Concept Note_ A WHA Resolution on Climate Change and Health_September 2022

Concept Note: A WHA Resolution on Climate Change and Health
Policy Background
In 2008, the World Health Assembly (WHA) adopted resolution WHA61.19 on climate change and health1
, noting
that climate change could undermine efforts to improve public health and reduce health inequalities globally.
This was followed in 2015 by resolution WHA68.8 on addressing the health impact of air pollution2
, which is
both exacerbated by climate change and shares fossil fuel combustion as a common driver. Climate change was
additionally referred to in resolution WHA68.2 on the global technical strategy and targets for malaria
2016–2030 and WHA68.19 on the outcome of the Second International Conference on Nutrition3
. The World
Health Organization (WHO) Global Strategy on Health, Environment and Climate Change was adopted in 20194
,
and a platform of the 13th
General Programme of Work (GPW13) is dedicated to the issue of climate change in
Small Island Developing States (SIDS) and other vulnerable States5
. The Convention on Biological Diversity
considers health and biodiversity as a cross-cutting thematic area, with links between climate, health and
biodiversity acknowledged in resolutions adopted at COP13 in 20166
, and COP14 in 20187
. However, even at
1.1°C temperature rise since pre-industrial times, severe impacts of climate change are being observed in all
regions, and the world is off track to deliver the Paris Agreement target of limiting warming to well below 2°C
and preferably to 1.5°C. The contributions of Working Group II and Working Group III to the latest
Intergovernmental Panel on Climate Change (IPCC) Sixth Assessment Report provide the latest evidence on
impacts, indicating progressively worse health outcomes in the coming decades, as well health co-benefit
opportunities of strategic climate action8,9
. An updated WHA resolution on climate change and health is
therefore both timely and necessary.
Climate Change and Health
Climate change has been described as the greatest health threat of the 21st
century10
. Climate-related impacts
threaten both public health and healthcare infrastructure (including hospitals, clinics and supply chain
infrastructure), making it a major environmental determinant of health and undermining progress towards
universal health coverage (UHC). Meanwhile, action to address climate change offers a great opportunity for
health, benefitting both people and the planet.
As recognised by both the WHO and the IPCC, climate change is a threat multiplier, driving heatwaves and other
extreme weather events, vector- and water-borne disease transmission, food and water insecurity, negative
10
World Health Organization, 2018. COP24 Special Report: Health and Climate Change. Online.
9
Intergovernmental Panel on Climate Change Sixth Assessment Report, 2022. Working Group III Contribution, Climate Change 2022: Mitigation of
Climate Change. Online.
8
Intergovernmental Panel on Climate Change Sixth Assessment Report, 2022. Working Group II Contribution, Climate Change 2022: Impacts,
Adaptation and Vulnerability, Chapter 7. Online.
7
Convention on Biological Diversity. Biodiversity and Human Health (14/4). CBD, 2018. Online.
6
Convention on Biological Diversity. Biodiversity and Human Health (XIII/6). CBD, 2016. Online.
5
World Health Organization, 2018. Thirteenth General Programme of Work, 2019-2023. Online.
4
World Health Organization, 2019. Global Strategy on Health, Environment and Climate Change. Online.
3
World Health Organization, 2015. Sixty-eighth World Health Assembly Resolutions and Decisions. Online.
2
World Health Organization, 2015. Resolution WHA68.8, Health and the environment: addressing the health impact of air pollution. Online.
1
World Health Organization, 2008. Resolution WHA61.19, Climate Change and Health. Online.
mental health impacts, and exacerbating non-communicable diseases (NCDs) including chronic respiratory
disease, cardiovascular disease, neurological conditions and mental health conditions. These challenges are
further compounded by climate-induced migration. Overall, climate-sensitive diseases caused 39.5 million
deaths in 2019 (69.9% of total annual deaths)11
, undermining the right to health and a healthy environment,
with the latter now recognised by the UN General Assembly as of July 202212
. Climate related health impacts can
be catastrophic, resulting in severe loss and damage in social and economic terms for communities and entire
countries. Populations forced to migrate by climate change also face compounded health risks. Countries with a
high burden of climate sensitive disease stand to be severely impacted by progressive warming13
. Climate change
exacerbates existing health inequalities both within and between countries. Furthermore, the same
unsustainable systems which accelerate climate change and encroach on nature also lead to increased risk of
emergence of new zoonotic diseases.
