LONDON – Summit it was not as there were no heads of state or even Bill Gates, although the UK’s Minister for Climate Change made a compelling presentation showing the kind of policy leadership starkly absent in the United States.  

Even so, the recent Climate and Health Summit, hosted by the UK Physiological Society, the nearly 150 year-old institution whose earliest members included Charles Darwin, offered a rich array of examples of what is going on in the climate and health research space. And that includes policy lessons that could and should be applied much more broadly as countries prepare their national commitments for the next UN Climate Conference (COP30) in Brazil, and health actors meet this week in Brasilia to review a draft Climate and Health Action Plan for the upcoming COP30.

“Physiology is the science of life, and there is no greater systematic threat to life across the world than climate change,” declared Mike Tipton, the society’s president.

“Physiology includes the study of the body’s responses to external challenges such as heat, cold, flooding, fire, pollution, starvation and dehydration, climate-driven examples of which are sadly, all too easy to find at this time.

“Physiology defines our survival…and let’s make no mistake, this subject is about survival.”

From shadows to vogue

Even so, health remains in the ghetto of mainstream climate negotiations. It is not part of the formal UN climate negotiating framework. If mentioned in countries’  national-level commitments, there are usually few concrete, measurable metrics for reference.

Similarly, it is ignored in most global climate financial instruments. It’s not on the priority list of investments for finance ministries, and it’s not even very high on the priority list of most health ministries that are increasingly faced with the effects of climate change, from extreme heat to flooding, drought, and nutrition challenges. 

The UK, along with many European nations, is finally investing heavily in climate mitigation and adaptation. But other countries, notably, the US, are backpedalling, with global climate commitments far short of what is really needed to keep average temperature rise at or below the 1.5°C threshold set out in the Paris Agreement.

Most recently, Brazil, host of the upcoming UN Climate Conference, COP 30, saw its Congress pass a bill dismantling most environmental licensing requirements for new development projects. The “Devastation Bill”, as its critics call it, will allow agro-business and forestry and real estate interests to “self-license”, leading to what some have described as “the greatest legislative setback since the military dictatorship (1964-85)”.   

Although politicians lag behind, the science on climate change has evolved and matured. Patterns of rising heat and their impacts, have come out of the shadows of climate research to take center stage. But it remains to be seen if better estimates of the economic costs to health and productivity of global warming will lead to better policy decisions. 

Turning up the heat on heat  

“When I started working on this issue about 25 years ago, scientists would hem and haw and say ‘we can’t attribute any one specific event to climate change.’ That’s all gone now,” noted Diarmid Campbell-Lendrum, who heads up the World Health Organization’s (WHO) climate work. 

“They are now very clear when there is an extreme weather event that climate change is having an influence.

“And if, when I started on this issue, most of what we were talking about was future projections, that’s not the case any more either. …Wherever you look in the world, across almost any dimension of human wellbeing, we’re already seeing negative impacts.”

A 167% increase in heat-related mortality

The impact of heat on health has particularly come into its own, driven by weather trends that no one can ignore. 

“We have seen a 167% increase in global heat-related mortality since the 1990s, and 2023 was a record hot year,” said Marina Romanello, executive director of the Lancet Countdown on Climate Change and Health. Recently, 2023 data has been superseded by 2024, which was even hotter, she later told Health Policy Watch – and that trend is likely to continue for the next five years.

“If we look at heat-related mortality, that is just the tip of the iceberg,” added Romanello. “Underneath this tip, there’s a huge iceberg that has to do with the effects of heat comorbidity. 

“Heat is increasingly undermining sleep quality, also deteriorating labor capacity, labor productivity, and putting workers at risk,” Romanello said. 

Heat is also causing the expansion of certain infectious diseases, while the increased frequency of heat waves, resulting in both droughts and flooding, are impacting food insecurity – with 151 million more people experiencing more climate-related food insecurity in 2022.  

Food production is also a major driver of warming trends, said Romanello: “Cumulative deforestation has led to about half a billion hectares of global tree cover since 2001. Forestry is the main source, but the second one is agriculture.”

