On 24-29 April, the First International Conference for the Just Transition Away from Fossil Fuels will take place in Santa Marta, Colombia. Ahead of this conference,Global Climate and Health Alliance Executive Director Dr Jeni Miller outline how phasing out fossil fuels could be one of the most powerful public health interventions of our time, and the specific steps that the governments gathering at Santa Marta can take to make this so.
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On April 24, government delegations from more than 50 countries will gather in the Colombian city of Santa Marta to design an escape route from our fossil fuel addiction. While participants debate emissions, economics, and the financial cost of changing our ways, they must also recognise that health is our real wealth.
Civil society will also be present, including the organisation I work for – the Global Climate and Health Alliance, a consortium of over 250 health organisations working to accelerate climate action. We support and will participate in the Santa Marta Conference on Transitioning Away from Fossil Fuels, which the organisers hope will establish new space for dialogue – free from the pressure of fossil fuel industry lobbyists and petrostate influence – so they can kickstart a better future.
As I well know from my years working on preventing children’s asthma in neighborhoods exposed to diesel truck emissions and oil processing facilities, getting off of fossil fuels is crucial for human health and well-being, not a mere side benefit. By focusing solely on carbon, energy, and economics when discussing climate, we risk missing what’s really at stake – people’s health. Fossil fuels cause immediate harm – phasing them out is not only essential to protecting the planet but also critical to saving lives in the near term, reducing strain on health systems, and creating greener, more just, and healthier societies.
Our report, Cradle to Grave: The Health Toll of Fossil Fuels and the Imperative for a Just Transition shows that along with causing climate change, fossil fuels harm health at every phase of the industrial cycle, from extraction and processing to transport and burning, and in every stage of human life, from fetus to childhood to old age.
The Health Cost
The full economic cost of the wide-ranging health harms caused by fossil fuels has yet to be comprehensively estimated. Yet even a partial picture is staggering: air pollution from all sources, but with fossil fuels as a major contributor, costs the global economy approximately $8.1 trillion each year in healthcare expenses, lost productivity, and premature deaths, out of a total global economy of around $120 trillion.
Yet despite overwhelming evidence, health has remained largely absent from fossil fuel transition plans. Policy debates focus on energy security, economic growth, and climate emissions, while overlooking the health costs of fossil fuels borne by families, communities, and health systems. In doing so, they also fail to figure in the significant economic benefits of moving from fossil fuels to clean energy – like lower healthcare costs, higher productivity, and more climate-resilient economies and populations.
Health impact assessments, incorporating health into cost-benefit analyses, and accounting for full lifecycle harms of all fossil fuel projects makes the true costs visible, revealing that phasing out fossil fuels is both environmentally necessary and economically sound. Analysing and quantifying these health impacts and their costs also makes crystal clear that polluters should pay and be held legally accountable – public budgets, health systems, and communities should not be saddled with the bill for these impacts.
Ending Fossil Fuel Subsidies
Fossil fuels continue to receive significant subsidies: US $725 billion in 2024. This is public money – our money – used to prop up an industry that drives disease and premature deaths, that we then pay for again through the increased burden on our health systems. By concealing the true price of fossil fuels, subsidies make the transition to clean energy appear expensive.
Redirecting these funds to clean energy will generate savings by reducing the harms of fossil fuels, savings that in turn allow for greater investment in public goods like healthcare, education and social protection, providing immediate benefits and supporting vulnerable communities. Just and equitable subsidy reform should be recognized by governments as a common sense public health measure, and the health community hopes to see progress from Santa Marta in this regard.
Challenging the Social License of the Fossil Fuel Industry
Despite everything we know about the environmental and health harms from fossil fuels, the industry still wields enormous influence over our daily lives through advertising, sponsorships, public relations, and partnerships, including with the health sector. In the public health community we have seen the consequences of such influence – so we took action – banning tobacco sponsorships and advertising, and putting in place clear rules around conflict of interest to prevent the industry from shaping the policies required to regulate it. The same must happen with fossil fuels, and the forward-thinking governments convening in Santa Marta have the chance to initiate guardrails to curb industry influence.
Legal Accountability
The Santa Marta conference also provides a ripe opportunity to connect transition discussions with emerging legal frameworks and accountability mechanisms. Recent developments, including advisory opinions from international courts and the growing recognition of the right to a clean, healthy, and sustainable environment, are opening new pathways to hold both states and corporations accountable for the harms caused by fossil fuels.
The meeting provides a platform to implement the ICJ Advisory Opinion on states’ legal duties related to climate change, promote accountability and justice, and to emphasise that moving away from fossil fuels is a legal and moral obligation rooted in health and human rights.
Phasing out fossil fuels could be one of the most powerful public health interventions of our time. There are many concrete and specific steps that the governments gathering at Santa Marta to lead on fossil fuel phase out can take to make this so. Putting health at the heart of every decision taken, every declaration made in Santa Marta will put us on a path to an energy transition that protects people, protects the environment, and transitions us to healthy economies.