New and growing disease threats associated with climate change place strain on under-resourced health systems
and necessitate rapid adaptation in the health sector to build climate-resilient health systems to guard against
climate change undermining progress towards UHC. Underlying gaps in disaster-specific adaptive capacity
prevails in most countries, rendering communities to increasing risk as climate disasters escalate14
. National
adaptation plans (NAPs), nationally determined contributions (NDCs), and other party-driven work under the
United Nations Framework Convention on Climate Change (UNFCCC) need to include specific focus on protecting
health. At COP26, WHO and partners launched the COP26 Health Programme initiative, under which 60
governments have now committed to health systems which are both climate resilient but also low-carbon and
environmentally sustainable15
. WHO has also promoted quality criteria to develop health national adaptation
plans (HNAPs)16
. Such measures will require robust financing, including international finance for low- and
middle-income countries.
Meanwhile, climate action, such as cutting use of fossil fuels, increasing walking and cycling and transitioning to
plant-rich diets, not only prevents health impacts but yields far-reaching health benefits. Measures to reduce
emissions in line with the Paris Agreement would prevent 1.18 million air pollution-related deaths, 5.86 million
diet-related deaths, and 1.15 million deaths due to physical inactivity, across just nine countries, by 204017
. In
particular, a just transition18
away from fossil fuels (with no new expansion and phase-out of existing
infrastructure, as per the proposed Fossil Fuel Non Proliferation Treaty19
) and the ending of fossil fuel subsidies
are public health imperatives, and are indispensable to achieve SDG320
. In addition, adaptation measures in
non-health sectors including agriculture, water and sanitation, urban planning, and nature-based solutions can
improve food and nutrition security, provide safe living environments with protection from heat and extreme
weather events, and improve mental health.
Adopting a One Health21
approach would help to bring together evidence and actions across health and
health-determining sectors, and across scales of society to reflect the complex, interconnected reality of climate
change and health.
21
UN Environment Programme, Food and Agriculture Organization, World Health Organization, World Organisation for Animal Health, 2021. Joint
tripartite and UNEP statement on definition of “One Health”. Online.
20
World Health Organization, 2020. WHO Manifesto for a Healthy Recovery from COVID-19: Prescriptions and Actionables for a Healthy and Green
Recovery. Online.
19
The Fossil Fuel Non Proliferation Treaty, 2022. Online. The Treaty Principles are supported by health professionals from around the world (signed
by over 200 organizations and 1400 individuals as of 12 September 2022).
18
According to the International Labour Organization, a just transition refers to greening the economy in a way that is as fair and inclusive as
possible to everyone concerned, creating decent work opportunities and leaving no one behind. A Just Transition involves maximizing the social and
economic opportunities of climate action, while minimizing and carefully managing any challenges – including through effective social dialogue
among all groups impacted. Online.
17
Hamilton et al, 2021. The public health implications of the Paris Agreement: a modelling study. Lancet Planetary Health 5(2): E74-E83
16
World Health Organization, 2021. Quality Criteria for Health National Adaptation Plans. Online.
15
World Health Organization, 2022. COP26 Health Programme. Online.
14
Marcus H, Hanna L, 2021. Barriers to Climate Disaster Risk Management for Public Health: Lessons from a Pilot Survey of National Public Health
Representatives. Disaster Medicine and Public Health Preparedness 2022; 16(4): 1351–4
13
Intergovernmental Panel on Climate Change Sixth Assessment Report, 2022. Working Group II Contribution, Climate Change 2022: Impacts,
Adaptation and Vulnerability, Box 7.2. Online.
12
UN General Assembly, 2022. Resolution A/76/L.75, Promotion and protection of human rights: human rights questions, including alternative
approaches for improving the effective enjoyment of human rights and fundamental freedoms. Online.
11
Intergovernmental Panel on Climate Change Sixth Assessment Report, 2022. Working Group II Contribution, Climate Change 2022: Impacts,
Adaptation and Vulnerability, Chapter 7, Box 7.2. Online
Potential Actions for WHO Secretariat
● Update the estimate for the current global burden of disease mortality attributable to climate change.
This will aid the direction of necessary funding to address the issues at hand, and inform relevant
climate change adaptation actions and funding. In addition, develop an estimate for the global burden
of disease attributable specifically to fossil fuel use.
● Continue and expand the WHO and UNFCCC Health and Climate Change Country Profiles project,
complemented by tools to calculate the health impacts of climate change at national level.
● Build capacity of National Focal Points and other Member State representatives to respond to the health
impacts of climate change by developing specific guidance in responding to heat and other extreme
weather events, and also by integrating climate change into programmatic work including but not
limited to vector-borne and water-borne diseases, nutrition, sanitation, NCDs and mental health,
reproductive maternal newborn child and adolescent health (RMNCAH), migration, health systems
strengthening and UHC, pandemic prevention, and emergency preparedness.
● Develop guidance on cross-sectoral coordination at national level for health and climate change,
including as part of a One Health approach, and complemented by lists of priority policies across
sectors. Specifically, support Member States to quantify health co-benefits of mitigation in additional
sectors, such as the food and agriculture sector and nutrition, including complementing the Carbon
Reduction Benefits on Health ‎
(CaRBonH)22
tool on air pollution and the health and economic
assessment tool (HEAT)23
for cycling and walking.