While forests remove CO2 from the atmosphere, agriculture contributes to 21% to 37% of greenhouse gas (GHG) emissions. The biggest single contributor to agricultural emissions is livestock. Ruminant rearing contributes to over half of agricultural GHGs, and high meat consumption is a major driver of noncommunicable diseases (NCDs).

“By transitioning to healthy, planetary-compatible diets, we could save about 11.2 million lives every year through healthier diets,” Romanello said.

“Excess red meat intake, disproportionately in industrialized, very high human development-index countries, is not only the main contributor to agricultural greenhouse gas emissions and deforestation, but also to 14 to 16 [premature] deaths per 100,000 population  – a high rate of mortality.”

Mental health risks 

The mental health risks of increased heat are also becoming ever more evident, with increased suicides and suicide risk during heat waves, and a higher incidence of hospitalization, said Emma Lawrence of Imperial College, who leads the Connecting Climate Minds initiative, a Wellcome-funded data hub at the intersection of climate and mental health. 

Neurological disorders such as dementia and schizophrenia, as well as epileptic seizures, are also more likely to be associated with heat waves, said Sanjay Sisodiya, professor of neurology at University College, London (UCL).

“I’m seeing people with complex epilepsies who, either themselves or their families, are reporting that during heat waves in particular, having more trouble; having more seizures, more intense seizures, and more lethargy and all sorts of other complications,” he said. 

The brain is attuned to function at a certain temperature, and when that temperature is increased, cellular functions and neurological functions become distorted, he explained. 

“When that happens, then different bits of the brain, of course, don’t work together in the way they were set up to do, and that can then cause secondary problems.”

Medication for neurological disorders can also be compromised by extreme heat, putting those vulnerable at further risk. 

Effects on worker productivity

New research showcased included studies that looking at what levels of heat are tolerable, as well as where and in what conditions, based on thresholds of human heat and humidity tolerance. 

Even for desk workers, heat safety thresholds may be lower than previously thought, said Larry Kenny of Penn State University.  Temperatures higher than 34°C at 66% relative humidity cross the safety threshold for young men and women doing light desk work, with red lines even lower for outdoor workers and older and younger groups.   

Improved mapping of temperatures in different scenarios has found that, if temperatures rise by 3° to 4°C by 2050, up to three billion people would be in “unliveable” zones of heat and humidity for at least one week out of the year. For 1.5 billion people, for up to a month and half a million for three months, said Kenny.

“With estimates in the 3° to 4°C  global warming target range, we’re talking about somewhere on the order of 1.5 to almost three billion people living under those conditions for long periods,” Kenny said.  

Global losses in worker productivity due to climate change have been underestimated significantly, added Josh Foster of King’s College, one of the lead investigators in the European Union-sponsored Heat Shield project, which has recalibrated economic losses from heat stress from the bottom up. 

The project involved lab-based studies on healthy volunteers in controlled “environmental chambers” to yield better estimates of reduced labor output at high temperatures – which turned out to be much more significant than previously assumed, Foster said. 

The new models are already being incorporated into new economic modeling about climate impacts on labor and productivity. 

The findings can also help inform adaptation decisions, he added.  For instance, the studies found that fans can be useful as a cooling technique, but after a certain point, they can become harmful. 

When temperatures rose to 37°C and above, higher than the body temperature of 36.8°C, a fan is going to merely push more heat onto the body. So there are certainly some very hot conditions where we need to rethink how we keep workers safe,” Foster said.

“This is not projection data. This is from 2017. This is real climate data, and not a fictitious scenario. Physiology work isn’t perfect. We completely acknowledge that it almost entirely ignores adaptation,” said Foster.

“The take-home message is that physiology can play a critical role in unexpected areas, in this case, economic modelling of climate change.”

 ‘Co-creating’ resilience 

The data can also feed into advocacy by organizations such as the ACGIH, a US-based charitable science organization advancing occupational and environmental health, Foster notes. 

But government guidelines for workers’ heat exposure are often badly out of line with reality. In the US, some states have even moved backwards. In 2023, Texas removed rules mandating water and rest breaks for outdoor workers, a move later followed by Florida.

At the same time, there are encouraging stories about field research “co-creation” that yields small, but significant solutions. 

