In an eleventh-hour move, World Health Assembly member states on Monday deferred a final vote on a draft WHO Action plan on Climate Change and Health until Tuesday morning – in an effort to find a last-minute compromise with a bloc of oil-rich states trying to put the plan on ice.

The move followed a Russian-backed Saudi initiative over the weekend to postpone approval of the Action Plan until 2026, with the support of other members of WHO’s  Eastern Mediterranean Region.

But in a nearly three hour debate on Monday, few other member states appeared ready to fall in line.

After it appeared unlikely that opponents could muster the votes to delay the plan for a year, WHA delegates recessed into evening consultations in an effort to find an eleventh-hour consensus – and avoid a ballot that would be embarrassing for any losers.

In their comments at the WHA on Monday, dozens of states from Africa, Asia, Europe, the Americas and Pacific Islands, expressed support for the action plan and its immediate approval. The plan maps ways in which WHO can support low- and middle-income nations to adapt to climate change and reduce future health impacts, including impacts on health systems.

During the debate, a number of high income states, including the United Kingdom and Australia, as well as developing countries nations expressed differences of opinion over some of the plan’s references to broader UN principles, particularly the “common but differentiated responsibilities (CBDR)” of rich versus poorer nations to take climate action.

The CBDR concept, while embedded in UN climate frameworks, is out of place in an action plan, complained the UK.  India, on the other hand, maintained that “any global plan must align with existing international agreements under the UNFCCC and the Paris Agreement. Central to this is the principle of common but differentiated responsibilities and respective capabilities, which safeguards equity and fairness in global climate action.”

Either way, the action plan remains a voluntary framework and not a legal instrument, its proponents argued. And against the differing interpretations of some passages in the  plan, most agreed that there is an overriding urgency to approving the measure at this year’s WHA session.

‘No time to lose’

“Instead of delay we need to accelerate actions to address the health impacts of climate change – already visible all over the world,” declared Peru, on behalf of nearly 50 nations across the Americas, Asia and the Western Pacific, Africa and the European Union. “Now, there is no time to lose.”

Mozambique, speaking for the 47-member African Region, said that the group also supported “full adoption of the global action plan on climate change and health.”

Referring to the increased frequency of drought, cyclones and flooding being seen in the region, he added, “the African region is disproportionally impacted by climate change, and although our continent contributes minimal to the global emission it bears the greatest burden… We call for urgent action to build climate resilient health systems across the continent.”  

Unusual rearguard move

The rearguard action by oil-rich member states against the climate action plan was an unusual move, insofar as it follows on from a new resolution on Climate Change and Health that was approved overwhelmingly by the Assembly just last year. At that time, as well, more than  three dozen WHA delegations spoke on behalf of the measure, the first on climate since 2008. See related story:

New Climate and Health Resolution Wins Strong Support from WHO Member States

“The very survival of our species will depend on this,” Colombia said at last year’s debate in May 2024,  deploring the dearth of climate finance for developing nations which have contributed the least to the climate problem.

This year’s Action Plan is supposed to provide just that – helping vulnerable nations access climate finance to bolster their climate resilience in ways that benefit health.

The Plan also aims to empower health sector engagement with climate actors in other sectors that generate significant climate pollution harming health, e.g. transport, household energy, agriculture and nutrition. Finally, it is supposed help health facilities become more climate resilient and support tens of thousands of energy-poor health facilities the world over to gain access to clean and reliable electricity sources.

While Russia decried the plan as duplicative and costly, at $168 million over the coming 2.5 years, its near-term costs are covered by dedicated funding, other member states underlined. And the plan’s costs are still only a fraction of the costs of other resolutions approved at this year’s WHA – some of which have no committed funding at all.

Air Pollution road map endorsed – but meeting target impossible without more climate action

In contrast to the headwinds encountered by the climate plan, a new WHO road map on air pollution and health received a resounding endorsement from all WHO regions, including EMRO, in a debate earlier on Monday. The ambitious measure aims to halve deaths from human-produced sources of air pollution by by 2040.

