Healthcare Plays a Critical Role in All Our Lives; It’s Also Poised to Revolutionise the Climate Conversation
On the eve of the first-ever COP Health Day, 124 countries endorsed a milestone declaration on climate and health. The political declaration marks the first time that the health impacts of climate change have taken centre stage in 28 years of UN climate talks.

At the 2016 UN Climate Conference in Marrakesh, a small group of public health professionals from around the world laid out the shocking connections between the more than half a million childhood pneumonia deaths annually and children’s routine exposures to air pollution from both household and outdoor sources.

While this was a first, our health-focused message was glaringly absent from the mainstream COP agenda at that time. Fast forward to 2023, and thankfully, the healthcare community is no longer sitting on the sidelines of the climate conversation. 

In fact, this year’s COP28 UN Climate Conference features a health and climate ministerial as well as a dedicated WHO Health Pavilion, which aims to incorporate health concerns into climate negotiations. 

The speakers are armed with a growing array of data about the 7 million lives lost yearly from air pollution — much of it generated by the same sources that drive climate change.  Additionally, the latest IPCC report has projected some 9 million deaths annually by the end of the century from climate change-driven extreme heat, infectious diseases, and malnutrition in a business-as-usual scenario.

Public health professionals also are joining the larger discussion. Even so, health professionals may struggle with the contribution that they can make to the debate. 

While the health sector is looking at new ways to clean up its own carbon emissions, estimated to be about 5% of the global total, it cannot dictate policies on energy, transport, agriculture and building sectors that contribute the lion’s share to climate change today. 

So how can the health care community continue to expand its role in accelerating climate and clean air action? Here are some concrete examples of actions that healthcare professionals can undertake.

They are drawn from settings as diverse as Kampala, Uganda;  Accra, Ghana and Indore, India among others, and offer a kind of ‘proof of concept‘ about the role the health sector can play. 

These stories illustrate three main arenas in which the health sector can make significant contributions on the front lines, in policy circles and in more linked-up health and environment data collection and analysis.

Raising awareness and reducing risks on the front lines of care

Air pollution looms over New Delhi, November 2023.

Visits between patients and their primary healthcare providers are the most crucial touch point in the chain of outreach for healthcare services generally. In terms of the intersection of health and climate, these contacts are being mobilized to build awareness as well as minimize peoples’ exposure to both climate and air pollution risks.  

In Indore, ranked as India’s cleanest city, ASHAs are now being trained to provide guidance to their patients on minimizing their exposure to leading pollution sources, such as traffic, the open burning of waste, and cooking over open wood fires. These contacts can most frequently happen when patients seek medical attention for conditions such as asthma and pneumonia, which have clear air pollution triggers.

A continent away, community health officers across East Africa have learnt how to use messages on clean air as a strategy to promote health. In the Ugandan capitol of Kampala, they have been instrumental in a campaign to discourage open waste burning. 

Linked up health and climate policymaking 

A man from Ghana burns electronic waste to reveal the metals at the Agbogbloshie electronic waste site in Accra, Ghana (2018).

At the policy level, even more potential exists to build a united front between the health and climate sectors, which emphasizes the health gains and avoided health costs of action. . Demonstrating the lifesaving capacity and cost-saving potential of climate and environment action through the lens of health can turn the tide on empty pledges and quicken measurable improvements.  

In Ghana’s capital,  Accra, an Urban Health Initiative launched in 2016 by the Ministry of Health, Ministry of Environment, and metropolitan authorities, with the support of the UN agencies, had the explicit goal of increasing awareness of the benefits of health-driven clean air policies. 

The work included mapping the policies and stakeholders concerned with Accra’s air quality and then, sector by sector, developing plans for alternative means of powering homes and businesses, managing waste, and making transport more eco-friendly. 

Multiple policy recommendations made by the Urban Health Initiative were ultimately implemented as part of Accra’s ongoing urban planning strategies. Even more profoundly, the credible evidence provided by the health sector on both the health impacts of the status quo and the health benefits of greener development alternatives helped cement a shared understanding of linked problems and solutions.

More data, more awareness and better solutions  

Kampala, the bustling capital city of Uganda, is home to 1.5 million people. Air pollution claims 28,000 in the city lives every year.

What binds this all together is the availability of data. Good data informs strategy and provides convincing evidence for politicians to act.

This has been evident not only in Ghana but also in the experiences in Uganda, a nation where an estimated 28,000 people die annually as a result of air pollution. 

In 2021, Kampala’s city authority released details of a three-year Clean Air Action Plan that was anchored by investments in low-cost air-quality monitoring stations to deliver real-time data. 

That data then activates health experts in the region, who know exactly where and how to disseminate messaging around local blights like waste burning as well as the importance of clean air, generating a groundswell of public support for more action. 

As a result of the monitoring programme,  Uganda’s National Environment Management Authority has now developed standards for ambient air quality across the country. 

The Kampala Capital City Authority can, in turn, cross-reference the data from monitoring stations against the Environment Management Authority’s regulations and use that to guide enforcement and accountability.

Crucially, the Capital City Authority has begun hosting events such as the 2023 Car-Free Day alongside partners from Kampala’s  Environment Management Authority and the national Ministry of Health to emphasize the symbiosis between cleaner air and longer, healthier lives.  

The good news is that even if they are not attending COP, the world’s health workers can still contribute to addressing the inextricable link between our health and that of our planet. 

This includes lobbying for effective legislation to reduce carbon emissions and protect our ecosystems from pollution; training frontline workers and clinicians to raise awareness and reduce environmental health risks among their patients; and supporting linked-up health and environment data collection and analysis.  Progress necessitates all three. 

About the authors

Sumi Mehta is the vice president of environmental and climate health at Vital Strategies. 

Daniel Okello Ayen is the Director of Public Health and Environment at Kampala Capital City Authority.

Image Credits: Jean-Etienne Minh-Duy, EPA/CHRISTIAN, Angella Birungi.

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