In Vietnam, a group of informal outdoor workers including scrap collectors, motorbike taxi drivers, construction workers and street vendors, simply planted a tree to provide shade for them to rest under, noted Anh Vu of the UK’s National Center for Social Research. 

“We know that climate change and health are deeply connected in people’s everyday lives, but in policy terms, they are quite disconnected and fragmented,” she observed.

“Climate policy tends to focus on infrastructure and engineering, and health policy tends to be clinical, focusing on hospitals, disease surveillance and labor policies, which tend to assume formal contracts. 

“But informal outdoor workers in a country like Vietnam, are falling through the cracks of all three.”

Most research on heat and workers’ health takes place in the global North, with limited applications to workers in the South, where the socio-economic context is very different and regulatory frameworks are generally weaker. 

“These workers face chronic job insecurity. They are unprotected by labor laws, and at the same time, they are at the front lines of economic risks,” Vu observed. “They have no protection for their ears, may be wearing no shoes, and no hats in the heat.”

These workers can also be fearful of strangers, which meant the research team Vu led had to make repeated field visits to build trust with them and their communities. 

The research team found that most workers were over the age of 40, had been working in the informal market for over a decade, and could rarely afford to seek formal health care. 

They also found workers adapting and innovating with simple solutions, including self-care and traditional home remedies, getting health information from social media, and creating very modest green spaces.  

“You see the tree here,” she said, pointing to a slide on her screen, “These outdoor workers,  motorbike taxi riders, street vendors, get together and plant trees so that they can have some shared space to rest, to recover. So these are examples of vernacular innovation. They are very non-technical, but embedded and grounded.”

The challenge, of course, is to translate acceptable community innovations into broader policies.  But that process, she believes, must still begin from the street up. 

“Climate adaptation must begin where the risks are most real,” she concluded. “Informal workers are on the front line of climate risks, but they also are at the front line of innovation, and their knowledge and agency must be at the center of the adaptation thinking.” 

Adaptation, mitigation and painted rooftops

Painting roofs was another simple adaptation initiative showcased at the summit, which can impact on climate mitigation, air pollution and health.

The innovation is being tested in two African countries, Ghana and South Africa, by the new Wellcome-funded project, Heat Adaptation Benefits for Vulnerable groups in Africa (HABVIA), said Lara Dugas, one of the leaders of the study, from the University of Cape Town. 

The project is part of a Wellcome-supported consortium of heat adaptation research projects known as HeatNexus, developed following a major new strategic investment by the philanthropy into climate and health.

The first stage of research at the South African site of Khayelitsha, a low-income area of Cape Town, has already showed an average 4 °C decline in indoor temperatures over the hottest part of summer days in houses whose roofs were painted with the heat-reflective paint, says Dugas. 

A next stage of research aims to test if the reduction in indoor temperatures translates into health gains. 

“The Wellcome Trust’s initial call was for the evaluation of existing solutions [in low-income countries],” related Dugas, “which very early on revealed that in fact, there were little to no existing solutions in these settings. 

“HABVIA was thus conceived to co-design and implement a low-cost, socially acceptable heat adaptation solution in two settings (urban and rural) in both Ghana (Ga’Mashie and Nkwantakese) and South Africa (Khayelitsha and Mphego).” 

The collaboration includes government and civil society, from Slum Dwellers International to the Ghana Metereological Agency and South African Weather services, she said. In addition, the team is collaborating with researchers in Africa, India and the South Pacific Island country of Niue, who are exploring similar solutions.

In the next stage of research, the HABVIA team will assess the health benefits of lower temperatures, looking at parameters such as sleep behaviour, mental health, and NCD risk factors such as blood pressure and fasting blood glucose.

Reflective paints are already widely available in developed countries and some developing economies although they cost more than standard paint products.  In addition, there are differences in whether they can be applied to asbestos, as compared to zinc or tin roofs, which are typical of low-income countries. 

While labelled as adaptation, the solution can also reduce climate and air pollution emissions as households move up the energy ladder, Dugas notes. 

“In our research settings, there is very little access to electricity, as most of these vulnerable low-income settings do not have electricity. But certainly, yes, in settings with greater energy demands, this may have significant synergistic effects.”

