Global spending on health increased during 2021 at the height of the COVID-19 pandemic, reaching a record $9.8 trillion or 10.3% of global gross domestic product (GDP) – mostly as a result of governments devoting more domestic resources to health,

Country spending was highest on hospitals, accounting for 40% of expenditure, followed by ambulatory care (outpatients) providers (19%–24%) and pharmacies (16%–23%). 

The fastest growth in spending was on preventive care providers, such as public health institutions and disease control agencies. 

This is according to the World Health Organization’s (WHO) Global Health Expenditure Report 2023, based on data from 50 countries.

However, the per capita spending was “unequal”, the report notes, with high-income countries spending an average of $4001 per person in comparison to a mere $45 in low-income countries. Upper-middle-income countries spent $531, which was substantially more than the $146 per person in lower-middle-income countries.

“The distribution of global spending on health remained highly skewed in 2021: 79% was in high-income countries, which are home to less than 16% of the world population,” according to the report. 

“Low-income countries accounted for only 0.24% of the global health expenditure, despite having an 8% share of the world’s population.”

Spending on COVID-19 rose in real terms in 39 of 48 countries with data, accounting for 11% of government and compulsory insurance health spending in 2021, up from 7% in 2020. 

There was “no evidence” that the additional COVID-19 spending meant countries spent less on other diseases, or that spending on COVID-19 vaccines meant less money for testing and treatment, the report finds, stating: 

“The analysis suggests that the increased spending for COVID-19 did not crowd out spending for other health needs, although it might have affected the rate of growth of spending for these other purposes.” 

In addition, out-of-pocket spending on health in low-income countries fell in 2020 and 2021 but rose to pre-pandemic levels in high, upper-middle and lower-middle-income countries in 2021 after a decline in 2020.

Lack of data on spending patterns

The WHO said that action is still needed at the domestic and international levels to improve data collection on spending patterns. 

“While most countries regularly report aggregated health spending data, few consistently report the critical details that underpin these high-level results. Accordingly, only a partial view of the spending dynamics during the COVID-19 pandemic – by provider, function, and disease and condition – is possible in this report.”

The report also notes the lack of information on health capital investment “which limits the insights into this critical area of health policy”. 

“More effort is needed, therefore, to improve data collection and increase the number of countries developing and reporting disaggregated health account data. Key to this is institutionalising health account practices at the country level.”

Hard to sustain higher spending levels

External aid was “crucial” in supporting government spending in 2021 in low and lower-middle-income countries. However, sustaining government health spending and external aid at 2021 levels may be challenging given “the deterioration in global economic conditions and the rise in debt-servicing obligations”.

“Amid this more difficult financing environment, a key challenge for countries will be to resist the urge to de-prioritize government spending on health. Doing so risks rolling back progress towards universal health coverage,” according to the report.

Image Credits: WHO African Region , WHO PAHO.

Dr Anshu Banerjee, WHO director for maternal, newborn, child, adolescent health and ageing, described the new guidelines as “a tool to support a holistic approach to chronic low back pain care”.

The World Health Organization (WHO) has released its first guidelines for addressing low back pain, a condition affecting an estimated 619 million people, or one in 13 worldwide.

The new guidelines are designed to enhance care quality for millions suffering from the condition, offering healthcare professionals a range of non-surgical treatments applicable in primary and community care settings. The guidelines also list treatments to avoid, including lumbar braces, traction-based physical therapies, and opioid painkillers.

The prevalence of low back pain is expected to surge as the global population ages, with estimates predicting a rise to 843 million affected individuals by 2050. Low back pain currently accounts for 8.1% of years lived with disability globally, according to the WHO.

“To achieve universal health coverage, the issue of low back pain cannot be ignored, as it is the leading cause of disability globally,” said Dr Bruce Aylward, WHO assistant director-general for universal health coverage and life course, in a press release accompanying the guideline launch.

Nine out of ten cases of low back pain are chronic, deeply affecting patients’ ability to work and stay active in family and social life, often leading to broader economic and mental health consequences. The guidelines emphasise mental health care as crucial in treating these conditions.

Chronic low back pain also has significant economic repercussions at the national level, pushing individuals out of the workforce and straining health systems.

The annual global costs associated with low back pain exceed $50 billion and potentially reach up to $100 billion at the upper end of estimates, according to the British Medical Journal. This financial impact is especially pronounced in low- and middle-income countries (LMICs), where 80-90% of employment involves heavy labour, significantly increasing the prevalence of LBP compared to high-income nations.

The WHO guidelines provide a multifaceted approach to treatment, emphasising patient education in self-care techniques, structured exercise programs, spinal manipulative therapy, and massage, while cautioning against certain treatments like traction and therapeutic ultrasound.

WHO officials emphasised that while the guidelines provide a general framework, adapting them to local clinical practices is essential for effective implementation.

“Addressing chronic low back pain requires an integrated, person-centred approach,” said Banerjee. “This means considering each person’s unique situation and the factors that might influence their pain experience.”

Recognising low back pain as a national health priority is crucial for optimising healthcare management in this area, WHO stressed – a step many countries have yet to take.

Image Credits: Adam McGuffie.

Vidya Kishnan and Garry Aslanyan on "Dialogues," a new series from the Global Health Matters podcast.
Vidya Kishnan and Garry Aslanyan on “Dialogues,” a new series from the Global Health Matters podcast.

The elimination of tuberculosis cannot be achieved if medicines are locked in a “patent panoply,” according to Indian author and journalist Vidya Kishnan.

Speaking to Garry Aslanyan on the most recent episode of Dialogues, a new series from the Global Health Matters podcast, the author of “Phantom Plague: How Tuberculosis Shaped History” said that “everything that happened in COVID has been happening for decades with TB.

“In India, the entire TB program got ‘Covidized,’ down to the helpline of the Ministry [of Health], and infections and respiratory diseases don’t simply go away,” Kishnan said. “So, the first thing we need to do is look at how technology is transferred because vaccines and drugs first and foremost, it’s technology. It’s somebody’s intellectual property. And I feel like TB elimination cannot, will not be achieved if the medicines, the latest most humane therapy, is locked in a patent panoply.”

The most exasperating aspect, according to Kishnan, is that the advancements in tuberculosis therapies resulted from a sincere collaboration within the public domain. Universities, student funds, and philanthropic contributions collectively supported these efforts. Notably, several late-stage clinical trials for bedaquiline took place in India and South Africa, with patients actively contributing to the process.

