COP28 in Dubai is the first ever UNFCCC climate conference to host a health day. It will bring together a range of participants to discuss the health impacts of climate change and will host a high-level climate and health ministerial meeting. 

This milestone reflects the increasing recognition that the climate crisis is affecting peoples’ health. From drought and floods to extreme heat and wildfires, health impacts are more severe in low- and middle-income countries and affect vulnerable populations the most. The year 2023 is on track to be the hottest year on record, and the health consequences are yet to be measured. According to a study by Columbia University, 83 million people could die because of higher temperatures by 2100. Besides deaths, heat waves cause fatigue, nausea, dehydration and heat stroke and they aggravate chronic respiratory diseases, and overall worsen inequalities in human development. 

Climate-induced inequalities are not limited to heat. Extreme weather such as storms, floods and landslides caused over two million deaths between 1970 and 2021, with over 90 percent in low- and middle-income countries. Not only is burning fossil fuels a leading cause of climate change, but air pollution is also the world’s largest environmental health threat. Ninety nine percent of the world breathes polluted air, and more than 90 percent of premature deaths caused by air pollution occur in low- and middle-income countries. While the fossil fuel industry benefits from subsidies of over US$13 million every minute, or $7 trillion (7.1 percent of global GDP) in 2022, research shows that eliminating fossil fuel subsidies in 2015 would have reduced global carbon emissions by 28 percent and fossil fuel-related air pollution deaths by 46 percent.

UNDP works to reduce air pollution in highly vulnerable countries. An EU-funded initiative links air pollution with health in Ethiopia, India, and Mongolia. It has piloted two new methods, an air pollution investment case methodology that calculates the health, social, and environmental costs and return on investment on selected air pollution interventions, and a legal environment assessment methodology for health and pollution to review existing laws, regulations, and policies. The three governments are piloting the methods and developing national plans for health and air pollution.

While the health sector’s mission is to improve health and well-being, it is also a major polluter itself, with large mitigation potential. The health sector’s climate footprint is equivalent to an estimated 5.2 percent of global greenhouse gas emissions – more than double than the global aviation industry’s climate footprint. A milestone was achieved at COP26 in Glasgow, where two main outcomes emerged. The COP26 Health Programme calls for countries to commit to building climate-resilient and sustainable health systems and the WHO-led global Alliance for Transformative Action on Climate and Health to support these pledges, of which UNDP is a member. Two years later, 76 countries have joined these initiatives.

Nonetheless, there is still a need to integrate health action into Nationally Determined Contributions (NDCs). Currently only 32 percent specifically mention the health sector and note climate related health outcomes or adaptation measures. Under the Climate Promise, the world’s largest NDC offer, UNDP works with 85 percent of all low- and middle-income countries to identify bottlenecks to greater ambition. Looking towards the next 2025 NDC revision cycle, UNDP has identified the need to integrate health more directly into NDCs  while also strengthening mitigation targets by reducing health sector emissions. Demonstrating the positive health outcomes of climate action can help make the case for greater ambition. 

This work will build on UNDP’s longstanding support to countries on the climate and health nexus, in close collaboration with ministries of health and partners such as WHO. The Sustainable Health in Procurement Initiative, supported by the Government of Sweden and in collaboration with Health Care Without Harm, works with 10 low- and middle-income countries to reduce greenhouse gases and toxic emissions. This includes assisting countries with the Global Road Map for Health Care Decarbonization. UNDP has also been spearheading the “Solar for Health” programme in sub-Saharan Africa and beyond to help countries advance universal health coverage while protecting the environment. With funding from the Global Environment Facility, UNDP works with WHO to build climate resilience of health systems in 11 least developed countries and small island developing states in Asia and the Pacific.

According to a WHO survey, insufficient financial resources remain a critical barrier to turning climate and health pledges and targets into action. To address this, UNDP and WHO have been working with the Green Climate Fund (GCF) to design a global multi-partner investment facility on climate and health. It will be initiated at COP28. A dialogue will be launched to convene climate funds, multilateral development banks, UN partners, bilateral aid agencies, the private sector, and philanthropies to bring much needed financing to national climate and health investments.

While COP28 marks a milestone in strengthening the dialogue between health and climate, it should also be used as a platform to creating ambitious climate and health action plans. Tangible solutions that address the health impacts of the climate crisis and strengthen climate-resilient and sustainable health systems are urgently needed. Only through health conscious and well-financed national climate policies will countries be able to save the lives of millions of citizens and make progress on the Sustainable Development Goals. Climate and health action is a lifeline for the world’s most vulnerable communities.