The team is also exploring pathways for introducing such innovations into broader policies – whether through new building regulations, subsidized production or pricing, or a combination of those. 

Policy is still the missing link

But policy remains the missing link – worldwide. Despite the strong statements last week by the International Court of Justice on states’ “duty to prevent significant harm from climate change”, most countries are nowhere near their potential in clean energy investments, according to a report also released last week by UN Secretary General António Guterres. 

The US is missing “the greatest economic opportunity of the century” by shifting away from renewables, Guterres declared at the launch.  

The US Environmental Protection Agency is reportedly set to cancel its own 2009 rule that gave it scientific authority to regulate on climate issues – another example of the government’s denial that climate impacts on peoples’ environmental health are real.   

In mid-July, along with rescinding financial incentives for renewables, the US Department of the Interior set up a a major new regulatory hurdle for solar and wind power. It now requires tge review of all “leases, rights-of- way, construction and operations plans, grants, consultations and biological opinions” for new projects at the level of the Office of the Secretary in Washington DC, a lengthy process previously delegated to regional and field offices.  

This, and the loss of subsidies, is prompting international investors to cancel plans for new solar and wind production in the US at a time when the country is also loosening restrictions on new oil and gas project exploration on public lands in an effort to ramp up fossil fuel production.

Meanwhile, Shell and other leading fossil fuel producers have walked away from a plan to develop a net zero emissions strategy because it would force them to cease exploitation of new oil and gas fields. 

Concurrent with the UK summit, Brazil’s Senate approved an historic rollback of government rules on environmental impact assessment of new urban and rural development projects.  The new law would allow high-impact industries, like agribusiness and mining, to “self-license” projects, potentially leading to increased deforestation, habitat destruction, and harm to indigenous communities.

It also eases the way for the renewed construction of a major highway, BR-319, which traverses a sensitive part of the Amazon rain forest – which Brazil’s leftist President Luiz Inácio Lula da Silva himself has supported. 

The new law comes amidst a growing political crisis between Lula and an increasingly assertive Congress, where his party has a fragile hold. Da Silva has until 1 August to veto the new law, although the Congress is likely to overturn a veto, leaving it to the Supreme Court to decide. 

Adaptation should no longer be a sideshow

Against that background, it was encouraging to see a strong UK government presence at the summit, including the UK’s Undersecretary for Climate (Minister for Climate), Kerry McCarthy, and Dame Julia King, Baroness Brown of Cambridge, a House of Lords member and chair of the Adaptation Committee of the Government’s Independent Advisory Committee on Climate Change. 

What they offered was not just polemics but studied, critical presentations of the statistics by leaders who seem to have a firm grasp on the evidence as well as a vision of a way forward – even if their views collided at times.  

“Let’s just remind ourselves of how much of a problem it is today,” said King, an engineer by training. “Half of our top grade agricultural land is already at risk of flooding… If we don’t do more, one in four properties will be at risk. 

“We see something on the order of 3,000 excess deaths [annually], which are heat-related. The predictions are that we will be seeing over 10,000 heat related excess deaths by mid-century, unless we take some significant action. All of the [increased] morbidity is having an increasing impact on the ability of our health system to cope with that.

“We’re now starting to see more and more predictions of what kind of impact on GDP there will be,” said King, adding that robust research suggests a 7-8% reduction in GDP growth by 2050.

“I think it’s probably more than COVID. This is a huge impact, and I would absolutely put money on the fact that it is an underestimate,” she added.

Urgent to address heat impacts on health

The summit followed publication of the UK’s 2025 State of the Climate report, which found that, within the last decade the number of days 10°C above the 1961-1990 average, have quadrupled. 

“We had record temperatures of 40.3°C back in 2022 but the Met Office has now said that there’s a 50-50 chance that we exceed 40°C degrees again in the next 12 years,” said King.

“This is not modeling. This is empirical data that shows that, in the southeast of England, they’re already going up about 1°C per decade. So it wouldn’t be surprising if by mid-century, we were hitting temperatures from time to time of 45°C in the southeast. That’s something we really need to be prepared for.” 

King added that data to monitor climate change indicators, such as deaths from heat, flooding, diet, and climate-resilient health services delivery, remain sparse.  

