Exclusive: COP28 Climate and Health Draft Declaration Ignores Fossil Fuels as Driver of Health Harms 
Can oil, gas and coal give way to renewables? A draft COP 28 declaration on climate and health omits any reference to fossil fuels or their phase-out, something scientists say is critical to human and planetary health.

BERLIN –  A draft  “health and climate ministerial declaration” set to be released at the upcoming UN Climate Conference in Dubai (COP28) 30 November-12 December, omits any reference to fossil fuels and their health harms, Health Policy Watch has learned. 

While the declaration mentions the need for climate mitigation, as well as the related health harms of air pollution in passing, the language and commitments focus mostly on the “adaptation” of health systems to climate change.

The omission of any reference to what is widely recognized as the leading driver of climate change in the draft declaration was confirmed to Health Policy Watch by a negotiator who had seen the text, which began circulating Tuesday among UN member states. 

“Mitigation language from Intergovernmental Panel on Climate Change (IPCC) is in there, so is air pollution,” said the source, who requested anonymity. “Just nothing on fossil fuels.”

Assistant Foreign Minister, Maha Barakat unveils key messages in the COP28 declaration on climate and health

Speaking about the still-unpublished declaration at a session on “The Road to COP28” on the closing day of the World Health Summit, a senior official from the United Arab Emirates (UAE), which is hosting COP28, discussed the urgency of integrating health into climate debates.

But the comments by Dr Maha Barakat, an assistant foreign minister, also made no reference to fossil fuels – and to what scientists say is the urgent need for a fossil fuel phase-out in energy, transport systems and cities to prevent snowballing health impacts.  

COP 28 declaration: focus on health sector adaptation

The UAE is organizing a first-ever day dedicated to Health, Relief, Recovery and Peace” on 3 December. during COP28. It is also sponsoring the first-ever Health Ministerial meeting at the meeting – a much-trumpeted event in global health circles. 

Key health-related climate messages at COP28 would rather focus on more health sector adaptation to climate change;  increasing the health sector’s access to climate adaptation finance; and “mainstreaming” of health into climate policies, said Barakat, at the “Road to COP28” session, the keynote climate event at the Berlin conference.

Three actions to be highlighted in the declaration 

Drought, flooding and extreme heat are among the growing health impacts of climate change in WHO’s Eastern Mediterranean region – and at current trajectories, temperature rise could double within a century.

“I would like to highlight three key action areas of climate and health to be captured in the declaration,” stated Barakat

“First, the declaration relates to the need for stronger climate adaptation in the health sector itself. Health care makes up around 4.4% of global (climate) emissions and takes up around 10% of global GDP. Health systems will need a transformational shift in order to become climate resilient, low carbon sustainable and equitable,” Barakat said.

“Secondly, the declaration requires significant concentration on finance and at COP28, we want to increase not only the overall amount of climate financing but also the proportion devoted to public health. Today, just 2% of adaptation funding and 0.5% of multilateral climate funding, go to health. 

“And thirdly, there is the need to break down silos between health and other sectors in the climate response. We know that in order to keep people healthy, we rely on actions far beyond the health sector. Building climate resistant societies with healthy populations therefore needs better cross-sectoral collaboration and the mainstreaming of health into climate policies.”

The pre-release of the draft declaration seems to confirm mounting fears that the UAE, a major fossil fuel producing nation, will sidestep the main issue at stake in the climate debate: unsustainble oil, gas and coal production.

Urgent need for reduction in fossil fuels  

Solar panels provide electricity to Mulalika health clinic in Zambia. ‘Greening’ health facilities is important – but its not a solution on its own, advocates say.

‘The proposed commitments to fund adaptation in the health sector are certainly welcome, but if fossil fuels aren’t addressed, then the declaration is incomplete, ‘said Jeni Miller, head of the Global Climate and Health Alliance (GCHA), who said she hasn’t seen the text but knows what the science says.

“We do need greater investments in our health systems to adapt to the impacts we are feeling across the world. But we are currently feeling large health impacts at 1.1 C [of warming] in terms of extreme weather, heat and disease, while we are on track to hit 2.8 C.

“So we just don’t have the capacity to adapt to the level of warming that we are currently projected to hit based on the policies being implemented,” said Miller, speaking to Health Policy Watch

“Mitigation is critically important and fossil fuels are the major driver of climate change.  We have to phase out fossil fuels.  

Levels of population access to electricity, by country, 2021

“And even if some of the strategies to reduce emissions from fossil fuels were feasible, they’re not currently feasible at scale, and this wouldn’t address the other many harms of fossil fuels,” she pointed out.

Those include seven million premature deaths a year from air pollution and over 750 million people lacking household energy access – whose needs can be served more efficiently and cost-effectively by community electrification and mini-grid systems, based on renewables, as compared to conventional power plants.   

