The World Health Organization plans to make climate change and its impact on health a major focus in the coming years, along with strengthening health systems, improving health equity and access, and preventing disease, according to the organization’s plan for its general program of work from 2025 to 2028.

The four-year plan, known as GPW-14, also prioritizes mental health, gender equality, migrant health, food safety, digital health, and artificial intelligence. It was developed through an extensive 10-month consultation process involving member countries, UN organizations, and civil society organizations.

“This document will act as our canvas, articulating our collective aspirations and strategic priorities in global health for the coming four years,” said Dr Saia Ma’u Piukala, the WHO’s regional director for the Western Pacific, as discussions on the plan concluded Tuesday morning, the second day of the ongoing 77th World Health Assembly.

Dr Piukala added that the plan “reflects the learning from the Covid-19 pandemic and response to shared issues like climate change, ageing, migration, evolving geopolitics, increasing spillover events and rapidly advancing science and technology.”

The World Health Assembly approved the draft GPW-14 following Tuesday’s discussions, but funding remains a concern. The GPW-14 program has a price tag of $11.1 billion, with WHO member states’ assessed contributions covering just over a third of the cost at $4 billion. The WHO is still looking for $7 billion in flexible funding, which it will attempt to raise at an investment conference in late 2024.

Focus on Climate Change

In recent years, the impact of climate change on health, particularly non-communicable diseases, has become increasingly clear. The WHO has warned that severe weather events, pollution, and climate-sensitive diseases are becoming more frequent worldwide, with vulnerable areas like small island developing states bearing a disproportionate impact.

The GPW-14 also notes that human migration and displacement have reached unprecedented levels, with an estimated one billion people choosing to migrate or being forcibly displaced due to various factors, including economic, environmental, political, and conflict-related issues – with dire consequences for health.

“The pace of climate change and environmental degradation has accelerated, emerging as a major threat to human health in the 21st century,” the GPW-14 warns. “Increasing inequities within and between countries, which were exacerbated by the COVID-19 pandemic, are leading to a growing divide in health, social and economic outcomes between those with financial resources and those without.”

Countries like Japan and the United States praised the WHO for its growing focus on climate and health. Member states acknowledged that health-related Sustainable Development Goals are not on track, and Turkey drew attention to attacks on health facilities and disruptions to essential health services, calling it a “man-made crisis.”

“GPW-14 includes the measures to address climate change in the primary objective,” the representative from Japan said. “Now, the world is facing a huge impact of climate change on health. And we affirm the importance of disaster management, especially in the healthcare field.”

Civil Society Warns WHO Plan is Incomplete

Civil society groups have pointed out several shortcomings in the WHO’s GPW-14 plan, despite its ambitious goals to address climate change and health equity.

The NCD Alliance, an organization focused on fighting non-communicable diseases (NCDs), criticized the plan for not adequately addressing NCDs, which account for 74% of global deaths. The lack of specificity on NCDs in the GPW-14 comes despite the increasing burden of disease from climate and environmental factors like heat and air pollution.

“We regret the missed opportunity to ensure comprehensive outcome indicators for NCDs,” said a representative for the NCD Alliance. “The absence of answers to indicators hinders prioritization for achieving agreed targets.”

Other civil society groups noted the plan’s lack of specific references to maternal health indicators and provisions to address the vulnerability of women in the health workforce, despite women constituting 70% of healthcare professionals globally.  However, the healthcare workforce and ways to improve equity were mentioned in the plan several times.

“Integrating gender-responsive approaches into health workforce planning and management can help address gender disparities in health outcomes and advance progress towards achieving universal healthcare,” said a representative from the Global Health Council in a constituent statement.

The absence of gender-responsive provisions in the GPW-14 is likely due to opposition from conservative countries to the terminology. Countries like Russia, Egypt, and Iran objected to any references to “gender” on religious and political grounds during closed-door negotiations, Health Policy Watch reported.

Despite these criticisms, several member states thanked the WHO for the extensive consultations carried out before finalizing the draft plan.

“We particularly applaud the Secretariat for extensive and inclusive consultation through various platforms with member states, various organizations and partners in the drafting process,” the representative from Botswana said.

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