“Are we seeing improvements in terms of protecting population health and the accessibility of health care delivery as the climate changes? No, not yet.,” she added.

“We’re starting to see some improvements in planning. So we’ve got a health service high temperature plan. I don’t think it’s enough planning. We’re not seeing any benefits yet. We’re still seeing heat-related deaths with morbidity increasing.”

Adaptation and mitigation need to be recognized as a cross-government issue, she added: “Government needs clear adaptation objectives supported by measurable targets.  We absolutely need to know what the government is aiming for.”

The UK Adaptation Committee recently commissioned a major review of potential adaptation actions, efficacy, costs and benefits. A subsequent modeling exercise, still under review, has since identified some potential “very easy, quick wins” such as “ensuring that the public knows what to do when it’s hot, making sure they are prepared, they know what they need to do to keep hydrated, that kind of thing.  

“This is the kind of process we’re trying to go through. And then when we do our reporting, when we assess progress, we will be able to say, well, here’s the target, here’s what’s been done, and here’s the gap.”

Make British Energy Great Again

Despite the gaps, it was encouraging to see how the UK Government is moving full-steam ahead on mitigation, filling a vacuum in international leadership left by the withdrawal of the US from the Paris Climate Agreement. 

“We don’t want to take the easy option of pretending that climate change isn’t happening or that all its effects can be mitigated. We want to act, and that’s exactly what we’re doing,” said Climate Undersecretary McCarthy at the start of the two-day event. 

“And it’s not just the direct impact [of heat] on our health, it’s also the indirect impacts. UK wheat production declined by over 20% last year, due to devastating rainfall.” 

Shortly after his election, UK Prime Minister Keir Starmer’s new Labour government established a Clean Power by 2030 action plan, with the vision of becoming a clean energy “superpower”. 

In May, the Great British Energy Corporation, backed by the UK’s National Wealth Fund, the Monarchy’s Crown Estate and the Scottish Government, was created by Parliament.  It is turbocharging investments in offshore wind projects, solar, nuclear, carbon capture and hydrogen storage, McCarthy said.

In the country that was the cradle of coal-powered industrialization a century ago, clean energy industries are now growing at three times the rate of the rest of the economy, McCarthy said: “We’ve seen £40 billion of investment into clean energy announced since last July.” 

The decarbonisation effort extends across all economic sectors, from transport and urban settings to rural environments, agriculture and buildings – including a £13.2 billion investment to retrofit the country’s ageing housing stock to better protect people from extremes of heat and cold.  

Internationally, the UK is stepping into some of the leadership gap left by the US retreat from clean energy. At last year’s COP29 in Azerbaijan, for instance, Starmer announced an ambitious goal of reducing domestic climate emissions by 81% by 2035.

“That was very much a signal that we wanted to lead those international efforts,” said McCarthy. “We set up a global clean power alliance. We’ve signed new climate agreements with India and China. Its obviously, incredibly important to bring them on board. We’re championing UK investors to invest in emerging and developing economies.”

Follow the money 

The government is working on making good on past COP commitments, such as the Powering Past Coal Alliance, which it co-chairs with Canada; the Forest and Climate Leaders Partnership and the Climate and Clean Air Coalition, which is addressing super pollutants, like methane and black carbon, and clean cooking.

At  COP29, developed countries committed to providing at least $300 billion annually by 2035 to support developing countries in mitigating and adapting to climate change. The commitment tripled the previous goal of $100 billion per year – but even that goal was never met. 

Additionally, the “Baku Finance Goal” aimed to raise $1.3 trillion per year by 2035 from public and private sources, to tackle climate change effectively, noted McCarthy, pledging that the UK would be doing its part to advance those commitments. 

She sees the core funding as supporting adaptation in LMICs, but adds that, “the outer core of funding will be more on the mitigation side, because if you’re decarbonizing industry, setting up a clean alternative, there’s a need to make the return easier to get the private sector to invest in that.”  

Powering past coal with a ‘message of hope’

At last month’s London Climate Action Week, the UK government also unveiled a new initiative to develop high integrity carbon markets.  

