Over 30 health organizations representing 12 million doctors, nurses, and public health professionals globally have pledged to no longer work with advertising agencies that partner with the fossil fuel industry, citing conflicts of interest and the resulting health effects from industry disinformation campaigns.

The organizations span five continents and include prominent groups such as Médecins Sans Frontières, The Lancet, the World Organisation of Family Doctors, and the Yale Centre on Climate Change and Health.

For decades, oil and gas companies have employed PR and lobbying tactics strikingly similar to those of the tobacco industry: seeding doubt about established science, creating front groups, and pushing misleading narratives to stall regulation despite overwhelming evidence that fossil fuel pollution harms human and planetary health.

Yet many of the same PR and advertising agencies employed by health groups to promote healthy habits, vaccinations, and cancer prevention have continued partnering with fossil fuel companies, spreading misleading messages that downplay or deny these health harms and delay action needed to curb emissions.

“The same PR firms spreading fossil fuel disinformation are also working with health organizations—a clear conflict of interest for health,” said Shweta Narayan, Campaign Lead at the Global Climate and Health Alliance (GCHA). “Fossil fuels are making us sick, and the companies behind them are spending millions on advertising and PR to cover it up.”

Air pollution from fossil fuel combustion causes more than five million premature deaths annually. Burning oil and gas has been linked to increases in respiratory illnesses, cardiovascular diseases, cancers, and adverse pregnancy outcomes.

“As health professionals guided by humanitarian values, we have a responsibility to speak out when public health is under threat,” said Dr Maria Guevara, international medical secretary for Médecins Sans Frontières. “Fossil fuels are at the heart of a growing global health crisis, and the PR and advertising firms that help obscure this reality undermine efforts to protect lives.”

Cutting ties 

The health sector often relies on professional advertising and PR services for public health messaging, including cancer awareness, infectious disease prevention, and vaccine uptake.

In 2020, the World Health Organization hired Hill+Knowlton to fight COVID-19-related disinformation. Scientists and environmental groups have widely criticised the company for its oil and gas portfolio, including clients ExxonMobil, Shell, Chevron and Saudi Aramco.

Edelman, the world’s largest PR company with over $1 billion in revenue, exemplifies this contradiction and the scale of the challenge.

The company assembled a task force of global health and pharmaceutical companies, including Novo Nordisk, GSK, and Roche to “accelerate the transition to net zero health systems” in India and China—a campaign hailed as groundbreaking public-private collaboration.

Yet Edelman won the bidding war for Shell’s worldwide public relations account in 2024, extending their decades-long relationship in a deal worth tens of millions—one of the agency’s most lucrative contracts. In March, Shell abandoned a key climate target for 2035 and weakened another goal for 2030.

While Edelman publicly states it “believes climate change is the biggest crisis we face as a society,” the firm creates “innovative promotional campaigns” for Shell, including a video game where users imagine themselves as engineers “keeping the lights on.”

The Climate Investigations Center describes Edelman as “the dominant PR firm for trade associations that promote an anti-environmental agenda.”

“Just like health leaders once stood up to Big Tobacco and its advertising, it’s time to stand up to Big Oil,” said Jeni Miller, GCHA executive director. “Organisations are demonstrating that they won’t help spread fossil fuel disinformation, and will use every tool they have, including their ad and PR dollars, to protect people’s health and the planet.”

Building on healthcare’s trusted voice

With doctors and nurses consistently ranked among the world’s most trusted professions, advocacy groups believe their voices are essential to reframing fossil fuels as a health crisis rather than just a climate issue.

“We are trusted voices in the community,” said Dr Viviana Martinez Bianchi, president-elect of the World Organization of Family Doctors. “We are uniquely positioned to inform, explain, and speak about the equity implications. We can counteract this disinformation and mobilize public understanding and action.”

The decision to cut ties with these PR firms aligns with a broader movement to place health at the heart of climate policy and counteract the “commercial determinants of health,” where corporate practices from sectors like tobacco, ultra-processed food, and fossil fuels shape conditions for disease.

“We see the effects first-hand in vulnerable populations,” Bianchy explained, citing patients with asthma exacerbations, cardiovascular conditions, and poor respiratory health, all linked to pollution exposure.

Decades of scientific studies have linked fossil fuel activities to rising rates of asthma, heart disease, heat-related illness, infectious disease spread, and mental health stress during climate-related disasters—evidence that health professionals say has forced them to act.

“We, the health community, have a duty to warn humanity about the profound health harms from burning fossil fuels and to act on that knowledge,” said Edward Maibach, Director of the George Mason University Center for Climate Change Communication. “We must refuse to work with any marketing agency that works with fossil fuel companies.”

Industry disinformation campaigns

For over fifty years, fossil fuel companies have run multi-billion-dollar campaigns to misinform, lobby, and confuse the public about the climate crisis, varying their messaging strategy by region and audience.

In the global North, these tactics focus on “greening” the gas industry by positioning fossil fuels as climate solutions.

The playbook includes shifting blame to individuals through concepts like the personal carbon footprint, which British Petroleum popularised in 2004 with a calculator that encouraged people to tally up how their morning commute, grocery runs, and vacation flights were heating the planet.

The industry also championed plastic recycling, rolling out blue bins across American driveways while chemical giants like Chevron, DuPont, and Exxon knew the technology to recycle at scale did not exist.

Plastics are now a key justification used by nations and companies to pursue higher fossil fuel production, even though only 9% of plastic ever produced has been recycled. The technology to recycle complex polymer plastics at scale still does not exist decades later.

In the global South, fossil fuel-producing nations and companies promote oil as essential for economic and sustainable development, according to Vivek Parekh, an analyst with London-based climate risk think tank Influence Map.

Saudi Arabia made this argument while trying to block the climate resolution at last week’s World Health Assembly, saying: “As an oil producing sector, we are aware of our role in [energy] transformation, but can’t ask developing countries to pay the price for transformation when they are not responsible for the problems.”

“The fossil fuel industry dominates the lobbying landscape,” Parekh said. “What we see is the industry’s attempt to weaken and obstruct climate policy, despite clear economic, health and climate benefits.”

At major UN climate conferences, fossil fuel lobbying groups have dramatically outnumbered health organizations. Nearly 2,500 fossil fuel lobbyists attended COP28 in Dubai—more than delegates from the ten most climate-vulnerable nations combined.

At November’s plastic treaty negotiations, 220 fossil fuel and chemical industry lobbyists descended on Busan, forming the largest single delegation and outnumbering host South Korea’s 140 representatives as well as the European Union and its 27 member states.

The oil giants got what they came for, successfully derailing what was meant to be the final treaty adoption session by opposing any caps on plastic production.

This strategy has led UN Secretary-General António Guterres to call fossil fuel companies the “godfathers of climate chaos.”

“It’s an almost comical conflict of interest that Big Oil’s spin doctors are also in charge of communications for the UN climate talks,” Dr. Geoffrey Supran, a Harvard researcher who studies fossil fuel disinformation tactics, told environmental news website DeSmog.

Despite some victories, including a Dutch court upholding The Hague’s ban on fossil fuel advertising and Energy Australia apologizing for greenwashing, greater transparency is needed as the industry’s activities continue undermining climate action.

“We can’t be neutral,” added Dr. Jemilah Mahmood, executive director of Malaysia-based Sunway Centre for Planetary Health. “Our Hippocratic Oath goes beyond just treating disease to preventing it.” Like the tobacco industry, she argued, fossil fuel companies “manipulate the truth,” leaving marginalized communities polluted and vulnerable to health risks.

Image Credits: CC, IPSOS, SweepSmart.