Health at COP26: meaningful progress or watered down promises? 

Air Quality News reporter Chloe Coules reflects on the role of health at COP26 and explores whether the health emergency of climate change is being taken seriously by world leaders. 

The climate emergency is already affecting a range of social and environmental factors that contribute to our quality of health, including how clean the air is, how safe the water is to drink, and whether there is sufficient food and shelter for our global population.  

As a result of this, the World Health Organization (WHO) expects climate change to cause approximately 250,000 additional deaths a year between 2030 and 2050, from malnutrition, malaria, diarrhoea and heat stress.  

Going into COP26, as countries continued to fight ongoing waves of the Covid-19 pandemic and delegates arrived in Glasgow masked, sanitized and tested, discussions of health had never been more visible in modern society.  

While there is no direct evidence of a link between climate change and Covid-19, research has linked many of the root causes of an increased risk of pandemics with the root causes of climate change, such as deforestation and unsustainable meat production, making tackling the health impacts of climate change more pressing than ever if we want to prevent future outbreaks.  

The ongoing pandemic and increased awareness of health risks granted health a bigger platform at COP26 than had ever been seen at a UN climate conference, but did it do enough to deliver a sustainable and resilient future for healthcare? 

Building resilient health systems 

For the first time, the health community had its own pavilion at a UN climate conference, with the World Health Organization showcasing the arguments for ambitious climate action to protect health across different sectors and issues.  

Together with the UK government and other partners, WHO was able to establish the COP26 Health programme, an initiative to bring a stronger health focus and ambition to COP26. 

As part of the programme, over 50 countries committed to building climate resilient and low carbon health systems. Many countries also committed to transforming their health systems to be more sustainable, with 14 countries pledging to reach net zero carbon emissions in their health systems by 2050.  

Will Clark, Executive Director of Health Care Without Harm, explains: ‘The headline success story was that the governments of over fifty countries around the world made commitments to developing climate-resilient health systems, with most also going further and committing to low-carbon or even net-zero health systems. Given the contribution of the healthcare sector to global emissions (4.4% of net total) and the health impacts of a changing climate (which are becoming increasingly clear) this is a major step forward.’ 

The event also saw the creation of the headline Glasgow Climate Pact, which saw nations recommit to limiting warming to 1.5 degrees, alongside new commitments to reduce coal and revisit emission-cutting plans in a year.  

However, some health industry experts criticized the pact for not going far enough to outline how the pledges will be delivered. 

Dr Jeni Miller, Executive Director of the Global Climate and Health Alliance, “welcomed” the pact’s strong language recommitting governments to limiting warming but argues that it lacks sufficient information about how countries will deliver on their promises in such a crucial area, with every tenth of a degree of warming important when it comes to protecting lives from devastating climate impacts.  

She adds: ‘The health community came to COP26 with clear demands from 46 million health workers on issues critical to protecting people’s health and social equity – yet COP26 has delivered on just a few of them. 

‘Where progress was made it was incremental, when what was required was a great bound forward by governments. People’s health and lives remain grievously in harm’s way from climate change – and the clock is still ticking to achieve the 1.5C target.  

‘Coming out of this COP, governments cannot assume that they can now rest – they must instead push far beyond what is asked of them in the Glasgow Climate Pact in order to achieve what is required to protect human health from climate change.’ 

Watered down promises 

Ending coal use is key to protecting health, as burning the fossil fuels produces a range of toxic pollutants, including sulfur dioxide, nitrogen oxides and particulate matter, leading to over 800,000 premature deaths a year globally and many millions more serious and minor illnesses according to End Coal.  

Activists and health experts hoped that COP26 would see nations finally commit to cutting out coal. However, pledges to phase out its use in the Glasgow Climate Pact were watered down after last-minute objections from China and India, leaving the final document calling for a “phase down” not “phase out”.  

The last-minute softening of this language around coal was met with widespread disappointment from the health sector. 

Will Clark tells Air Quality News: ‘It was disappointing that China and India insisted on a last-minute softening of language around phasing out of coal power and fossil fuel subsidies – not only does burning coal contribute to change, but pollution from coal combustion also has a significant impact on human health. Just this week India shut five coal-fired plants in an effort to combat the appalling levels of air pollution being suffered by people in New Delhi.’ 

However, even a tiny shift away from coal use marks progress for air quality, according to Dr Jeni Miller.  

‘While it seemed that COP26 was set to deliver the crucial commitment of governments to phase out coal and end fossil fuel subsidies, this language was progressively whittled away during the drafting process of the Glasgow statement – a shameful act, given that air pollution from burning fossil fuels kills millions of people per year, with coal the worst offender. 

‘It is notable – and reprehensible – that even this weak language indicates progress, as it is the first time the need to phase out fossil fuels has ever been mentioned in a UNFCCC agreement.’ 

In addition, governments failed to deliver the $100bn USD per year of climate finance that had been promised last year to developing countries. 

This is concerning as developing countries with weaker health infrastructure and more vulnerable people are likely to be hit with the brunt of the health impacts of climate change.  

Dr Jeni Miller argues: ‘In vulnerable countries and communities, lives are being lost and people’s health is being harmed, now. Developed countries cannot just keep talking about finance for loss and damage and adaptation – they need to deliver the necessary resources. This has got to be a major focus of COP27, which will be hosted by Egypt on behalf of the Africa region.’ 

Ultimately, it is unclear whether COP26 delivered sufficient action to keep warming within 1.5 degrees, which will be crucial in preventing the worst health impacts.  

Professor of Economics at the University of Roehampton and former Green MEP, Molly Scott Cato, explains the impact that small temperature increases can have on health. 

‘Nations know they have to cut emissions deeper and faster. Yet despite a limited increase in ambition, the majority of countries have failed to strengthen the promises they made in Paris in 2015, leading well-respected Carbon Action Tracker, to put the world on track for a calamitous 2.4 degrees of warming. 

‘While the difference between 1.5 and 2.4 might not seem like very much, it is the difference between a liveable climate and one where thousands die from heat shock in Europe and millions are faced with starvation in Africa due to drought.’ 

Taking health seriously 

In the wake of an entirely different public health emergency, it was good to see health on the agenda at COP26, even if only in the fringes. 

However, Will Clark says health needs to play a bigger role in future conferences: ‘Given that climate change is now widely regarded as a spiralling public health emergency, we feel it could have had a much more prominent focus, particularly within the main negotiations. We will be advocating for a health day in Egypt next year with other global health partners.’ 

Although health was discussed in a more meaningful way than at past UN climate conferences, it still did not get the level of attention that is needed to address the impacts of climate change on human life. 

Climate change is already killing people. It’s not a health crisis of the future – it’s the most immediate threat to human life in the 21st century. And yet, the heath industry is left questioning whether COP26 gave the issue of health the moment in the spotlight it deserved.