“There’s been a lot of concerns about greenwashing. But we think that if we can establish high integrity markets, we can channel huge amounts of finance to them, .. and because of our role as a leading financial centre, we can be at the forefront of financial innovation,” McCarthy said.

Along with the all-important financial and tech sectors, new initiatives in fashion, sports and the creative industries were showcased at the recent London Climate Action Week events. 

“We want a science-led approach to the crisis,” McCarthy added. “We believe that the government has a duty to be honest with people about the scale of the crisis… but we also want to deliver a message of hope – because that’s the only way we will be able to bring people with us to deliver the change we need.” 

Dearth of renewables investments in least developed countries

The UK is not the only leading player amongst developed countries. The European Union has set a target of reducing its net emissions by 55% by 2030, with a proposed 90% reduction by 2040, attaining net zero emissions by 2050. 

Last Thursday (24 July), the EU and China also signed a precedent-setting agreement to drive a “global just transition” on climate change. While it didn’t introduce any new commitments, it has been welcomed as a “timely stabilising signal” by groups such as 350.org  in the turbulent landscape of US retreat.    

But no significant climate and clean air investments have been made in the least developed economies, which are too indebted already to invest domestically and viewed as too high-risk for international investors, Sean Maguire of the Clean Air Fund told the simmit. 

By2024, only 1% of overseas development aid (ODA) has been invested in air quality projects, which reduce the global burden of seven million air pollution-related deaths annually and cut climate emissions, slowing global warming. 

“We do an annual report on levels of investments in air quality projects, and the numbers are pretty dismal,” Maguire said. “Roughly 1% of all ODA is spent on investments in air quality. It’s 6% when you add in projects that have air quality co-benefits. 

“We spend a lot of time and energy lobbying multilateral development agencies to increase that amount. There are some signs of them beginning to shift. But obviously you’ve got the countervailing cuts [in aid]  that’s going on in the bilateral development space.”

Money “tends to flow to middle income countries that can afford to take on more debt and have capability and capacity to take on loans,” he added.  “And a lot of this is coming in the form of lending rather than grants. 

“I do worry that, particularly in Africa, where you’re seeing mega cities developing, rising levels of air pollution and chronic levels of state indebtedness, that model of lending for improvement is just not going to work.”

Since the beginning of the year, the Green Climate Fund (GCF), has only approved six renewable energy projects including Africa, over the past five years.  Only five specifically African renewable energy projects had been approved since 2019, a Health Policy Watch assessment last year revealed. 

This month, a new GCF investment was made into the revised Global Green Bond platform, investing €200 million in equity funding to support the development of low-carbon energy systems for electricity production and stimulate reduced emissions for transport and other development areas.

Along with Brazil and Bangladesh, eight African countries are part of this new 10-nation initiative – Angola, Cameroon, Côte d’Ivoire, Egypt, Kenya, Namibia, Senegal and Uganda.

Air pollution deaths projected to grow – but mitigation returns are large

Unless and until major new investments in clean energy are made, exposure to air pollution that already kills some seven million people a year, will only get worse, Maguire pointed out. 

 “The World Bank predicts a 21% increase in the number of people who will be breathing air with pollutants (of PM 2.5) worse than 25 micrograms per cubic meter (µg/m³) in the next 15 years. So if it’s bad already, it can get a lot worse.

“We are going to have a much worse pollution crisis in many African cities and countries in the years to come,” added Maguire, referring to a World Bank report, which also showed that increasing investments in clean air strategies from $8.5 billion to nearly $14 billion annually could also halve the number of people exposed to excessive PM2.5 by 204o.  

“So not only do we need to invest for a return, we need to invest to avert a worse crisis,” Maquire said. 

“But if economies plan rationally, they would see the returns on clean air investments are very large,” Maguire underlined. 

“The World Bank recently said an investment in clean air in cities like Delhi would give you a two to 3.5 times,  rate of return. 

“And in the same report, they said that there’s $2 trillion worth of economic gains to be had by 2040 if we managed to get the amount of air pollution halved. So the message is simple and clear: invest in clean air. It makes sense for health. It makes sense for the planet. It’s a fabulous rate of return.”

Putting health at the center of climate negotiations: Belém and beyond?

One way to unlock more investments in renewable energy and other projects that yield health co-benefits, would be to establish health as a formal parameter of climate negotiations and commitments. 