● Work together with other UN Agencies supporting the SDG3 Global Action Plan to develop policy
recommendations promoting measures to regulate fossil fuels on health grounds comparable to those
to regulate tobacco, including fiscal policies which reflect the true costs of unhealthy commodities and
regulation of advertising. Provide guidance for Member States on protection of public health policies
with respect to climate change from commercial and other vested interests of the fossil fuels industry,
following the example of Article 5.3 of the Framework Convention of Tobacco Control, and existing
guidance for WHO staff on limiting engagement with the alcohol industry24
.
● Provide technical assistance to support Member States in delivering the COP26 Health Commitments,
including developing national strategies and plans for adaptation and mitigation in the health sector and
in using existing tools developed by WHO including those on conducting vulnerability and adaptation
assessments and developing HNAPs.
● Build on existing resources such as the online Health in UN Climate Negotiations Course25
to support
representatives of national ministries of health to engage in UNFCCC processes, including the
integration of health into NDCs and NAPs and other Party-driven work under the UNFCCC, and
participation of health sector representatives in COPs and Subsidiary Board meetings.
● Build capacity of Member States to secure required finance through facilitating the sharing of examples
of good practice in applications for funds for health projects, including to the Green Climate Fund, the
Global Environment Facility, and the Adaptation Fund.
● Work with the Quadripartite (FAO, UNEP, WOAH), WMO, UNDP, Unicef, World Bank, the Convention on
Biological Diversity secretariat, the United Nations Framework Convention on Climate Change
secretariat, and other appropriate organizations of the United Nations, to ensure that these health
impacts and their resource implications are understood and can be taken into account in further
developing national and international responses to climate change. Establish a formal concrete
structure to support collaboration across these agencies, with an accompanying joint programme of
25
World Health Organization, 2019. WHO launches Online Training on Climate and Health in the UN climate negotiations. Online.
24
World Health Organization, 2019. Information Note 12/2019: Principles and guidance for interaction between WHO Secretariat and the alcohol
industry.
23
World Health Organization Regional Office for Europe, 2017. Health economic assessment tool (HEAT) for walking and for cycling. Online.
22
World Health Organization Regional Office for Europe, 2018. Carbon Reduction Benefits on Health. Online.
work, building on the existing collaboration of the WHO/WMO Joint Office, and the model of the
Quadripartite.
● Convene a high-level conference on Health and Climate Change, with a view to securing a UN General
Assembly High Level Meeting on Health and Climate Change by 2028.
● Allocate increased financial provisions to the issue of climate and health in future budgets, and a
worldwide focus on Health and Climate Change in the GPW14.
Potential Actions for Member States
● Support cross-sectoral dialogue and decision-making to maximise health co-benefits of climate action
including through participation of the national health ministry and wider health sector in the
development of NDCs, NAPs, and other party-driven work under the UNFCCC, and on national climate
commissions, and as part of a One Health approach. Coordinate with national civil society partners
working on health and climate change and with groups which experience the most severe impacts of
climate change, while also recognising international and intergenerational equity issues surrounding
climate change and health.
● Conduct and report on health impact assessments and quantify health co-benefits of climate policies
and actions at national level.
● Work with the relevant ministries, and to regulate fiscal allocations and advertisements for fossil fuels,
while seeking to protect related policymaking from industry interests and vested influence.
● Make and deliver commitments under the COP26 Health Programme to achieve climate-resilient and
low carbon sustainable health systems, which are both able to ensure the delivery of care during times
of crisis, while adopting emissions trajectories consistent with current and historical responsibility.
o Undertake a vulnerability and adaptation assessment for the health sector and develop a
tailored HNAP to strengthen both health infrastructure and the health workforce in the face of
climate change, and specify the budget required for delivery. Strengthen the capacity of health
systems for anticipating monitoring the public health impacts of climate change and building
the evidence base for robust finance to enable recovery.
o High emitting and high ambition countries26
should mitigate climate emissions in the health
sector, by carrying out a baseline assessment of greenhouse gas emissions from the health
system (including supply chain) and developing a roadmap towards a sustainable low-carbon
health system, achieving net zero targets in advance of 2050.
● Develop and implement climate change and health education and training as part of healthcare
professional curricula.
● Promote public access to information, public awareness on climate change and health, as well as public
participation.
26
“High emitting and high ambition” is language used under Commitment 2 of the COP26 Health Programme. Countries with high emissions should
urgently reduce emissions across all sectors, including the health sector. Countries which are not high emitters, but which nonetheless have high
ambition to reduce emissions, may also opt to reduce emissions in the health sector.