For the first time, this year’s UN climate change conference had a focus on the impact of climate change, caused by burning of fossil fuels on our health.

COP28, which finished on December 12, had a dedicated “health day” with a meeting of global health ministers and a Declaration of Climate and Health committing to tackle health impacts from climate change.

“That is something that should be celebrated” says Marina Romanello, Executive Director of the Lancet Countdown, an international research collaboration that tracks the connections between climate change and health.

“We had countries laying out the urgent need for action on climate change to protect people’s health and the urgent need to build resilience in our health systems and we should be clear that was a big success.”

Does the COP28 final agreement deliver in terms of global health?

Representatives from nearly 200 countries agreed to transition away from coal, oil and gas in a landmark deal that signals the eventual end of the fossil fuel era.

However a commitment to a complete phase-out of fossil fuels was left out of the final agreement after lobbying from oil-producing countries.

Romanello explains that although getting health on the agenda was a big success, the final deal does not go far enough.

“The deal has done very little in protecting our health,” states Romanello. “It opens a lot of loopholes for the persistent burning and expansion of fossil fuels that we know are a direct threat to our survival.“

“Our health will definitely be the ultimate price to pay from the agreement at COP” she warns “unless individual countries lead the way in phasing out fossil fuels irrespective of the final agreement.”

2023 the warmest year on record

The agreement comes during what will prove to be the hottest year in recorded history.

According to the latest monthly climate update from the Copernicus Climate Change Service (C3S), part of the European Union’s Earth Observation Programme, 2023 will be the warmest year on record with every month since June hitting record highs. The global mean temperature for the first 11 months of the year is the highest on record at 1.46 degrees Celsius (2.63 degrees Fahrenheit) above the 1850-1900 average.

November 2023 was the warmest November on record globally.

The average surface air temperature was 0.32°C above the previous warmest November in 2020 and the average sea surface temperature was 0.25 °C warmer than the previous warmest November in 2015.

What impact would breaching the 2 degrees warming limit have on our health?

“We’re looking at a pretty dire scenario If we breach that 1.5 degrees or reach the 2 degrees threshold” warns Romanello.

The world is ‘not on track’ to cap global warming at 1.5 degrees Celsius according to the UN’s Global Stocktake which assesses countries’ progress (or lack of it) on meeting the goals of the Paris Climate Agreement.

Scientists consider 1.5 degrees of warming as a key tipping point, after which the chances of extreme drought, flooding, wildfires and food shortages could increase dramatically.

“We’re currently at about 1.1 degrees – 1.2 degrees and we’re already seeing that climate change is costing lives and livelihoods worldwide. We’re seeing, for example, an 85% increase in heat related mortality from the nineties,” says Romanello.

Heatwaves put extra pressure on the human body with the elderly, young children, pregnant women and those with underlying health conditions particularly at risk.

The Lancet Countdown modelled a scenario in which the world warms by 2 degrees which shows extreme heat will likely kill nearly five times more people by 2050.

“Perhaps the most concerning conclusion is that this impact will not be happening in isolation” Romanello explains.

“So it’s not that we will be exposed to an extreme heat or a drought or a flood or an infectious disease outbreak. This is expected to happen simultaneously.”

Planning for climate-related disease in Europe

Europe is warming at twice the global average rate, according to the Copernicus European State of the Climate report with longer and more intense heatwaves each year.

Higher temperatures will increase the public health threat of diseases spread by mosquitoes, sandflies, fleas and ticks, and even snails, known as vector-borne diseases.

Earlier this year, health authorities in Paris fumigated areas of the French capital for the first time ever to kill tiger mosquitoes after the first case of indigenous dengue fever.

The tiger mosquito is a highly invasive mosquito species which originates from Southeast Asia and is fast advancing into northern Europe.

Julie Letertre is officer in charge of the implementation of the Copernicus Health Hub. The Copernicus hubs serve as a “one-stop shop” with data, products and information from all Copernicus services including the Climate Change Service, in this case relating to climatic health.

The data along with case studies helps the healthcare sector better understand and prepare for the development of climate-related diseases and the health implications of extreme weather events such as heatwaves.

One of the services they provide is a projection of areas that are favourable to the life cycle of dengue fever spreading mosquitos, based on climate models. The Health Hub also maps air pollution and provides information on allergens.

Another useful dataset is the Universal Thermal Climate Index (UTCI) dataset which looks at heat stress on the body. It takes into account factors such as wind, humidity and radiation as well as the air temperature outside and so is a more accurate indicator to use when analysing the impacts that the environment conditions have on the human physiology.

“We try to be inspirational and show how Copernicus can support public health applications – including those induced by climate change,” says Letertre. “We collect different use cases and different user stories that have been developed like, for example, the link between pollution and breast cancer, or pollen and wellbeing and how pollen in Finland and France are different and there are different ways of reacting to it.”

Is our health at the mercy of fossil fuels? ?

The Lancet Countdown’s 2022 report was entitled Health at the Mercy of Fossil Fuels.

Since this report was published, Romanello says the situation has worsened. “From February 2022 to February 2023 oil and gas companies have further expanded their oil and gas production plans and are now on track to exceed by 178% the levels of emissions compatible with the 1.5 degree goal.”

“So if we had said in 2022 that our health was at the mercy of fossil fuels, our health is absolutely, absolutely in their hands at the moment as a result of those activities”

Ambitious action to rapidly curb emissions and transition away from fossil fuels is critical to deliver health benefits for us all.