Just as health leaders reframed tobacco from a consumer product to a public health threat, they can now help shift the narrative on fossil fuels.

In the coming days, the annual World Health Assembly will convene in Geneva. Following the recent Santa Marta Conference on Transitioning Away from Fossil Fuels, national health ministers and global health leaders have both an opportunity and responsibility to address the root cause of the climate-induced health crisis: fossil fuels.

The Santa Marta conference addressed the need to transition away from fossil fuels, the root cause of climate change. Fifty-seven countries, representing one-third of the global economy, committed to developing roadmaps to end fossil fuel use, marking an important step toward protecting public health and the climate.

Santa Marta demonstrated growing momentum beyond traditional climate negotiations. While the UN climate COP process remains essential, countries increasingly recognize that progress has been too slow given the escalating impacts of climate change and health. The next Santa Marta conference, hosted by Tuvalu and Ireland in 2027, will provide a key opportunity to strengthen international cooperation on phasing out fossil fuels.

Fossil fuel combustion constitutes the biggest public health emergency of our time

Climate change is not only an environmental issue; it is a public health emergency. Fossil fuels are not just an energy source; they are harmful to health. Despite this, health was largely overlooked – the final Santa Marta conference text had no mention of health. The health community must raise a clamour to ensure that future climate negotiations take our health into consideration.

Fossil fuels harm human health throughout their lifecycle, from extraction and refining to transport, combustion, and petrochemical production. They pollute air, water, and soil; drive extreme heat and food insecurity; worsen respiratory and cardiovascular diseases; and contribute to millions of premature deaths each year. Frontline communities near extraction sites, refineries, highways, ports, and petrochemical facilities face disproportionate risks of toxic exposure, cancer, displacement, and economic disruption.

The world is already experiencing the consequences of the fossil-fuel-driven climate crisis. Last month, temperatures in parts of South and Southeast Asia reached 45 to 46°C, making outdoor work unsafe and pushing the limits of human survivability. Floods, wildfires, storms, crop failures, and infectious disease outbreaks are increasingly overwhelming health systems worldwide.

Subsidizing the sale of products that harm human health 

Yet governments continue to subsidize the very products causing this harm. In 2024 alone, fossil fuels received an estimated US$725 billion in public subsidies, even as air pollution, much of it from fossil fuels, costs the global economy about US$8.1 trillion annually in healthcare expenses, lost productivity, and premature deaths. From a public health perspective, this contradiction is stark: governments are using public funds to subsidize disease, death, climate disruption, and increased pressure on already overburdened health systems.

The true cost of fossil fuels remains obscured because health harms are treated as “externalities.” But asthma, strokes, heat deaths, cancers, pregnancy complications, and polluted drinking water are not externalities; they are direct and devastating impacts. When these costs are fully accounted for, fossil fuels are no longer economically rational. They are a dangerous and outdated relic.

Following the example of Tobacco

For decades already, the health community has carried the weight of responding to the symptoms of the climate-induced health crisis while often avoiding its primary cause. This must change.

And yet, the health community has both the moral authority and institutional capacity to speak to the impacts of fossil fuels directly. Just as health leaders reframed tobacco from a consumer product to a public health threat, they can now help shift the narrative on fossil fuels.

There is already a clear precedent: the World Health Organization Framework Convention on Tobacco Control (FCTC), the first global treaty negotiated under WHO leadership. The FCTC recognized that protecting health requires more than treating disease; it requires regulating the industry responsible for the harm. We can apply this same approach to fossil fuels.

Tobacco control showed that effective public health action requires conflict-of-interest protections, restrictions on advertising and sponsorship, public education, fiscal measures, warning labels, litigation support, and international cooperation to reduce demand for harmful products. Fossil fuels require a similarly comprehensive response.

Health ministries and the WHO have a critical role in advancing this agenda.

The World Health Assembly is the world’s highest decision-making forum on health. Resolutions passed in Geneva shape national health priorities, influence financing, guide public health norms, and determine how governments respond to emerging threats.

WHA can guide the WHO Secretariat in advocating for stronger conflict-of-interest protections to limit the influence of the fossil fuel industry in health policymaking and other multilateral processes. They can document the full lifecycle health harms of fossil fuels, plan protective health measures, promote health impact assessments for fossil fuel projects and infrastructure, and support air pollution standards based on current science. They can also champion subsidy reform as a public health intervention and help redirect public finance toward clean energy, resilient health systems, and social protection.

The health community can also help revoke the social license of the fossil fuel industry by clearly communicating that these products are fundamentally incompatible with health protection. This is especially urgent as fossil fuel companies continue to use disinformation, greenwashing, and political influence to delay action, tactics long recognized by the public health community from efforts against other health-harming industries.

At WHA78 last year, countries made progress through the WHO Global Action Plan on Climate Change and Health and commitments to reduce air pollution deaths. However, these efforts will remain incomplete unless governments address the primary driver of both climate change and air pollution: fossil fuels. WHA member states must recognise that fossil fuels are health-harming products, and their phase-out is a public health imperative.

The science is clear, the health evidence is overwhelming, and solutions exist. The question now is whether the global health community is prepared to address the cause of the crisis, not just its consequences.

On May 19th, the Global Climate and Health Alliance and the Office of the United Nations High Commissioner for Human Rights (OHCHR) will co-host Fossil Fuels, Health, and Human Rights – Centering Health and Human Rights in the Global Transition Away from Fossil Fuels where the issue will be discussed. It would be open to attend in person in Geneva and via Zoom.

Dr Jeni Miller is Executive Director of the Global Climate and Health Alliance, a consortium of more than 250 health professional and health civil society organisations and networks from around the world addressing climate change.

Image Credits: Mike Muzurakis IISD/ENB , UNEP, Galen Crout , Sarah Johnson.