As leaders gather for COP28 in Dubai, where the first ever health day and climate-health ministerial will take place, the need to highlight how ambitious policies and actions to cut greenhouse gas emissions can save lives has never been greater.

Despite increasing awareness of the growing and unequal impacts of climate change on health, progress towards global climate goals is insufficient to avoid disaster. Climate change is threatening our food security and water supplies, changing patterns of infectious disease spread, increasing the likelihood of extreme weather events and exacerbating inequalities.

Adaptation is essential to protect communities from changes that cannot be avoided. But in order to ensure a safe and sustainable future, adaptation alone is not enough. Governments must address the systemic drivers of rising greenhouse gas emissions and support a rapid and just transition to net zero. The health, societal and economic benefits of doing so could be substantial.

A recent report by the Lancet Pathfinder Commission highlights three key pathways to health from climate mitigation actions: reduced air pollution through phasing out fossil fuels and transitioning to clean renewable energy; a shift to healthier more sustainable diets; and increased physical activity from promoting active mobility (walking and cycling) alongside improved public transport. The report brings together global evidence showing that actions across sectors to reduce greenhouse gas emissions have the potential to prevent millions of premature deaths worldwide each year.

Further studies show that air pollution from fossil fuel burning is estimated to be responsible for over 5 million premature deaths a year; over 5 million deaths are linked to physical inactivity; and over 10 million deaths a year could be prevented through changes towards diets that include more whole grains, vegetables, fruit, nuts and legumes, with less red meat and processed foods.

The health co-benefits of climate mitigation actions would help to address these burdens of ill-health in the near term, in addition to reducing future risks of climate change. Emphasis on the health gains and returns on investment that can be achieved through reducing greenhouse gas emissions should be a powerful incentive for governments and decision makers at all levels to increase ambition and integrate health into climate policies. High-emitting, high-income countries must lead the way with the biggest cuts, and support low-emission development pathways in low- and middle-income countries.

This year will mark the first Global Stocktake (GST), a five-year assessment of collective progress towards meeting the goals of the Paris Climate Agreement. Though we know that we are not on track to limit warming to 1.5C of pre-industrial levels, the GST provides an important tool for advancing climate action and encouraging countries to set more stringent targets. Monitoring the health and equity implications of delivering the Paris Agreement should be a key focus of the GST going forward.

The World Health Organization’s 2023 review of health in nationally determined contributions (NDCs) and long-term strategies (LT-LEDS) shows that significant progress has been made in the integration of health into national plans, but actions are not yet happening at the scale and pace required, while financing for both adaptation and mitigation remains inadequate. COP28 provides an opportunity to change course.

As part of research for the Pathfinder Initiative*, researchers from the London School of Hygiene & Tropical Medicine have gathered case studies from around the world of climate actions that have contributed to greenhouse gas emissions reductions and brought benefits to health and society. Examples include transitioning to renewables for electricity generation in the United States; improving energy efficiency of homes in Victoria, Australia; creating a network of cycle lanes and a bike sharing scheme in Buenos Aires, Argentina; and using nature-based solutions to restore and protect natural ecosystems while bringing health and livelihood benefits to local communities in Tanzania and Ethiopia.

It is encouraging to see these actions being implemented across sectors and at a range of scales. But further examples are needed to inform and inspire change. This will require policymakers, researchers, funders and communities to work together, not only to deliver transformative actions to address the climate crisis, but also to monitor and evaluate the impact of actions on health and equity.

Following recommendations from the Lancet Pathfinder Commission report, partners of the Pathfinder Initiative are now forming a global coalition of partners committed to the implementation, monitoring and evaluation of climate actions for health. Countries, cities, non-governmental organisations, businesses and their representative bodies, funding agencies and research institutions are encouraged to join this collective effort to advance research, policy and action on climate and health.

The fact that health has been included as a key theme for the first time at COP28 is an important step. But the conference must also deliver a genuine commitment to put health and equity at the centre of climate action, facilitate a fast and equitable phase-out of all fossil fuels, and accelerate people-centred transformation across all sectors of society. Failure to do so would be a missed opportunity to ensure a healthy, sustainable net-zero future for all.

*The Lancet Pathfinder Commission and its report are part of the wider Pathfinder Initiative that aims to accelerate the transition to net-zero societies through providing practical, evidence-based emissions reduction pathways that also benefit human health. The initiative is funded by the Wellcome Trust with support from the Oak Foundation. Research is led by the London School of Hygiene & Tropical Medicine; partners of the first phase of work include C40 Cities, CDP, the Organization of Economic Co-operation and Development (OECD), the Sustainable Development Solutions Network (SDSN), and the Alliance for Health Policy and Systems Research. 

This piece was originally published on the OECD Forum Network website.