“It’s really unfair that you use patients for research, but then when … all of these drugs came out of industrial scale subsidies to pharmaceutical companies, and others in patent panoplies.”

Throughout her writing career, Kishnan has dedicated considerable effort to investigating and documenting the profound impact of tuberculosis on individuals from various backgrounds in India. In her book, she delves into critical questions concerning the intersection of race and caste within policies that shape the dynamics of tuberculosis spread and control in the contemporary context of her home country.

Kishnan tells Aslanyan that in India, people live in congested cities and are still segregated by race, caste, and class. Pathogens do not respect these boundaries. However, the rich generally access medicines, whereas the poor are left behind.

In India, tuberculosis has reemerged as the foremost infectious disease killer. She said the lessons from previous pandemics underscore a fundamental truth: No one can be considered safe until everyone is protected from the threat.

“I feel like a stuck record saying this over and over again everywhere I speak. But it was quite surreal to see the science denialism and the racism and casteism in my country, all of the things I had read about, the xenophobia, all of it just came to life in the past three years,” Kishnan said. “If we are greedy and if we think in these myopic ways, I don’t see any way we will prevail over these pathogens despite all the fruits of modern medicine.”

Aslanyan concluded: “This conversation reminds us, as global health professionals, of many challenges on the long road ahead toward the ultimate goal of tuberculosis elimination and the importance of community engagement.”

Listen to previous episodes of Dialogues on Health Policy Watch.

Image Credits: Global Health Matters (TDR), Global Health Matters Podcast (TDR).

Dr Tedros Adhanom Ghebreyesus at end 2023 press briefing

In the wake of COP28, WHO will press ahead with calls for fossil fuel phase out, stepped up commitments for health sector decarbonization, and a new resolution on Climate and Health, set to go before the World Health Assembly in May 2024.

Those were key takeaways from an end-year WHO global press briefing by WHO Director General Dr Tedros Adhanom and other senior officials in an end-year press briefing Friday before the Geneva press corps.

Health and humanitarian crises associated with raging conflicts in Gaza, Sudan, Myanmar, Haiti, DR Congo and other conflict hotspots were also top on the agenda of WHO, as well as other UN agencies in as second press briefing Friday morning, looking back on 2023.

In addition, WHO warned that a more dangerous clade of mpox, the virus that swept the world in 2022 and 2023, is now being transmitted by sexual contact in the central and western Africa, including female sex workers as well as men who have sex with men – and its spread also represents a potential global threat. Even so, “not a single dollar” of donor funds has been raised to support the scale up of diagnosis, treatment, vaccination or monitoring and surveillance in DR Congo and other African states where the virus is most active and spreading, said Maria Van Kerkhove, a WHO Health Emergencies specialist.

Fossil fuels the main driver of climate change

Drought in Burkina Faso, yet another sign of climate change impacting human health and livelihoods.

“We single out fossil fuels because it’s not just one of the contributors, it is the major contributor to climate change,” said Dr Tedros, at the Friday afternoon press briefing. “Fossil fuels are three components – oil, coal and natural gas.  And these three combined contribute more than 75% of carbon emissions.  So if you don’t focus on the fossil fuels that contribute more than 75% to the carbon emissions, then where do you focus?

“When you focus on the major contributor, you can make progress and that is why the global community is asking for more consensus on phasing out fossil fuels.”

A landmark agreement Wednesday, at the close of the UN Climate Conference in Dubai, COP28, took the first tentative steps towards that goal. The final agreement calls, endorsed by 198 nations, for a “just, orderly, and equitable” transition away from fossil fuels in energy systems to achieve “net zero by 2050 in keeping with the science”.    A call for a complete phase out of fossil fuels, supported by 127 nations at COP28, was removed from the text after intense lobbying by oil-producing nations, led by Saudi Arabia. The reference to “energy systems” also creates a giant loophole in the calls for transition, effectively overlooking fossil fuel use in heavy industries like cement and steel industries, as inputs to fertilizers and plastics, and possibly transport.

Following a first-ever “health day” at COP28, a WHA resolution on climate and health is now being negotiated by member states, said Dr Maria Neira, head of WHO’s Department of Climate, Environment and Health.

There are also initial efforts underway to explore how health indicators could be better integrated into global measures of progress on climate change – to better underline the health connection and inspire progress, she said.

“Why not put up a health-related indicator as the ultimate demonstration of success,” she told Health Policy Watch, adding that air pollution exposures could be one relevant measure, insofar as most air pollution is created by the same sources of fossil fuel or biomass burning that contribute to climate change.  “Or how about the number of countries implementing air quality guidelines for instance, or having health incorporated into national determined contributions (NDCs)?”

Unprecedented number of health and humanitarian crises

Emergency shelters at the Awar camp site in Mahagi, Ituri province in the eastern Democratic Republic of the Congo.

As the climate crisis continues to exact an increasingly severe human toll, 2023 has seen an almost unprecedented number of health and humanitarian crises raging across the world, Tedros and other WHO officials at the briefing noted.

Those range from the approximately 1.9 million Palestinians displaced in Gaza amidst the ongoing Israel-Hamas war; to the war in the Sudan which has displaced over 7 million people, also causing acute, widespread hunger; a new civil war in Ethiopia, this time with rebels in the country’s Amhara region; gang violence in Haiti, and rebel violence in eastern DR Congo that has displaced a record 6.9 million people. And that list doesn’t even include Russia’s war in Ukraine, as well as protracted conflicts in Myanmar, northwestern Syria and elsewhere.

“All of these crises come at a heavy price, in term of lives lost and communities destroyed, but also in terms of the cost of delivering humanitarian aid,” said Tedros.  He called again for an immediate cease-fire and unfettered access by health workers transporting patients and bringing supplies to hospitals in all parts of the beseiged enclave, and particularly to three still-functioning hospitals in northern Gaza, an epicenter of combat.

While a recent Israeli announcement that it would open up a new crossing into Gaza from its Kerem Shalom crossing point is “very good news”, Dr Richard Peeperkorn, WHO representative to the Occupied Palestinian Territories, stressed that “we are not only talking about getting supplies into Gaza, ware talking about getting supplies to people all over Gaza.”

Sexual transmission of Clade 1 mpox raises renewed concerns

Mpox lesions

Meanwhile, WHO officials expressed growing concerns over the increasing signs of sexual transmisson of the deadly Clade 1 of mpox in DR Congo, Nigeria and neighboring countries.  While last year’s global outbreak of Clade 2 of the virus was primarily seen among men who have sex with men, Clade 1 is now being transmitted sexually to women, including sex workers in major Nigerian and Congolese cities, such as Goma, said WHO’s Rosamund Lewis, speaking at a Friday morning press briefing convened by the UN press office in Geneva.

