As COP28 has now drawn to a close, Charlie Boyd reflects on the major developments and the implications for healthcare.

Wednesday 13 December saw the conclusion of the COP28 summit, culminating in the ‘UAE consensus’ which includes nearly 200 clauses across more than 20 pages. Reaching an agreement was far from smooth, with negotiators working into the early hours of the final day to address concerns over wording.

The final text calls on countries to contribute to the “transitioning away” from fossil fuels – the first time this has been explicitly mentioned in an official COP agreement.

Inevitably, critics have raised a number of issues. These include the absence of a wholehearted commitment to the phasing out of fossil fuels, as well as failure to require richer nations to support the developing world with the hundreds of billions more in finance they require to make the transition away from coal, oil and gas.

But, given the COP28 president, Sultan Ahmed Al Jaber, also happens to be the chief executive of the United Arab Emirates’ national oil and gas company, Adnoc, perhaps all of this was to be expected…

But where did health feature in this edition? What were the important developments? And what did we learn?

Higher profile

It is almost certainly the case that health, and the relationship between climate change and population health, had a higher profile this year than ever before, with a weekend of dedicated discussions, debates and analysis talking all about health and the impact on health of climate change.

This renewed focus was well received, having been tipped as the ‘centrepiece’ of this edition of COP by US Special Climate Envoy John Kerry, who made it clear that health should have been made a central workstream long ago – a sentiment with which we agree.

The most significant health-related announcement made over the weekend was the COP28 UAE Declaration on Climate and Health. Announced by the COP28 Presidency, in partnership with WHO and the UAE Ministry of Health and Prevention, the declaration has been endorsed by over 130 countries and marks a world first in governments acknowledging the growing health impacts of climate change.

The declaration sets out a number of common objectives, which sound promising at the least. These include:

• ‘Improving the ability of health systems to anticipate, and implement adaptation interventions against, climate-sensitive disease and health risks’;
• ‘Promoting steps to curb emissions and reduce waste in the health sector’; and
• ‘Strengthening trans- and inter-disciplinary research, cross-sectoral collaboration, sharing of best practices, and monitoring of progress at the climate-health nexus.’

Working in partnership

As we have seen over the last couple of years, learning from and collaborating with each other, whether in the independent or public sector, is an incredibly impactful approach to reducing carbon emissions. We have certainly found huge value in our close working with the NHS

So, it was positive to hear phrases and sentiment such as the ‘commitment to convene regularly’ across governments and departments, and the need to ‘foster synergies and strengthen national and multilateral collaboration on climate change and health’.

To see this happening for climate-health on the world stage suggests that the development of knowledge and technology on this subject will only accelerate.

Money talks

Alongside the declaration, several financial commitments have been made to back up these promises. Under the ‘Guiding Principles for Financing Climate and Health Solutions’, funders have announced over $1bn US in funding to address the climate health crisis, which includes $54m from the UK government.

A third of the UK’s investment has been promised to support partner countries with a view to increase, adapt and strengthen health systems to better cope with the impacts of climate change – the first climate-health programme announced by a G7 country. Wouldn’t it be nice if this work prevents the morbid predictions made by climate scientists discussed in my previous blog?!

Sunday 3 December’s ‘Health Day’ was opened by WHO chief Dr Tedros Adhanom Ghebreyesus, and Bill Gates, whose speeches focused on the effort required to address worsening humanitarian emergencies from severe weather events and disease. Of the day’s sessions that I watched, the content was largely focused on curbing healthcare sector pollution.

The How Ambitious Emission Reductions Can Save Lives session that I had hoped would provide IHPN members with all the world’s secrets on how to rapidly reduce emissions, turned out to be mostly surface level content, much of which we have discussed with members.

The session did however make some powerful points, such as Dutch health minister, Enrst Kuipers’, description of the healthcare sector’s responsibility regarding climate change: “the way we deliver to patients today contributes to creating the patient of tomorrow”.

A familiar narrative, but for me, this does a great job at summarising the sector’s responsibility to not only reduce emissions, but to take a leading role in preventing the harms caused by the climate crisis.

The overall outcome of COP28 appears to be a small but important step in the right direction, whereas the outcome of the health-climate work, having joined the table and cemented itself as a core feature of most (if not all) future conferences, is a significant leap.

I look forward to the next edition of COP, which will be held in Baku, Azerbaijan. It’ll be particularly fascinating to see how the “transition” away from fossil fuels is picked up there – a nation which reported $22.8bn value of exports in 2021, of which just under $20bn came from petroleum…