The Health Community at COP28 – Where Do We Go to From Here?

Following December’s UN climate negotiations in Dubai,  Global Climate and Health Alliance Executive Director Dr Jeni Miller reflects on the climate summit’s outcomes, and the action needed next to protect people’s health from the climate crisis. 

Last December’s COP28 featured the first ever COP Health Day, which elevated the importance of protecting people’s health through action on climate change and put the issue before heads of state and their national delegations from around the world. Health Day also saw nearly 50 ministers of health coming to COP28 for the first time, and included an Inter Ministerial Dialogue along with representatives from ministries of environment and finance. The COP28 UAE Declaration on Climate and Health, launched during the Inter Ministerial event and signed by 148 countries (to date), called upon signatory governments to recognize that the climate crisis is a health crisis, and that addressing it requires both investing in health systems and working across sectors to protect health.

The Health Community at COP28
More than 1900 health sector representatives converged in Dubai, by far the greatest representation by the health community at a climate summit, and the health community played a role in driving COP28 to deliver an agreement on the need to end the use of fossil fuels.

The work began much earlier – during  2023 health leaders made clear that phasing out fossil fuels is a health imperative. This included sending a letter to the COP28 President Sultan Al Jaber, signed by leaders of organizations representing 46.3 million health professionals calling for commitments at COP28 to phase out fossil fuels. While investing in health systems is crucial to protecting health in the face of a changing climate, health systems won’t be able to protect people’s health if the Earth warms by three degrees Celsius – the level of warming toward which we are currently headed. The health community joined a chorus of leading governments, scientists, businesses, and climate groups, leading to governments committing during COP28, for the first time, to “transition away” from fossil fuels.

The events ahead of and during the summit demonstrated that organized engagement by the health community can make a difference. Seizing the opportunity provided by the COP28 Presidency’s decision to designate a Health Day, WHO and health organizations worked throughout the year to give substance to that symbolic day; health ministries fed into development of the COP28 climate and health declaration; and health organizations pushed for that declaration to be stronger. Health groups developed joint policy positions related to key areas of the negotiations, and supported public letters – not only on fossil fuel phase out, but also clean air and ministries of health in Africa came together to develop a Common Position on Climate Change and Health for the region, ahead of COP. Organized engagement by health professionals and health organizations shaped the content and impact of Health Day, and contributed to shaping a bit of the substance of what was decided in the negotiations.

Outcomes
COP28 took steps in the right direction for health, some of them quite important; and yet at the same time, it did not deliver the level of ambitious, serious, transformational action on climate change that we really need in order to protect health. The agreement reached at COP on fossil fuels came with loopholes by which countries can rationalize continued and expanded use of oil and gas. Meanwhile, a loss and damage fund was established, but with wealthy nations committing less than 0.2% of the estimated $400 billion per year, low income vulnerable countries need to be able to respond to and recover from the climate impacts they are facing.  The agreement on adaptation includes reference to health adaptation, but lacks clear metrics for assessing country progress, and lacks the necessary financial support to keep low income countries from being left behind. So while COP28 delivered some progress, much more needs to be done to achieve the climate action people’s health requires.

The health community can and must play a vital role.

Where do we go from here?
Via the COP process, it will be critical to push governments to build on and strengthen the commitments made at COP28, and GCHA will be working to bring a coordinated health message to that effort. But COP and the UNFCCC are by no means the only place where those of us from the health community can make a difference.

At the next World Health Assembly in May, Ministers of Health will have the opportunity to consider a new WHA resolution on climate change and health. The last resolution on the issue was adopted 14 years ago. Right now, Member States are in the process of developing the details of the proposed resolution to put forward in May.

To deal with climate impacts, each country’s health systems need to train and prepare the health workforce for how climate impacts may affect their patients, and hospitals and clinics need to be made more resilient to protect critical infrastructure from impacts like floods or power outages, and transition to stable and sustainable renewable energy sources. Working for universal health coverage is vital, so that community residents have good baseline health status, and are therefore more resilient and better equipped to deal with changing conditions. Public health systems must also be strengthened, with access to localized timely data in usable form, and the staffing they need, to identify opportunities to prepare their communities, and to develop adaptation plans.

Changes within our health systems are a natural place for health professionals to make a difference. There are real opportunities for health professionals and others in the health community to be champions for these changes, and for the investments needed to make them possible, both nationally and internationally. And health systems, often important anchor institutions in their communities, can be highly influential and lead by example.

So much of climate change, however, is determined outside of the health system, and indeed, so much of people’s health is determined by other sectors. That includes decisions about water and sanitation systems, urban development, transportation systems, energy systems. Policy decisions in other sectors can either result in health improvements, lives saved, illnesses, with implications, in turn, for the nation’s economy; or they can be responsible for significant health harms or lost opportunities for the population’s health. Health is needed at the table across sectors, to ensure that when decisions are made with people’s health in mind, and health expertise informs the outcome.

It might be many months until the next major climate summit, but climate change has not slowed down. In early January, the EU Copernicus Climate report confirmed that 2023 was warmest year on record. According to the World Meteorological Organization, this January was the warmest January on record. February is also set to break records. This year has already delivered storms around the world, and wildfires in Chile, exacerbated by a heatwave, that caused more than 100 deaths.

All the more reason for the health community to build on the momentum we generated during 2023, ramping up our influence, and accelerating transformational action throughout our societies. We have the opportunity to inspire our colleagues, our patients, our communities, and our governments to take steps to protect the health and wellbeing of everyone through ambitious policies and by taking bold stances at an international level. Let’s do this!