Whereas the Clade 2 virus that trigggered a WHO declaration of a global public health emergency in 2022, has a case fatality rate of about .18%, death rates of Clade 1 are 5-8% in the DRC, which has recorded its highest-ever levels of confirmed and suspected cases this year, Lewis said.

“This is a much more serious disease,” said Mike Ryan, at the WHO Friday evening briefing. “The virus is growing in geographic dimensions, and in numbers. Anytime you see a virus breaking those geographic barriers, breaking the susceptible group barriers. You have to be very careful. 

“From a global level, we have not been able to raise any funding to deal with an ancient threat that is killing right now, spreading right now, evolving, right now,” Ryan stressed, also noting the genetic links between mpox, an orthopoxvirus, and smallpox, which was finally eradicated in the 1970s.  

“We talk about all of the casualties of war, but smallpox probably killed more people than all of the wars in  history,” Ryan added. 

Image Credits: E. Fletcher , Yoda Adaman/ Unsplash, IOM 2023, Tessa Davis/Twitter .

Dr Olivi Ondchintia Putilala Silalahi, WHO Indonesia national professional officer for routine immunization, inspects a COVID-19 vaccination site in Indonesia.

A spike in COVID-19 cases in Southeast Asia has prompted Indonesia, Singapore and Malaysia to reintroduce screening for travellers at airports.

In the past week, Indonesia has installed thermal body scanners at Jakarta International Airport and the main ferry line.

The Bali Port Health Office has also implemented thermal checks at three border entry points: Benoa Port, Celuk Bawang, and I Gusti Ngurah Rai International Airport, and appealed to travellers to wear masks – particularly if they are feeling unwell.

Should a tourist or foreign national test positive for COVID-19 upon arrival, they will be immediately quarantined in a designated health facility or referral hospital in Bali, according to a circular issued this week by the Ministry of Health.

The Indonesian health authorities have also urged citizens to wear masks, ensure they are fully vaccinated and postpone travel to areas that are reporting a spike in COVID-19 cases.

https://twitter.com/BloombergAU/status/1735242493136920598

Jump in cases in Singapore

In Singapore, COVID cases increased by 10,000 in a single week, jumping from 22,000 to 32,035 in the week ended 2 December, according to the health ministry.

“The increase in cases could be due to a number of factors, including waning population immunity and increased travel and community interactions during the year-end travel and festive season,” said the Ministry of Health. 

“We urge the public to exercise precaution, personal and social responsibility,” said the Singaporean Health Ministry.

“When travelling overseas, stay vigilant and adopt relevant travel precautions, such as wearing a mask at the airport, purchasing travel insurance, and avoiding crowded areas with poor ventilation.”

“Everyone is advised to keep up to date with their COVID-19 vaccinations. This includes an additional dose around one year after their last vaccine dose for those aged 60 years and above, medically vulnerable persons, and residents of aged care facilities,” it added.

Malaysia COVID cases: 14 December 2023

Meanwhile, cases in Malaysia doubled in a week, jumping from 6,796 cases at the end of November to nearly 13,000 by 9 December, according to the New Strait Times.

Malaysian Health Minister Dzulkefly Ahmad recommended on Thursday that people wear masks and get a COVID-19 booster if they were elderly or had co-morbidities, according to the Strait Times.

Image Credits: WHO Indonesia.

The COP28 climate summit, the largest in history, concluded with a landmark but contentious agreement to transition away from fossil fuels, endorsed by 198 nations. This historic agreement, known as the UAE Consensus, represents the first time in the 28-year history of UN climate summits that nations have collectively resolved to move away from the fossil fuels that are at the heart of the climate crisis.

The final agreement calls for a “just, orderly, and equitable” transition away from fossil fuels in energy systems to achieve “net zero by 2050 in keeping with the science”. A call for a complete “phase-out” of fossil fuels was left out of the final agreement after intense lobbying from oil-producing countries led by Saudi Arabia, despite strong support for the phase-out wording from 127 nations, representing over 72% of the nations attending the climate summit.

“To those who opposed a clear reference to phase out of fossil fuels during the COP28: Whether you like it or not, fossil fuel phase-out is inevitable,” United Nations (UN) Secretary-General Antonio Guterres said on Wednesday. “Let’s hope it doesn’t come too late.” 

The final agreement notably restricts the call for a fossil fuel transition to “energy systems”, raising questions over the agreement’s applicability to fossil fuels used in heavy industry, as feedstocks for chemicals and plastics, and in transportation — all major contributors to annual greenhouse gas emissions.

Dr. Sultan Al Jaber, the summit’s president, lauded the agreement as a “historic” triumph of “unity, solidarity, and collaboration.”

“Together, we have confronted realities and we have set the world in the right direction,” said Al Jaber. “We have given it a robust action plan to keep 1.5 within reach. It is a plan that is led by the science.”

Reactions from scientists, activists, and policymakers were mixed, with many highlighting both the deal’s historic nature and its shortcomings.

“The deal is historic, no doubt. The final text signals the beginning of the end of the fossil fuel era,” Dr Maria Neira, head of the Department of Climate, Environment and Health at the World Health Organization (WHO) told Health Policy Watch.

“However, as fossil fuels are the leading driver of climate change and its health impacts, responsible for seven million premature deaths every year, and many other additional health hazards, a rapid and ambitious phase-out will be critical for health,” Neira added.  

Language in the UAE Consensus limiting the transition away from fossil fuels to “energy systems” has raised concerns about the scope of global commitments to reduce dependence on fossil fuels in other sectors. / Data: IEA

Dr Friederike Otto, a prominent climate scientist from Imperial College London and a founding member of the World Weather Attribution group, expressed profound disappointment with the outcomes of the COP28 agreement.

 “The lukewarm agreement reached at COP28 will cost every country, no matter how rich, no matter how poor. Everyone loses. With every vague verb, every empty promise in the final text, millions more people will enter the frontline of climate change and many will die,” said Otto.  

“It’s hailed as a compromise, but we need to be very clear what has been compromised. The short-term financial interest of a few has again won over the health, lives and livelihoods of most people living on this planet,” she added. 

Small island states, already grappling with the existential threats of rising sea levels and intensifying storms, epitomize this sense of sacrifice and imminent danger on the frontlines of climate change. Delegates from these imperilled island nations characterized the absence of a complete fossil fuel phase-out in the final agreement as a “death sentence” for their homelands.