So far it is not. COP’s formal negotiation tracks include mitigation, adaptation, finance, technology, capacity building. Other issues, such a loss and damage; just transition, indigenous peoples, youth, agriculture and oceans have also played prominent roles in recent years. 

On the official UNFCC website, amongst the 19 topics mentioned, health does not even have its own section.

While health has played a more prominent role in adaptation talks, it is still a minor feature in mitigation agendas, with little or no technical attention to health co-benefits of certain actions. 

Quantifiable health co-benefits of mitigation actions still don’t play a significant role as a quantifiable metric for prioritizing mitigation actions or reporting on outcomes. This means that health impacts or outcomes from climate actions remains outliers in Nationally Determined Commitments by countries, and consequently as investment priorities.  As a result, in COP outcome documents, health is typically only mentioned in passing.  

While CO 28 in Dubai featured a glitzy, first-ever official Health Day, including figures like Bill Gates and then-US Climate Envoy John Kerry, the health declaration adopted at the conference made no mention of fossil fuel’s health harms.  

The following year, even the hoopla was missing at COP29 in Azerbaijan, where a handful of officials and online ministers addressed an audience of a few dozen people. 

Oil-producing states led by Saudi Arabia, held up the closure of the World Health Assembly in May for hours in an effort to scuttle a vote on a new WHO Climate Change and Health Action Plan, which didn’t even mention the word fossil fuels as a driver of climate and health impacts.  

Can Brazil lead at COP30, while it rolls back environmental measures?

Brazil has promised to make health a more prominent part of its COP30 agenda in Belém (10-21 November). A pre-COP Global Conference on Climate and Health, begins tomorrow (29-31 July) in Brasilia, hosted by the Brazilian government and co-sponsored by WHO via its regional office, the Pan American Health Organization (PAHO). 

The Brasilia conference is supposed to review and revise a draft Belém Health Action Plan, set to be adopted at the November COP. The plan’s main focus remains adaptation, and particularly adaptation of health systems to climate change – a critical area of work but hardly the only one. 

The plan also does call for more “intersectoral policies that maximize health and climate co-benefits,” including “actions that reduce air pollution, prevent fires and dust storms, ensure access to healthy and sustainable diets, water availability, promote quality public transport, [and] climate-resilient housing,”

But as in the previous rounds of climate talks, COP28 and COP29, fossil fuels, are entirely missing from the draft health text with only one reference to “renewable energy”. 

Brazil, itself is facing a crisis over development policies in the Amazon and elsewhere, leaving question marks about how firmly it can lead other partners in bold action.

Health is  part of the COP ‘circus’ but not the inner chamber  

In global climate negotiations, health still remains a sideshow, admitted Alan Dangour, head of Wellcome’s new strategic focus on Climate and Health, in the closing session of the London Summit.

“For those of you who have not been to a COP, basically, there’s a circus with entertainment, and then in the middle, there’s a room where the negotiations happen,” said Dangour. 

“The Health Day was part of the circus,” he added, referring to the first big health event at COP28. “We got the [COP] President speaking, we got all sorts of people to speak, and we were very pleased with ourselves, and the community was very pleased with itself that we had managed to achieve that, but we achieved absolutely zero in that little [negotiating] room. 

“Since COP28, our entire focus has been on the negotiating group and we now support the African group of negotiators to make sure that health evidence is part of what they negotiate. 

“That was a very big learning for us. We needed the health base so that health was prominent, and then we needed to invest separately in the negotiating rooms and who says what, when, where in those rooms. And that’s now our clear focus: on how to influence what happens.”

Image Credits: Yoda Adaman/ Unsplash, Flickr/Russi Allison Loar , E. Fletcher/Health Policy Watch , E. Fletcher/Health Policy Watch, Imperial College-Connecting Climate Minds , E. Fletcher/Health Policy Watcy, HABVIA , HABVIA , Photo by ICJ/CIJ | Frank van Beek, Great British Energy , @WeDontHaveTime, Clean Air Fund, Green Climate Fund , UNFCCC.int , PAHO/WHO/Karina Zambrana, Megha Kaveri/HPW.