“A rapid transition to clean and renewable energy is essential to meet the energy needs of the world, while keeping our climate and environment healthy and habitable,” added Miller. “And while mitigation in the energy sector is vital, we need strong mitigation across all sectors, food systems, transportation and industry.” 

Merits to health adaptation plans 

That’s not to say that the declaration, as it stands, would lack any merit.  As health facilities are major carbon emitters, more carbon-efficient and climate-resilient facilities with greater reliance on renewable energy sources such as solar power, would set an example for other sectors to follow. 

Similarly, climate “adaptation” in the housing sector can converge with climate mitigation if strategies promote, for instance, green  building codes and ventilation standards, as well as greater use of solar and thermal power.  Housing is another target of the UAE’s COP28 climate and health declaration, said Barakat. 

“We plan to launch a set of financing initiatives on climate and housing, and to do a pipeline of climate and health investments that  have strong country ownership, and can be scaled up to save lives and safeguard health – while materially reducing carbon emissions and other forms of pollution,” Barakat declared.

The Intergovernmental Panel on Climate Change (IPCC) has long identified buildings as a major carbon emitter, highlighting the huge climate mitigation potential offered by more climate-friendly and carbon-efficient housing and domestic energy systems  – that reduce reliance on fossil fuels. 

Health benefits from climate mitigation

(L-R) (left-right) Viktor Dzau, National Academy of Medicine; Alan Dangour, Wellcome Trust; and Nísia Trindade, Minister of Health, Brazil and Dr Maria Neira, WHO discuss climate mitigation and health synergies and the need for a broader evidence base to persuade policymakers to act.

In the Berlin climate and health events, leading figures from the US National Academy of Medicine, the World Health Organization (WHO),  governments and civil society, restated these themes over and again at different sessions. They stressed the need to remake transport, energy and urban design – along with health systems- so as to reap the full range of health “co-benefits” from climate action.

“When you think about of the sectors that are impacting climate change: agriculture, transportation, energy, you name it, every one of these sectors …is where we need to mitigate, but rarely does anyone say, what does that mean for health?” said Dr Victor Dzau, president of the US National Academy of Medicine, at a Tuesday afternoon session on “Sustainable Health for People and Planet.”

UK school children protest against climate change in February 2022.

“And, in fact, very few policymaking decisions are [framed] by the sectors in terms of health.”  That, despite the fact that meat-heavy diets rich in saturated fats, for instance, typically lead to more animal and agricultural waste, which also means more emissions of methane, a powerful short-lived climate pollutant more powerful than CO2, in the near-term.

“There are many issues, but in fact, if you get it right, you get better health as well as much lower carbon emissions.”

Said Dr Maria Neira, WHO’s Director of Climate, Environment and Health, at one session: “Instead of communicating about ‘co-benefits’, I prefer to talk about health outcomes and health benefits,” underlining that the health gains from cleaner transport, energy production and cities are arguably so great that they should be able to drive a change in policy direction.

Declaration endorsed by over a dozen member states 

A press release circulated by the UAE COP presidency at the end of the Berlin summit, states that the health and climate declaration had been developed “in close collaboration” with the WHO and a dozen “country champions – including Brazil, Malawi, UK, US, Netherlands, Kenya, Fiji, India, Egypt, Sierra Leone and Germany, as well as the UAE.

“Kenya, Fiji, Liberia, Sierra Leone and Malawi also expressed their support as ‘early endorsers’ of the Declaration,” the press release states. 

But with the UAE in the driver’s seat, it’s unclear how much practical influence the global health institutions and health experts can really have on the text references to the politically charged fossil fuel debate, insiders observed.

Meanwhile, a closed-door meeting with WHO member state representatives in Berlin kicked off the arduous process of circulating and collecting country signatures to the draft Climate and Health declaration in its current form.  

“Country endorsements of the COP28 Declaration on Climate and Health will be announced at COP28, and cover a range of areas, including cross-sector collaboration on climate and health, reducing emissions within the health sector, and increasing the amount and proportion of financing devoted to climate and health,” the UAE press release said. 

The link between climate change and health is becoming increasingly evident every day, with diseases like malaria surging as temperatures rise, and extreme weather events impacting people around the globe,” says COP28 President, Dr. Sultan Al Jaber, in the press release.

“Through the Declaration on Climate and Health, we aim to help deliver public health systems that are climate-resilient, sustainable and equitable, and we urge all nations to endorse it.”

Al Jaber also avoided any reference to fossil fuels. 

Image Credits: Mazen Malkawi/WHO, Gellscom/CC BY-ND 2.0., E. Fletcher/Health Policy Watch, UNDP/Karin Schermbrucker for Slingshot , Callum Shaw/ Unsplash.

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