“We have built a canoe with a weak and leaky hull. Yet we have to put it into the water because we have no other option,” a representative from the Marshall Islands told the closing plenary of the summit. “We need to phase out fossil fuels. It’s a small step in the right direction. In the context of the real world, it is not enough.”

‘A historic COP’

The agreement, nonetheless, is groundbreaking. It recommits the world to the 1.5°C warming target of the 2015 Paris Agreement, a goal reiterated 13 times in the text, and clearly states that the science dictates countries must cut emissions by 43% by 2030, and 60% by 2035 relative to 2019 levels.

It also commits to reaching net zero carbon dioxide emissions by 2050, calls for a tripling of global renewable energy capacity, and slashing methane emissions. 

The agreement also candidly addresses the immense scale of the financial challenges ahead. It estimates that developing countries will require between $215-billion and $387 billion in adaptation finance by 2030, with a global annual investment of $4.3 trillion in green energy required until 2030, escalating to $5 trillion thereafter. 

The agreement also includes a call for reforming the global financial architecture, notably the World Bank and the International Monetary Fund, to enable developing countries to access vital finance to adapt to climate change. 

“We got a loss and damage fund. We got the recapitalisation of the Green Climate Fund for adaptation. We got an affirmation of a climate finance system, which runs from public finance to private finance. We got a commitment to the tripling of renewables and we got an affirmation of transitioning away from fossil fuels,” Avinash Persaud, Special Envoy to Barbados Prime Minister Mia Mottley, said in a media briefing on Wednesday. 

“Those are five difficult things,” he added. “It’s a historic COP, the best we’ve had in eight years (since Paris).” 

Further accomplishments of the UAE Consensus include pledges to halt deforestation by 2030 and to incorporate health as a distinct sector in adaptation funding, a key ask of the World Health Organization and global health experts. 

“Health is firmly embedded in the newly adopted Global Goal on Adaptation,” Arthur Wyns, COP28 advisor at the WHO, told Health Policy Watch. “A dedicated health adaptation target helps to ensure the health sector itself will receive a stronger focus on adaptation going forward.”

‘A litany of loopholes’

Global greenhouse gas emissions has steadily increased year-on-year since the first UN Climate Summit in 1995.

Despite these advancements, the agreement’s non-binding nature and “litany of loopholes” elucidated by the Alliance of Small Island States have raised significant concerns about its implementation and whether it will mark a true turning point in the climate crisis.

The final agreement contains a series of concessions to fossil fuel interests, including references to “transition fuels” — code for natural gas — and carbon capture and storage technologies, which remain unproven on a large scale. An estimated 79% of operating carbon capture capacity globally is used to reinject captured carbon into the ground to produce more oil. These technologies also incur significant costs and frequently result in net increases in emissions. 

A timeline for the complete phase-out of methane emissions – a potent but short-lived greenhouse gas – and language calling for a peak in global greenhouse gas emissions by 2025, were removed from the final agreement.

Global standards for regulating carbon markets, a key issue given the prevailing skepticism about the legitimacy of carbon markets as a means to offset emissions, remained unestablished due to opposition spearheaded by Saudi Arabia, China, and India.

These loopholes leave considerable room for interpretation and potential exploitation by vested interests, Simon Stiell, President of the UN Framework Convention on Climate Change (UNFCCC) said in his closing remarks on Wednesday. 

“Loopholes leave us vulnerable to fossil fuel vested interests, which could crash our ability to protect people everywhere against rising climate impacts,” Stiell remarked in his closing comments. “Transparency and people holding their governments to account will be vital to closing these loopholes.”

“Whilst we didn’t turn the page on the fossil fuel era in Dubai, this outcome is the beginning of the end,” said Stiell. “Now all governments and businesses need to turn these pledges into real-economy outcomes, without delay.”

Climate finance question remains unanswered

Climate finance from rich countries fell to $21 billion in 2021, hundreds of billions short of the estimated financial needs of developing countries every year for adaptation alone.

While the agreement recognizes the need for trillions, not billions, of dollars to tackle climate change,  it stops short of outlining specific funding sources. The more than $85 billion mobilized in new climate finance at COP28 is significant but falls far short of what is required for developing countries to transition equitably to green energy. The United States, the world’s largest economy, committed a mere $20 million in new climate funds at the summit.

Madeline Diouff Sarr, chair of the Least Developed Countries Group representing nearly 50 of the world’s poorest nations, expressed disappointment in the agreement, describing it as “the very lowest possible ambition we could accept.”

“There is recognition in this text of the trillions of dollars needed to address climate change in our countries. Yet it fails to deliver a credible response to this challenge. Next year will be critical in deciding the new climate finance goal,” said Sarr. “Today’s outcome is full of eloquent language but regrettably devoid of actionable commitments.”

While COP28 marked a day-one victory for climate finance by operationalizing the Loss and Damage Fund, which aims to provide financial assistance to vulnerable countries in the path of the most devastating effects of climate change, the fund is effectively empty so will do little to bridge the climate finance gap in the short-term.

“Limiting warming to 1.5°C is a matter of survival,” said Sarr. “[It] not only requires countries to urgently reduce domestic emissions but also the delivery of significant climate finance.”

Fossil fuel production paradox

Governments’ fossil fuel expansion plans show they intend to produce, in total, 110% more fossil fuels in 2030 than are compatible with the 1.5°C limit set out in the Paris Agreement, and 69% more than is consistent with 2°C of warming, according to UNEP.

The agreement also fails to address the paradox of ongoing global fossil fuel production expansion. Despite a clear mandate for drastic emission reductions by the decade’s end, there remains a significant gap between current efforts and those required to maintain the 1.5°C target.

Saudi Arabia and other oil and gas-producing states made headlines for their efforts to exclude fossil fuel language from the final agreement, but governments and industries worldwide continue to ramp up fossil fuel production, casting a shadow over the commitments made in Dubai.

Ursula von Der Leyen, President of the European Commission,  praised the Dubai agreement as “historic” and marking “the beginning of the post-fossil era,” yet European countries continue to spend billions on new liquified natural gas terminals as the continent diversifies away from Russian oil and gas and increase imports from the very African countries it is asking to limit use of these energy sources. 

The United States, which backed stronger language on eliminating fossil fuels, continues to lead the world in oil and gas production, which is at historic highs, and expand production. 

Adnoc is opening up new oil and gas fields in the United Arab Emirates and expanding its drilling sites off the coast of the Arabian Peninsula. 

