WHO to promote finance, fossil fuel phase-out, and climate resilience of the health system at COP28

UNFCCC, a forum of 197 countries making climate deliberations, has so far not discussed with seriousness the climate change-health nexus but has incorporated a few references
Sultan Al Jaber officially assumes the role of COP28 President after being passed the gavel by his predecessor, COP27 President Sameh Shoukry. Photo: @COP28_UAE / X
Sultan Al Jaber officially assumes the role of COP28 President after being passed the gavel by his predecessor, COP27 President Sameh Shoukry. Photo: @COP28_UAE / X
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Health will take centrestage for the first time in the 27-year history of the United Nations Conference of Parties (COP), with a dedicated day on the theme Health/Relief, Recovery, and Peace on December 3 at Dubai, the venue of COP28.

The day, hosted by the COP28 Presidency along with the the World Health Organization (WHO), will have the very first climate-health ministerial which will see  more than 50 ministers of health, environment, and other sectors in attendance. 

WHO’s three calls at COP

On average, there were 86 days of health-threatening high temperatures between 2018 and 2022. Temperature and precipitation variations could increase the spread of vector-borne diseases, and the annual death toll of 700,000 may increase substantially without intervention. The year 2023 is the hottest year on record in 125,000 years, increasing the risk of such illnesses.

Tedros Adhanom Ghebreyesus, the director-general of WHO, said in a press conference on November 29 that he would make three calls specifically while at the COP28: Phase out fossil fuels, strengthen the climate resilience of health systems, and redirect fossil fuel subsidies towards the health sector.

On strengthening health systems to be more climate-resilient, Ghebreyesus said: “That means strengthening the health workforce and disease surveillance systems, building on investments that many countries made during the COVID-19 pandemic. And it means scaling up vector control and access to safe water and sanitation.”

The WHO director-general emphasised the health sector is at the frontline of the climate crisis. Despite this, it receives just half of one per cent of global climate financing. “The world spends trillions of dollars of public money in fossil fuel subsidies every year,” he added.

Ghebreyesus called on governments and investors to redirect those funds and requested high-income countries to honour their pledge of $100 billion in support.

Previously, COP28 President Sultan Ahmed Al Jaber recognised the need for increasing investment in the health sector. He said: “As we prepare for the groundbreaking Health Day at COP28, we are resolute in our determination to address the challenges posed to health by climate change and encourage ambitious investment in the health sector.”

Declaration on Climate and Health 

A draft developed by the COP28 Presidency, the Ministry of Health and Prevention (MOHAP) of the United Arab Emirates, and the WHO termed as “health and climate ministerial declaration” will be released during COP28.

The document aims to be a non-binding mechanism, existing outside the framework of the United Nations Framework Convention on Climate Change (UNFCCC). It will reflect the position and concerns of the countries on the climate change and health discourse. The draft is meant to engage all the parties convened in actions that address the urgent need for integrating climate and health.

The presidency launched the COP28 Declaration on Climate and Health during the World Health Summit in Berlin on October 17 and country endorsements of the declaration will be announced at COP28.

The zero-draft declaration, that is open for consultation, mentioned that one primary objective is the implementation of adaptation interventions against climate-sensitive disease and health risks, including bolstering climate-health information services, surveillance and early warning responses.

“These proposed commitments to fund adaptation in the health sector are certainly welcome. But if fossil fuels aren’t addressed, the declaration is incomplete,” Jeni Miller, head of the Global Climate and Health Alliance (GCHA), told Health Policy Watch, expressing her concern that the elimination of fossil fuels was not given weightage.

The George Institute of Global Health in India called for strengthening the UNFCCC Conflict of Interest Policy that further reduces the opportunity for influence by unhealthy commodity industries on COP outcomes.

“Strengthen the provision of mental health support and other primary healthcare services to improve psychological resilience and adaptation skills in the wake of environmental damage,” the Institute said in a statement prior to COP28.

According to an assessment by the WHO, 91 per cent of the available Nationally Determined Contributions (NDC) mentioned health considerations, up from 70 per cent of those reporting in 2019. Gaps still exist despite this improvement, as only 16 per cent of NDCs include standalone targets for air pollution and measures or policies to reduce air pollution.

For the third year in a row, the COP28 Health Pavilion will be hosted by WHO and the Wellcome Trust which will include as many as 40 events from December 1 to 12. On December 4, the Alliance for Transformative Action on Climate and Health will host a full day of events at the COP28 Health Pavillion.

The Energy for Health installation official opening is scheduled for December 2. It will showcase the importance of decentralised renewable energy solutions for the healthcare sector, for electrification and building climate-resilient health systems. The installation will be inaugurated by Ghebreyesus, UNICEF and India’s Selco Foundation.

UNFCCC, a forum of 197 countries making climate deliberations, has so far not discussed with seriousness the climate change-health nexus but has incorporated a few references.

A COP28 bulletin on health pointed out, “The 1992 framework of the UNFCCC recognised that climate change has an ‘adverse effect’ on human health (Article 1) and referenced the need for countries to minimise adverse effects on public health (Article 4.1.f).”

“Parties to the UNFCCC strengthened the rights-based approach to global climate policy in the Paris Agreement in 2015, by deciding to recognise the UN human right to health in its Preamble,” the bulletin added, suggesting that health has not been fully realised or valued in intergovernmental negotiations.

“Nearly 25 per cent of global deaths are attributed to economic decisions affecting the environment, but stakeholders from the health community are mostly unaware of — or not visible within — discussions and negotiations on global environmental policies,” a report by the international think tank International Institute for Sustainable Development said.

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