COP28 Health Day Reflections: Bringing a People-Centered Approach to the Climate Crisis

Last updated December 12, 2023

Written by: Jessica Pavel, Director of Global Health Advocacy, Malaria, United Nations Foundation

The climate crisis is a health crisis. This was my motivation for attending the United Nations Climate Change Conference (COP) in Dubai this year and the inaugural COP Health Day and Climate-Health Ministerial. For the first time, COP28 brought together ministers of health and health experts from around the world, alongside climate leaders – from ministers of energy and environment to adaptation, mitigation, and resilience experts and others.

Joseph Vipond from the Canadian Association of Physicians for the Environment at the Blue Zone during COP28. (Photo: UN Climate Change / Walaa Alshaer)

That alone would qualify as a major milestone. But this COP also set a record for number of attendees – bringing awareness of the health impacts of climate change to a wide and diverse audience. During the conference, the framework for real, multi-sectoral collaboration was established through declarations, commitments, negotiations, side events, pavilions, and more that finally humanized the climate crisis.

For years the global health community has warned against the effects of climate change on human, animal, and plant health and health systems with increasing urgency. The World Health Organization (WHO) has declared climate change as one of the biggest public health threats. As many COP28 attendees reiterated, if you search Google Images for “climate change” you’ll only find extreme weather events, heat maps, polar bears, and other images of a dying planet.

What’s missing are humans. People are at the center of climate change; people from diverse geographies and economies are forced to adapt to new climate realities every year. From severe flooding and droughts destroying the livelihoods of smallholder farmers and forcing women and girls to seek safe water sources further from home to major disasters displacing communities and ruining health systems and heat stress pushing the human body to the extreme, COP28 drew attention to the real human impacts of climate change, bringing a people-centered approach to the climate negotiations.

Becky Anderson (CNN Abu Dhabi), Shweta Narayan (Health Care Without Harm), Jane Burston (Clean Air Fund), and Julia Gillard (Wellcome Trust) at the Health Day Opening Session at COP28. Photo: UN Climate Change / Mahmoud Khaled

This is why the COP28 UAE Declaration on Climate and Health, signed by more than 120 countries, is so momentous. The declaration centers climate action around health: acknowledging the need for governments to build more resilient health systems, strengthening multisectoral collaboration to reduce emissions, maximizing the health benefits of climate action, and increasing funding for climate and health solutions.

According to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change, 3.6 billion people live in areas highly susceptible to climate change, mostly in low- and middle-income countries. The most vulnerable are already susceptible to the worst effects of climate change, such as extreme heat, food insecurity, degraded health systems, and the spread of vector-borne diseases.

WHO Director-General Tedros Adhanom Ghebreyesus on stage at the Reaching the Last Mile Forum during COP28. (Photo: UN Climate Change / Christopher Edralin)

Advocates for mitigation (reducing harmful greenhouse gases) and adaptation (adjusting to climate change impacts) must work together, but the reality is that health systems need to adapt to the present challenges immediately while governments work to mitigate warming. COP28 made evident the increasing consensus amongst experts that the world will inevitably surpass the 1.5 degrees Celsius benchmark for temperature rise. With health systems and communities already facing extreme strain, they will be pushed past their breaking points, and we will rapidly exceed the limits of what is possible in adaptation.

To support the political declaration, the COP28 Presidency, in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Green Climate Fund, The Rockefeller Foundation, and WHO developed and announced a new set of Guiding Principles for Financing Climate and Health Solutions, along with $1 billion in financing. Climate and health have historically used their own funding to finance co-benefits, leaving the intersection underfunded. Financing this intersection is a novel and necessary step for a truly coordinated, multisectoral approach. That said, there remains quite a bit of concern about how much funding is new versus repackaged. We need new, sustainable, and coordinated financing to really make a difference.

During the first-ever ministerial addressing the nexus of climate and health, more than 50 ministers and senior delegates from more than 100 countries and the European Union came together to discuss how countries are responding to the impacts of climate change, building healthy and resilient communities and health systems, strengthening adaptation, and urgently reducing emissions. Each country offered a unique perspective of climate change, yet similarly underscored the need for multisectoral collaboration, including among partners and donor agencies, to address the urgent challenges and to build resilient systems and communities that can withstand weather events, acute and persistent.

Dr. Maria Neira during a panel on health and climate change at COP28. (Photo: UN Climate Change / Mark Field)

Paraphrasing Dr. Maria Neira, Director of the Department of Environment, Climate Change and Health at WHO, it is essential governments, civil society, and the collective community remember negotiations at COP aren’t in the abstract; they aren’t about dollars and degrees. These are negotiations with peoples’ lives.

For 28 years, governments have negotiated on climate, fossil fuels, just energy transitions, and more, under the banner of COP. We do not have 28 more years to negotiate on climate and health. The effects are acute, severe, and worsening every day.

About the Author

Jess Pavel directs global health advocacy at the UN Foundation overseeing the malaria portfolio. She advances U.S. engagement in bilateral and multilateral programs working to eliminate malaria as well as U.S. support for a robust global health security agenda and engagement with multilateral global health institutions. Prior to joining the Foundation, Jess served as Senior Health Policy Advisor for Senator Mitt Romney (R-UT), overseeing the domestic and global health and energy and climate portfolios. Jess earned her Master of Public Health at the George Washington University Milken Institute School of Public Health focusing on global health, infectious disease, and the overlay of climate change. She holds a bachelor’s degree in political science and international relations from the University of Michigan.

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