Adnoc, the Abu Dhabi National Oil Company run by COP President Al Jaber, plans to invest over $150 billion over the next five years to expand production – the largest such plan by any company in the world. More than 92% of Adnoc’s oil and gas expansion plans are not compatible with the 1.5°C pathways, according to data from German environmental NGO Urgewalt. 

Despite the escalating climate crisis, 96% of oil and gas companies involved in exploration for new deposits continue to develop new oil and gas fields, according to the Global Oil and Gas Exit list, a database which tracks the activity of companies responsible for 95% of global oil and gas output.

“COP is meant to be the vehicle for solutions, but all it seems to do is recognise problems that the rest of the world identified years ago,” said Mike O’Sullivan, a leading climate expert from the University of Exeter. “It’s obvious to most people that limiting global warming meant reduced fossil fuel use, but only now do our leaders say this.

“But so what? Where are the real global plans for the energy transition, without relying on fanciful tech solutions, with adequate support for poorer nations? Where is the global leadership to take the right action, not the selfish action? Across the globe, there are plans to expand fossil production – how does this fit with the text that’s just been agreed?” said O’Sullivan. 

The market’s reaction to the COP28 pledge did not indicate concern for its potential impact on the fossil fuel sector. In fact, premarket trading saw a modest increase in the shares of oil giants Chevron and Exxon Mobil on Wednesday. 

In another sign of confidence in the sector, Aramco, the leading global oil producer, finalized an agreement on Tuesday to secure a 40% stake in Gas & Oil Pakistan, marking its inaugural venture into the Pakistani market and the latest chapter of the company’s global expansion. 

Mike Berners-Lee, a carbon footprinting specialist at Lancaster University, cautioned that the fossil fuel sector achieved its goals at the summit.

“Cop28 is the fossil fuel industry’s dream outcome,” he observed. “Because it looks like progress, but it isn’t.”

Image Credits: UNEP.

Rush hour traffic in Ho Chi Minh City in Vietnam.

Ten countries have slashed their road traffic deaths in half between 2010 and 2021, while  35 others have reduced deaths by between 30% and 50%, according to the World Health Organization’s (WHO) Global Status Report on Road Safety 2023 released this week.

The big achievers are Belarus, Brunei, Denmark, Japan, Lithuania, Norway, Russia, Trinidad and Tobago, United Arab Emirates and Venezuela.

Meanwhile, there was an overall global reduction in deaths of 5% over the period, with 1.19 million people dying per year.

“Yet with more than two deaths occurring per minute and over 3,200 per day, road traffic crashes remain the leading killer of children and youth aged 5–29 years,” according to the WHO.

“The tragic tally of road crash deaths is heading in the right direction, downwards, but nowhere near fast enough,” says WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “The carnage on our roads is preventable. We call on all countries to put people rather than cars at the centre of their transport systems, ensuring the safety of pedestrians, cyclists and other vulnerable road users.”

The majority of road traffic deaths occurred in the WHO’s South-East Asia Region (28%), followed by the Western Pacific (25%), African Region (19%), the Americas (12%), and the Eastern Mediterranean Region (11%). The least occurred in the European Region (5%).

Some 90% of deaths occur in low- and middle-income countries (LMICs), and the risk of death is three times higher in low-income than high-income countries despite low-income countries only having 1% of the world’s motor vehicles.

More than half of fatalities occur among pedestrians, cyclists and motorcyclists, in particular those living in LMICs. Pedestrian deaths rose 3% to 274,000 over the decade, accounting for 23% of global fatalities. Deaths among cyclists rose by nearly 20% to 71,000, accounting for 6% of global deaths. 

“Research indicates that 80% of the world’s roads fail to meet pedestrian safety standards and just 0.2% have cycle lanes, leaving these road users dangerously exposed. And while nine in 10 people surveyed identify as pedestrians, just a quarter of countries have policies to promote walking, cycling and public transport,” according to WHO.

The report also reveals an alarming lack of progress in advancing laws and safety standards. Only six countries have laws that meet WHO best practice for all risk factors, namely speeding, drunk driving, compulsory motorcycle helmets, seatbelts and child restraints.

The global motor vehicle fleet is set to double by 2030, but only 35 countries – less than a fifth of UN Member States – legislate on all key vehicle safety features, while only a quarter require vehicle safety inspections that cover all road users.

“Our mission at Bloomberg Philanthropies is to save and improve as many lives as possible, and one of the best ways to do that is to make more of the world’s roads safe for all,” said Michael R. Bloomberg, founder of  Bloomberg Philanthropies, which supports a substantial global road safety programme.

“For more than a decade now, we’ve made encouraging progress together with the WHO and our partners. Still, as this new report makes clear, road safety demands stronger commitments from governments worldwide – and we’ll continue to urge more leaders to take lifesaving action,” added Bloomberg, who is the WHO’s Global Ambassador for Noncommunicable Diseases and Injuries.

Image Credits: tph567/Flickr, Flickr/ M M.

The outsized effect of climate change on young children represents an “intergenerational injustice”, according to experts speaking at a side event on maternal and child health at COP28 in Dubai. 

“Nearly 90% of the global burden of disease associated with climate change is borne by children under the age of five,” according to UNICEF. 

“Climate change has already had an impact on heat-related child mortality in sub-Saharan Africa. The annual average heat-related child mortality for the period from 2005 to 2014 was approximately under 20% higher than would have been observed without climate change. This so-called ‘climate penalty’ will be worse over the coming years,” said Veronique Filippi, Professor at the London School of Hygiene and Tropical Medicine. 

There is also compelling evidence that heat can increase the risk of preterm births, stillbirths, hypertension as well as preeclampsia, she said.

“There are no physiological reasons why pregnant women or newborns are more vulnerable to the health impact of environmental disasters,” emphasized Filippi. “The main reason for vulnerability is the position of women in society, their limited agency and mobility.” 

Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at the World Health Organization (WHO) said that while global carbon emissions have to be reduced, health facilities also have to be equipped with solar power and cooling facilities for patients. 

“For every climate-related project proposal, we should make sure that it has a maternal, child, adolescent health impact lens as well,” he said. 

WHO’s Dr Anshu Banerjee.

Evidence gaps

While there is growing evidence of the different ways climate change affects pregnant women and young children, there continue to be gaps which affect the response.

“Most of the evidence is related to the effects of air pollution, followed by temperature and the effect of disasters, food insecurity, and water access,” Filippi said. 

