23rd October 2024
This commentary was jointly published by The Lancet and the BMJ on 23 October 2024.
In November, the 29th Conference of the Parties (COP), the annual United Nations meeting on climate change, will happen in Azerbaijan, a country where fossil fuels account for two thirds of its economy. [1] The attendees will gather after a northern hemisphere summer in 2024 that is the hottest ever recorded, with predictions that 2024 will reach 1.57C above pre-industrial levels. [2] The 2016 Paris Agreement [3] agreed to keep “the increase in the global average temperature to well below 2°C” and pursue efforts “to limit the temperature increase to 1.5°C above pre-industrial levels.” A recent study found that most authors of the reports of the Intergovernmental Panel on Climate Change are sceptical that warming will be kept to well below 2°C. [4]
The past year has seen the health and livelihoods of millions of people around the world severely impacted by extreme weather. Heatwaves across South and Southeast Asia resulted in school closures and deaths from heatstroke. Rains and flooding in Brazil led to 100 deaths and hundreds reported missing or injured. [5] Floods in Kenya displaced more than 200,000 people. [6] Canadian wildfires burned forcing towns to evacuate. A cyclone forced almost one million people in Bangladesh and India to evacuate. [7] In the US, a state of emergency was declared and millions ordered to evacuate as Hurricane Milton made landfall in Florida. [8]
Two issues will dominate and test COP29: hastening the transition from fossil fuels to renewable energy; and high-income countries increasing financial support to vulnerable countries. Climate-vulnerable developing nations, which suffer the most but contributed the least to causing climate change have identified four priorities: ambitious new climate finance goal; more ambitious climate action plans; accelerated adaptation efforts and finance; and a sufficient response package for the loss and damage they have suffered.[9]
Fossil fuels account for around four-fifths of global energy supply [10], are the main cause of global warming, and cause major damage to health, not least in contributing to seven million premature deaths a year from air pollution. [11] Yet fossil fuels did not feature in the calls that result from COPs until the Glasgow COP in 2021.[12] In 2020 countries responsible for 93% of all CO2 emissions provided net direct fossil fuel subsidies of $305 billion [13], more than three times the $80 billion provided in climate finance to developing countries. [14] The 2021 Glasgow Pact [12] marked a minor breakthrough with a call for countries to accelerate “efforts towards the phase down of unabated coal power and phase-out of inefficient fossil fuel subsidies”. It had little impact.
In the following year global fossil fuel investment increased by 10%, reaching over $1 trillion [13]. COP27 saw no progress, but COP28 ended with a call to governments for a “transition away from fossil fuels”. [15] While this was a welcome step it lacked detail. COP29 will be judged by the detail in commitments to phasing out fossil fuels. Encouragingly the new Foreign Secretary for the UK, David Lammy, has said that the climate and nature crisis is the issue that “defines our times” and that “action on the climate and nature crisis will be central to all that the Foreign Office does.” [16] His first priority is to build a Global Clean Power Alliance with the shared goal of “making Net Zero Power a reality, everywhere.”
The second issue on which COP29 will be judged is financial assistance from high income countries to vulnerable countries. Again progress has been woefully slow. COP27 did see the establishment of a loss and damage fund, but this was more than 30 years after the first call for a fund; and the fund falls way short of what is needed. At COP28 wealthy nations committed just over $700 million to the fund, which is less than 0.2% of the $400 billion a year that is needed. Harjeet Singh, the head of global political strategy at Climate Action Network International described the “meagre contributions from affluent nations” as a signal of “persistent indifference to the plight of the developing world.” [17]
Nobody can escape the climate and nature crisis, and it is in the self-interest of high income countries to support vulnerable countries. “Nothing,” Lammy has said “could be more central to the UK’s national interest than delivering global progress on arresting rising temperatures.” [16] Health editors from around the world have twice called in joint editorials for high-income countries to recognise the moral necessity as well as their self-interest to meet the needs of vulnerable countries [18,19]. This will not be easy with the US self-absorbed in an election, hard right populists flourishing in Europe, and the UK about to experience a cost-cutting budget.
Every COP has been followed by a rise in emissions of greenhouse gases, and in 2023 more than 300 health editors from around the world warned that we are facing a global public health emergency. [20] Yet health didn’t feature in the core agenda of the first 27 COPs. COP28 adopted a declaration that acknowledges “the benefits for health from deep, rapid, and sustained reductions in greenhouse gas emissions, including from just transitions, lower air pollution, active mobility and shifts to healthy sustainable diets” and that good health is “an outcome of successful adaptation across a range of sectors – including food and agriculture, water and sanitation, housing, urban planning, health care, transport and energy.” [21]
The biggest benefits to health will flow from dramatic cuts in fossil fuels, rapid transition to renewable energy, investing in nature, and wealthy countries providing much greater support to vulnerable countries. The whole world is watching COP29 to see it make real progress.
Elaine Mulcahy, Director UK Health Alliance on Climate Change
Richard Smith, Chair UK Health Alliance on Climate Change
https://www.bmj.com/content/387/bmj.q2244.full
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02307-9/abstract
References
[1] https://www.iea.org/reports/azerbaijan-2021
[2] https://www.carbonbrief.org/state-of-the-climate-2024-now-very-likely-to-be-warmest-year-on-record/
[3] 2016 Paris Agreement https://unfccc.int/process-and-meetings/the-paris-agreement
[4] Wynes, S., Davis, S.J., Dickau, M. et al. Perceptions of carbon dioxide emission reductions and future warming among climate experts. Commun Earth Environ 5, 498 (2024). https://doi.org/10.1038/s43247-024-01661-8
[7] https://www.bbc.co.uk/news/articles/ckvv8q10vxvo
[9] Swaby G, Thangata C, de Zoysa K. What Climate-vulnerable Countries Need on the Road to COP29. World Resources Institute 2024 16 May. https://www.wri.org/insights/vulnerable-countries-cop29-climate-action
[11] https://www.who.int/health-topics/air-pollution#tab=tab_2
[12] UNFCCC Glasgow Climate Pact outcomes from COP26 https://unfccc.int/process-and-meetings/the-paris-agreement/the-glasgow-climate-pact-key-outcomes-from-cop26
[13] 2023 report of the Lancet Countdown on Climate Change and Health https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01859-7/abstract
[14] OECD: Climate finance and the USD 100 billion goal https://www.oecd.org/en/topics/sub-issues/climate-finance-and-the-usd-100-billion-goal.html
[15] COP28 agreement https://unfccc.int/cop28
[16] The Kew Lecture: Foreign Secretary’s speech on the climate crisis https://www.gov.uk/government/speeches/foreign-secretarys-foreign-policy-speech-on-the-climate-crisis
[18] Atwoli et al. (2021). Call for emergency action to limit global temperature increase, restore biodiversity and protect health. BMJ https://www.bmj.com/content/374/bmj.n1734
[19] Atwoli et al. (2022). COP27 climate change conference: urgent action needed for Africa and the world. BMJ https://www.bmj.com/content/379/bmj.o2459
[20] Abassi et al. (2023). Time to treat the climate and nature crisis as one indivisible global health emergency. BMJ https://www.bmj.com/content/383/bmj.p2355
[21] COP28 UAE declaration on climate and health https://www.cop28.com/en/cop28-uae-declaration-on-climate-and-health