The devastation caused by record-breaking extreme weather events in 2023 and 2024 shows the human costs of a failure to curb greenhouse gas emissions and adapt to rapidly growing hazards. In 2023, annual global mean surface temperature broke all records, reaching 1·45°C above pre-industrial times; this 12-month record has also been breached again since then. Rapid attribution studies identified the influence of climate change in deadly events worldwide, including the floods that claimed over 300 lives in the Horn of Africa, the deadly heatwaves affecting much of the northern hemisphere, a record-breaking wildfire season in Canada, and many other events. At least 43 million child displacements were linked to extreme weather events over the past 6 years, and climate change-related extreme events are responsible for an estimated US$143 billion of annual losses. People in every country now face threats to their health and survival as climate hazards increase.
Current policies and actions, if sustained, put the world on track to 2·7°C of heating by 2100. The impacts seen to date could, therefore, be only the beginning of an increasingly dangerous future, with devastating impacts on the natural systems on which humanity depends. The outcome of the first Global Stocktake of the Paris Agreement, which culminated at 28th Conference of the Parties (COP28) of the United Nations Framework Convention on Climate Change (UNFCCC), noted with grave concern the growing impacts of climate change and the delays in necessary actions. Calling for a “transition away from fossil fuels in energy systems”, it was the first COP text in 30 years of negotiations to even acknowledge the need to address the use of fossil fuels in the energy system, which is the main driver of climate change. However, the final text reflected an over-reliance on carbon capture and storage—technologies that have not been developed or indeed proven to be safe at the necessary scale.
COP28 contributed to elevating health within global climate change negotiations with the first health thematic day. It also brought ministers of health and senior health officials to a UNFCCC COP for the first COP climate and health ministerial meeting, underscoring the imperative for health to be elevated in climate change negotiations. The inclusion of health in climate change negotiations was further bolstered by the endorsement of the COP28 Declaration on Climate and Health by 151 countries to date. The Global Stocktake recognised the right to health and to a healthy environment, and the Global Goal on Adaptation (GGA) set an overarching target towards the collective wellbeing of all people as well as a specific target for reducing the health impacts of climate change and promoting climate-resilient health services. Importantly, $1 billion was committed at COP28 to enable action on climate change and health. Although far from sufficient, this support could be an important enabler of progress. As countries work to update their Nationally Determined Contributions (NDCs) in response to the Global Stocktake, COP28 laid the grounds for countries to commit to ambitious, health-promoting climate change action tailored to the possibilities and needs of their people.
Complementing the health focus of climate negotiations, WHO’s Fourteenth General Programme of Work (GPW14) set the strategic objective of promoting health by responding to climate change and delivering climate-resilient health systems, as well as low greenhouse gas societies and health systems that contribute to better health and wellbeing. In addition, a new resolution on climate change and health adopted at the 77th World Health Assembly (WHA77) provides a platform for member states and WHO to develop and advance actions on climate change and health.
These milestones could provide new opportunities that pave the way to deliver a future of reduced life threats and improved health. Nevertheless, much is still to be done to promote an integrated and healthcentred response to the threats of climate change.
Climate negotiations still largely feature health in the sidelines, without formal inclusion as agenda items, making people’s health and wellbeing a secondary and voluntary consideration. 2024 could also see a major geopolitical shift, with multiple armed conflicts and 64 countries—representing nearly half of the global population—holding major elections. Amid this geopolitical uncertainty and with misinformation increasing, upholding international agreements and driving evidence-informed action on climate change and health are imperative to protect the future of present and future generations.
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