Angela Baschieri, UNFPA’s Technical Lead on Climate Change, reiterated that it was important to generate “evidence that helps us to inform how we design program as well as the evidence that we need to ensure that we are targeting and we are reaching those who are left behind or may be more exposed”. 

Only 23 national climate action plans out of 119 reviewed by UNFPA have made some reference to maternal and newborn health. These responses have largely been community-led interventions, Baschieri said.
Improving basics like water and sanitation, as well as involving community healthcare workers emerged as some of the key responses that experts said are known to deliver results.

Improve basics like water access

Nobel Prize-winning economist Michael Kremer from the University of Chicago said ensuring communities have basics like clean drinking water can go a long way in responding to worsening climate impacts.

“First, cyclones, floods and heavy rains spread pathogens into drinking water sources causing disease spikes,” he said. “Second, droughts can force people to move to less safe water sources. Finally, increased temperatures can accelerate the growth of pathogens and water,” he explained, elaborating on the climate change and poor water quality link. 

Kremer said water treatment provides a proven safe and cost-effective solution and could prevent a quarter of children’s deaths.

“Water treatment can save more lives than virtually any other health intervention,” he said. Kremer pointed out gains countries like India, Rwanda and Malawi have policies and pilot projects to improve the delivery of safe drinking water to populations. 

“Water treatment has historically been neglected because it falls between the health sector and the water sector. And as many people emphasize, we need to move beyond the silos, particularly as climate change increases threats to water safety and health,” Kremer said.

Working with community-based health workers to improve healthcare delivery is a direct way to provide relief to pregnant women and children.

Nobel Prize-winning economist Michael Kremer

Community-based response

In 2022, when extreme rainfall worsened by climate change caused devastating floods in Pakistan,  over 100,000 pregnant women were affected, primarily because they could not access services.

“The breakdown that had happened in continuity of care led to so many adverse outcomes in maternal health,” said Neha Mankani, a midwife and project lead at the International Confederation of Midwives. 

“They did not have a safe place to give birth. There were abortion care services that they weren’t able to get, and there were newborn feeding issues that were happening,” she said, adding that community-based healthcare workers were a solution in times of crisis.

Neha Mankani, a midwife and a Project Lead at the International Confederation of Midwives

“We should look at climate change through a rights and human capital development lens and ensure that meaningful engagement of the most vulnerable. Women and children need to be engaged in setting policies because they are the ones who know how it affects them,” said Banerjee.

Image Credits: Guillaume de Germain/ Unsplash.

The UN climate negotiations have gone into overtime – again.

Early this week, the 28th year of United Nations (UN) climate summits saw its hopes for a historic agreement to end the fossil fuel era dashed by industry interests resisting efforts to phase out their use.

The negotiations extended into overtime, familiar to COP proceedings, as diplomats from nearly 200 countries attempted to bridge the global divide on the future of fossil fuels and prevent the summit’s collapse.

The fight over the final agreement intensified when a draft was released by the United Arab Emirates (UAE) presidency on Monday. It removed language explicitly calling for a total “phase out” of oil, gas, and coal from the global energy mix.

The latest draft text, released on Wednesday after negotiations pressed on into the early hours of the morning, does not include a commitment to phase out or down fossil fuels. Scientists, environmentalists, and human rights advocates say phasing out fossil fuels is essential to maintaining the 1.5C warming cap set in the 2015 Paris Agreement.

Instead, the draft calls on nations to transition “away from fossil fuels in energy systems, in a just, orderly, and equitable manner, accelerating action in this critical decade, so as to achieve net zero by 2050 in keeping with the science.”

Other significant changes include removing a directive to phase out coal use “this decade” and limits on new coal production, allowing coal-dependent nations like China and India to continue their reliance on the highly polluting fuel.

Specific targets for reducing methane and other non-greenhouse gas emissions were removed. Recognition of the “need for deep, rapid and sustained reductions in greenhouse gas emissions in line with the 1.5C pathways” was added for the first time.

‘False solutions’

“It is clear that not everyone is ready to admit the truth of what’s needed,” said Tom Evans, policy advisor at climate change think tank E3G. “This text alone might help avoid disaster in Dubai but it does not avoid disaster for the planet.”

While the first draft drew widespread criticism, reactions to the new draft are mixed. The central change in language around fossil fuels is the shift from nations “should” transition away from fossil fuels to a text that “calls on” nations to do so — a minor but significant change in U.N. language.

Over 120 countries, 72% of nations at COP, have expressed direct support for an agreement that includes phasing out fossil fuels, according to an analysis by the Pacific Islands Climate Action Network and Oil Change International on Tuesday. This marks a significant increase from COP27 in Egypt, when 80 countries called for a phase-out limited to the electricity sector.

“Overall, we get a clear signal to phase out fossil fuels… It is not the most ambitious outcome we could have landed at this COP, given the momentum from over a hundred countries demanding strong language on this, but it’s a step forward,” said Amos Wemanya, senior advisor at Renewable Energy and Just Transitions. “But we still have a lot of false solutions in the text.”

 

The mood after the first draft agreement on Monday was summarized by former US Vice President Al Gore, who criticized the draft for reading “as if OPEC [the Organization of Petroleum Exporting Countries] dictated it word for word.”

“COP28 is now on the verge of complete failure. The world desperately needs to phase out fossil fuels as quickly as possible,” Gore said. “There are 24 hours left to show whose side the world is on: the side that wants to protect humanity’s future by kickstarting the orderly phase-out of fossil fuels or the side of the petrostates and the leaders of the oil and gas companies fueling the historic climate catastrophe.”

Although the draft falls short of the “phase out” demands from more than 120 nations, environmental groups, and scientists, it is the first COP agreement to directly address the need to move away from all fossil fuels. This represents a significant shift in focus for the UN climate negotiations, which did not explicitly mention any fossil fuels until COP26 in Glasgow, where coal was first included.

“For the first time in three decades of climate negotiations the words fossil fuels have ever made it into a COP  outcome,” said Mohamed Adow, Director of the energy and climate think tank Power Shift Africa. “We are finally naming the elephant in the room.”

While the diagnosis of the climate crisis is accurately represented in the draft agreement, scientists note the solutions and actions presented fall far short of the action required to address the scale of the crisis the text describes. 

“There seems to be a total disconnect between the diagnosis and the treatment,” said Jean Pascale van Ypersele, professor of Environmental Sciences at the UC Louvain and former vice chair of the UN’s Intergovernmental Panel on Climate Change (IPCC).  “The diagnosis is that of a potentially deadly cancer, due to abuse of fossil fuels,” said van Ypersele. “The prescribed treatment is a mixture of wishful thinking and magic.” 