But most experts agree that reducing air pollution is technically impossible without complementary shifts to cleaner energy sources that would also planet-warming fossil fuel emissions.

In fact, in a business-as-usual scenario,  air pollution “will only get worse” over the next 15 years – and that is even if all existing climate and clean air commitments are met, warned the World Bank’s Helena Naber, senior World Bank environmental economist, at an event in Geneva on Friday. She referred to a new World Bank analysis “Accelarating Access to Clean Air for  Liveable Planet,” launched in March.

“Even if countries successfully implement all their energy climate and air pollution control policies and measures that are announced or planned now over the next 15 years, by 2040 we will still see a rise of 21% in the number of people who are exposed to PM 2.5 levels above [the WHO annual guideline] of five micrograms per cubic meter, and this will be due to combined effects of population growth and economic expansion,” Naber said.

“And as a percent increase, the highest will be in Sub-Saharan Africa,” she said.

Conversely, halving the number of people exposed to high PM 2.5 concentrations (above 25 micrograms/cubic meter) by 2040 is feasible and affordable – but only if countries adopt a more “integrated” approach that accelerates the clean energy transition and reduces greenhouse gas emisions, Naber said.

Rising human health and financial costs of climate inaction

Meanwhile, the human health and financial costs of non-action on climate change are rising steadily over time – as average temperatures remain at record highs and the impacts of extreme weather grow.

One study published last year by the Swiss Federal Institute of Technology in Zurich (ETH Zurich) and partners, predicted a 10% loss of global GDP if global warming continues to 3ºC – with the worst impacts in less developed countries.

At the same time, limiting global warming to 1.5ºC could reduce the global economic costs of climate change by around two-thirds.

Large proportion of air pollution deaths are from fossil fuel sources

The opposition to the climate change and health action plan is all the more ironic insofar as a large proportion of deaths from air pollution are due to emissions from fossil fuels.

Although estimates vary depending on the method of analysis, between 2-5 million air pollution related deaths can be attributed to emissions from fossil fuel-producing sources.

Notably, diesel fuel which produces high levels of health-harmful particulate pollution, including black carbon “superpollutants” that also accelerate warming, ice and glacier melt.  Emissions of methane, a highly potent climate gas that leaks from oil and gas production, also contribute to the formation of ground-level ozone responsible for a significant chronic respiratory diseases and asthma.

“The Eastern Mediterranean has the highest air pollution sources of all member state regions,” noted Libya, in a statement in support of the WHO Air Pollution Road Map, on behalf of the same EMRO member states that are trying to stall the WHO Climate and health action plan.  “Although natural sources such as [sand] storms are a significant factor, addressing the anthropogenic sources is crucial to improving air quality in the region,” said the delegate.

Of the roughly 7 million premature deaths from air pollution that  annually worldwide, “85% of those deaths are attributed to non communicable diseases, including heart disease, stroke, chronic obstructive pulmonary disease and lung cancer,” the delegate also noted.

In 2015, Saudi Arabia also led an initiative by the EMRO region to block the World Health Assembly’s approval of a first-ever resolution on air pollution on health. Saudi delegates argued in closed door debates that air pollution was largely a product of wood and biomass burning – not fossil fuels – something African member states rejected. After a series of closed door, late-night negotiations, Saudi Arabia and the EMRO bloc it led agreed to go along with the landmark resolution. But the agreement was contingent on the revision of references linking air pollution and climate change, watering down those associations.

Since then the science around the linkages has become even more unequivocal – with more evidence pointing not only to the direct impacts of air pollution created by fossil fuel burning – but also the increased impacts of fossil fuel sources on emissions of super-pollutants, and impacts of air pollution on health when combined with extreme weather, such as heat waves.

Image Credits: Janusz Walczak/ Unsplash, UNDP/Karin Schermbrucker for Slingshot , IIAS.ac.at.