smart.
As part of this movement, in 2016 HCWH Europe established the European Healthcare Climate Council (EHCC) - a coalition of leading hospitals and health systems that are committed to strengthening the sector’s response to climate change.
Members of the EHCC also attended the Summit and reflected on what the healthcare sector can do to address climate change:
Radboud University Medical Center (The Netherlands) has a vision for climate-smart healthcare that saw the hospital commit to using 100% renewable electricity earlier this year. The organisation’s premise - that prevention is better than cure - was echoed by Radboudumc’s Wouter van Wijhe in Katowice:
“At Radboud, we have a holistic view of how the health sector engages in climate action. The health community and all actors that engage with the healthcare sector need to realise that they are also part of the broader ecosystem. Recognising that climate action benefits human health and wellbeing is crucial - the medical profession needs to acknowledge that human health and wellbeing is inseparably linked with a healthy environment. Air pollution serves as a great example - showing how the wider health community stands up and recognises the links between human induced environmental change and human health. The environmental determinants of health need to become an integral part of medicine and healthcare.”
The environmental determinants of health need to become an integral part of medicine and healthcare.
Wouter believes that the healthcare sector has a responsibility when it comes to tackling climate change, and that it is uniquely positioned to address this global challenge. He sees the healthcare sector as both the enabler and protector of the human right to health, and feels that advanced health systems can and should engage with other health systems facing challenges, thus ensuring that we can all live on a healthy planet. Furthermore, he believes that leadership is not about creating followers, but enabling others to lead, which is one of the goals of the EHCC.
This sentiment was also echoed by representatives from the Polish health sector at the Summit, who pointed out that less privileged countries are looking to wealthier and advanced Member States to lead from the front when it comes to sustainable healthcare.
Another EHCC member, The Sustainable Development Unit (SDU) of NHS England has carried out some of the most comprehensive research into the mapping of carbon emissions from the healthcare sector. Rick Lomax, SDU representative to the EHCC in Katowice reflected on the sector-wide climate action with a practical example:
“In England the government’s Climate Change Act (2008) set national carbon reduction targets, which the health and care system has adopted to provide an equal contribution. The national government has also proposed setting legally binding air pollution reduction targets in the proposed Clean Air Strategy (2018), to which the health and care system will assess how these targets can be embedded in to the NHS. The SDU in England publishes a report every two years to show where and how the system is progressing and set the direction and hot spots that need to be tackled going forward.”
The EHCC at the GCHA Summit – L-R: Susie Vernon, Sussex Community NHS Foundation Trust, Cathy van Beek, Chair of the EHCC, Rick Lomax, NHS SDU, Wouter van Wijhe,RadboudumcImage
Actors from the Polish health sector shared their challenges to take action during the GCHA summit and started a discussion whether health systems in wealthier and more advanced EU Member States should serve as leaders for innovative approaches that can be replicated in less privileged countries. Wouter van Wijhe from the Dutch Radboudumc believes that the healthcare sector has a duty and is uniquely positioned to address those issues that do harm to human health and wellbeing. Furthermore, he sees the healthcare sector as both the enabler and protector for the human right to health, where advanced health systems can and should engage with other health systems facing challenges, thus ensuring that all human beings, present and future, can live on a healthy planet.
According to Rick, a takeaway message for the SDU was to share the lessons learnt in Katowice about the universal risks of rising global temperatures and heat-related illnesses that affect all countries, irrespective of how developed their health systems may be.
Susie Vernon representing EHCC member the The Sussex Community NHS Foundation Trust (SCFT) pointed out that the NHS as a large scale provider is perfectly positioned to reduce its impact, and also feel the benefit. With 1 in 20 vehicles on the road attributed to NHS business, the SCFT’s multi-award-winning model for delivering sustainable healthcare to cut carbon, save money and support workforce wellbeing aims at greening the Trust’s travel and to significantly cut emission by reducing their business mileage without impacting on crucial clinical and operational roles and at the same time supporting wellbeing.
The Paris Agreement: a public health agreement
The UN climate summit is increasingly becoming both a technical platform for public health, where health-related messages can trigger attention on this global political stage, and that tangible climate action from the healthcare sector will be vital in reducing worldwide emissions. The WHO is investing vast efforts to link its agenda with the UN climate convention (UNFCCC) producing tools and resources for Member States and public health stakeholders, who are key to the meeting of the Sustainable Development Goals and targets.
Despite their efforts, unfortunately the health community at COP24 failed to successfully engage with countries to address health in the text of the Paris Agreement Implementation Guidelines, which were adopted in the final hours of the two-week long negotiations.
It is now therefore crucial for the health community to engage more fully with the UN climate change process. This is especially important as the post-2020 climate action plans (known as the Nationally Determined Contributions) will soon be updated. It is vital that health sector emissions are recognised and counted, and that the health effects of climate change are addressed.
Increased engagement in the COP process from the health sector is not enough, however - action is also needed at the national and EU levels, and HCWH Europe serves as a bridge between individual institutions and the public policy debate at all levels. Only by acting together and raising our collective voice can we truly create a health sector that does no harm and mobilises its ethical, economic and political influence to create an ecologically sustainable, equitable and healthy world.
The Call to Action on Climate and Health outlines a set of ten priority policy actions for health leadership to advance ambitious progress towards global climate and health goals endorse it here.
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Mireia Figueras Alsius and Viktor Jósa