The current draft agreement’s sole mention of “health” as a human right, without explicitly addressing key health issues like air pollution, has disappointed global health experts following the apparent momentum generated by the inaugural Health Day at the UN climate summit.

“The difference for people’s health of phasing out only ‘unabated’ fossil fuels, versus a full fossil fuel phase-out is night and day,” said Dr Jeni Miller, Executive Director of the Global Climate and Health Alliance. “Currently 99% of the world’s population breathes unhealthy air, with five million people per year dying prematurely due to the air pollution produced by the use of fossil fuels.”

“COP28’s only sane pathway – one that will protect people’s health – is an agreement that sets in motion the orderly and just phase out of all fossil fuels”, said Miller. 

‘We didn’t come here to sign our death sentence’ 

During a closed-door meeting at COP28 on Tuesday, as reported by The Guardian, sharp divisions emerged over the future of fossil fuels, highlighting the deep rifts that could derail an agreement crucial for the planet’s future.

Australia, representing a coalition of major fossil fuel consumers and producers including Canada, Chile, Norway, the European Union (EU), and the US, advocated for a decisive move away from these energy sources. The EU and US separately pressed for a firmer stance on fossil fuels in the final agreement.

“Overall it is clearly insufficient and not adequate to addressing the problem we’re here to address,” said EU climate commissioner Woepke Hoekstra. 

The US State Department demanded that the wording on fossil fuels be “substantially strengthened”.

Small island nations, facing immediate threats from sea level rise, see any agreement lacking a robust commitment to fossil fuel phase-out as a potential “death sentence”.

Joseph Sikulu, a climate activist from the Pacific island of Tonga, broke into tears at a press conference on Tuesday when asked about the stakes of the agreement for his and other island nations. 

“We didn’t come here to sign our death sentences and the text in its current state is that,” said Sikulu. “We know that our negotiators are in there, holding the line and they’re still fighting.” 

“In Paris, we fought for our lives for 1.5C and slowly we see it going away from our grasp every year,” added Sikulu. “[Negotiations] have now just become words.” 

John Silk, Minister of Natural Resources and Commerce for the Marshall Islands, echoed the desperate plea of small island states for their continued existence.

“We will not go silently to our watery graves,” said Silk. “We will not accept an outcome that will lead to the devastation for our country.” 

Finance disputes significant for developing nations

The debate over financing climate adaptation and green energy transitions in developing countries, which have not benefited from centuries of fossil fuel development, is as central to the final text disagreements as the phase-out language. Many developing nations view the phase-out demands from wealthy countries without accompanying funding as unfair, arguing that it fails to recognize their limited role in historical emissions.

“Rich countries say they want a global phase-out of fossil fuels, but they are refusing to fund it,” said Adow. “There is simply not enough in the current text for African countries to believe there will be finance to help them leapfrog dirty energy nor adapt to climate impacts.”

India also highlighted the omission of historical cumulative colonial emissions as a crucial oversight of the draft agreement, a criticism echoed by environmental groups and experts, who have singled out industrialized nations like the U.S., Canada, and Norway for their historical emissions and ongoing oil production expansion.

Governments Plan Massive Expansion of Fossil Fuel Production Despite Climate Crisis, UN Warns

“Many reports have clearly shown that these same countries, as they come here and pretend to be climate champions and talk about limiting temperature rise and talk about ending fossil fuels, have signed and continue to sign licenses for expansion and production of fossil fuels,” Meena Raman, of the Third World Network and a veteran of the COP process, said in reference to recent reports by the UN Environment Programme and Oil Change International. 

Governments and industry continue to expand fossil fuel production, with governments worldwide on track to produce fossil fuels at a rate 110% higher than the 1.5°C target by 2030. The top 20 oil and gas companies, meanwhile, are projected to emit 173% above the 1.5°C limit in 2040.

Raman also pointed out the draft’s failure to address the means of implementation which would allow developing countries to invest in green energy. These include can areas such as finance, technology, and capacity building, crucial for developing nations to phase out fossil fuels. 

Despite a day-one victory at COP28 to operationalize the Loss and Damage Fund, which aims to deliver financial assistance from developed nations to vulnerable countries coping with the escalating effects of climate change, the fund remains largely empty.

Demands for increased climate finance in the COP agreement, especially from the US, face domestic political hurdles, with a Republican-led Congress unwilling to allocate such funds. This standoff affects not just climate-related financing but also other areas of greater political consensus in the US, such as military aid to Ukraine.

Bangladesh, representing the 46 Least Developed Countries, expressed disappointment with the draft’s lack of a commitment to keeping global warming below 1.5C, labelling the text as weak and contradictory.

Cuba, on behalf of the G77+China group of 135 nations, argued in the meeting that the draft inadequately recognizes the primary responsibility of affluent countries in climate action and their obligation to support less wealthy nations.

China objected to including a 2025 global carbon emissions peak target in the agreement, citing the longer historical emissions of developed countries.

OPEC arrives at the party 

The complex geopolitics of oil-producing nations, especially Saudi Arabia’s role as the de facto leader of OPEC, are complicating COP28 talks. Reports from Dubai indicate that UAE’s COP28 President Sultan al-Jaber is under substantial pressure from Saudi Arabia to exclude any references to fossil fuels in the agreement. This stance is shared by other OPEC and OPEC+ members, including Iran, Iraq, and Russia. 

Al Jaber has so far resisted complying with these demands, stating on Tuesday “We must remain focused on our primary goal of keeping the 1.5C target within reach”.

Saudi pressure to eliminate any mention of fossil fuels from the final agreement follows a letter from OPEC Secretary-General Haitham Al Ghais that was leaked to The Guardian on Friday. The letter urged OPEC members to “proactively reject any text or formula that targets energy, i.e. fossil fuels, rather than emissions”.

Ghais stressed the urgent need to counter what he described as politically motivated campaigns threatening the prosperity of OPEC nations that would put “our people’s prosperity and future at risk.” 

Dan Marks, an energy security expert at the Royal United Services Institute (RUSI), explained to the Guardian that major oil producers, including Saudi Arabia, are cautious about policies aimed at reducing fossil fuel supply, due to significant national interests.

Saudi Arabia, holding nearly 300 billion barrels of oil, accounts for about one-fifth of the global oil reserves. As the unofficial leader of OPEC, which represents close to 80% of the world’s oil reserves, the kingdom plays a pivotal role in global oil dynamics.

“They have interests they need to protect,” said Marks, adding that proposals for phasing out fossil fuels could trigger instability in these oil-rich nations. 

Earlier in the year, OPEC criticized projections by the International Energy Agency (IEA) suggesting a peak in demand for fossil fuels such as coal, oil, and gas before 2030 as “overly hazardous” and “unworkable”. The oil cartel has also accused the IEA of “unjustly vilifying the [oil and gas] industry as being behind the climate crisis” as well as setting out a roadmap for the global energy system that will cause “energy chaos on a potentially unprecedented scale”.

“Clearly, there is an emerging proactive fossil coalition,” a senior EU negotiator close to the negotiations told the Financial Times after the new draft was released. “In the past, we had more silent resistance and now it seems more conscious and more focused and more co-ordinated.”

Negotiators in Dubai now face the daunting task of crafting a consensus-driven agreement that avoids outright rejection by any party. Veteran observers speculate that in the face of a potential deadlock, no agreement might be preferable. Countries desiring a robust deal are trapped between accepting a diluted agreement or none at all.

“It seems more or less impossible now to get a wording that clearly calls for the ‘phase out’ goal, as demanded by the small islands and the EU,” said Michael Jacobs, a COP veteran and professor of political economy at Sheffield University. “The OPEC states won’t agree to it, and the UAE (a member of OPEC) won’t insist on it from the chair.”

Jacobs pointed out that the summit’s most significant achievement, the establishment of the loss and damage fund, was already secured on the first day. “Even if the COP negotiations were to collapse now, this milestone wouldn’t be reversed,” he said.

“What would be lost are – sorry, but this is true – various forms of words which are not binding and won’t materially affect any countries’ immediate behaviour.” 

UN Secretary-General Antonio Guterres, who made a return trip to Dubai for the final stage of the talks earlier this week, underscored the urgency of the situation. 

“We need an ambitious outcome that demonstrates decisive climate action and a credible plan to keep the 1.5°C warming limit alive,” said Guterres. “[We must] protect those on the frontlines of the climate crisis.” 

Image Credits: Simon Evans.

Caged animals held for sale and slaughter in unsanitary conditions at Wuhan’s Huanan Seafood Market prior to the outbreak of COVID-19, from top left: King rat snake, Chinese bamboo rat, Amur hedgehog, Raccoon dog, Marmot and Hog badger.

The powerful Group of 20 (G20) countries will host a high-level meeting on One Health in October 2024 to better prepare members to address the health of people, animals and ecosystems.

This was revealed by Alexandre Ghisleni, Brazil’s Global Health Ambassador, at a COP28 side event to launch an implementation guide for the One Health Joint Plan of Action devised by the four United Nations (UN) agencies.

Known as the quadripartite, the four are the Food and Agriculture Organization , UN Environment Programme (UNEP), World Health Organization (WHO) and World Organisation for Animal Health (WOAH).

“Brazil has been very supportive of the One Health approach,” said Ghisleni. “Evidence of this was the way we have handled the avian flu cases that we’ve had this year in our country.  It was only due to very close cooperation between the Ministries of Environment, Agriculture and Health, that Brazil was able to handle these cases satisfactorily.”

Brazil, which assumes the G20 presidency next year, will host the One Health meeting to “explore in detail and at length, all the aspects related to it so we can better face the challenges of our time”, he added. 

Alexandre Ghisleni, Brazil’s Global Health Ambassador

There has been heightened awareness about the need for a holistic approach to human, animal and environmental health since the deadly COVID-19 pandemic. Both SARS-CoV2, which caused COVID-19, and MERS-CoV originate in bats. Meanwhile, there is widespread speculation that the Huanan market in Wuhan, where wild animals were kept in unsanitary conditions, was the origin of the COVID pandemic.

Mpox and anthrax outbreaks, both originating in animals, have also surged over the past two years. There is growing awareness that countries need to contain zoonotic spillovers from animals to people, and One Health is featuring prominently in the current pandemic agreement negotiations being conducted under the auspices of the WHO.

Surging vector-borne diseases

On Tuesday, the European Food Safety Authority (EFSA) released a report on the most common zoonotic diseases in the European Union in 2022, noting that there had been a marked increase in West Nile virus, which is transmitted by mosquitoes.

“Climate change is increasing the surge of vector-borne diseases. That’s why today a One Health approach integrating human and animal risk assessments is the way forward” said Frank Verdonk, Head of EFSA’s Biological Hazards and Animal Health and Welfare unit.

The number of food-borne outbreaks in the EU increased by 44%, from 4,005 outbreaks in 2021 to 5,763 in 2022, associated with a wide variety of foods, ranging from meat and dairy products to fish and vegetables. 

Dr Ariane Hildebrandt, Director-General of Germany’s Ministry for Economic Cooperation and Development (BMZ)

Dr Ariane Hildebrandt, Director-General of Germany’s Ministry for Economic Cooperation and Development (BMZ), told the launch that a “multidisciplinary approach that considers the interconnection between health, climate and biodiversity is necessary” as,  “without a healthy environment, there cannot be health for human and animal life”. 

“We will continue to work towards the goal of reducing health risks in our partner countries, strengthening human and veterinary health systems, improving early warning systems, protecting biodiversity and thus contributing to epidemic and pandemic prevention,” she added.

The guide is an operational addition to the 2022 One Health Joint Plan of Action, and  outlines three pathways – governance, sectoral integration, and evidence and knowledge – and five steps to achieve One Health implementation.

“One of our main principles when developing the guide is to make it applicable to all countries, regardless of their status of One Health implementation, and acknowledges transdisciplinary and diversity of stakeholders.” Dr Amina Benyahia, WHO head of the One Health Initiative.

“The climate emergency has far-reaching consequences that threaten all life on earth. Direct factors like heat waves and floods as well as indirect factors like changes to disease spread due to changing weather patterns are just some of the risks to the health of animals, humans, and entire ecosystems,” said Doreen Robinson, the Head of Biodiversity and Land at UNEP.

Robinson added that an “early investment in inclusive and systemic One Health approaches ensures we’re tackling such interconnected, complex issues for a healthier, more resilient future for both people and planet.”

“Despite the growing awareness of the One Health approach in recent years, the world remains vulnerable to many global threats unless this approach is translated into policies and actions, and adequately and sustainably financed,” said Thanawat Tiensin, FAO’s director of Animal Production and Health Division.

At the first-ever health and climate day during COP28, 134 countries backed a Climate and Health Declaration to place health at the heart of climate action and accelerate the development of climate-resilient, sustainable and equitable health systems.

Image Credits: Nature .