The Lancet countdown on Health and Climate Change
The Lancet medical journal was one of the first to highlight the enormous threat posed to health by climate change, describing it as the single largest public health threat of the century. In 2015, the Lancet Commission on health and climate change made ten policy recommendations, including financing of climate-resilient health systems, encouraging city-level low carbon transition to reduce pollution, and rapidly expanding access to renewable energy. Since then, they have been tracking progress towards achieving these recommendations, using 41 indicators across five domains, publishing the results annually.
The latest report has just been published, and is available at: www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32594-7/fulltext.
It warns that current trends in emissions and climate change are leading to an unacceptably high level of risk for the present and future health of populations across the world. The slow progress being made in reducing global greenhouse gas (GHG) emissions threatens lives and the viability of health services. However despite delays in reducing those emissions, there are moves towards a low-carbon transition, and it is clear that the nature and scale of the response to climate change will be the determining factor in shaping the health of nations for centuries to come.
The five domains covered by the report’s indicators are: climate change impact; adaptation of health services; mitigation actions and health co-benefits; finance and economics; and public and political engagement.
It reports that vulnerability to heat extremes has risen steadily since 1990, with 157 million more people exposed to heatwaves in 2017 than in the year 2000. This causes economic losses too – in 2017 a total of 712 extreme weather events resulted in 326 Billion US dollars worth, almost triple the amount of 2016. And small changes in temperature and rainfall can cause big changes in the transmission of infectious diseases, so that as well as the potential for transmission of Dengue fever (a potentially fatal tropical viral disease) being the highest ever recorded, this has an impact even in temperate zones, with for example a 24% increase in the area of the Baltic coastline suited to epidemics of cholera. Meanwhile, agricultural yield potential is falling.
Globally, inertia in adapting to climate change persists, with spending remaining well below the $100Bn per year commitments made in Paris in 2015. Failure to take actions to reduce GHG emissions has meant that globally we are missing out on enormous potential health benefits that would follow on if we did so. So for example, between 2010 and 2016 air pollution worsened in 70% of cities around the world, particularly in low and middle income countries. In 2015, fine particulate matter air pollution (so called PM2.5) was responsible for 2.9 million premature deaths worldwide.
However some of the indicators tracked to give cause for optimism.. For example, in the power generation and transport sectors there are positive trends, with a continuing reduction in coal use, more renewable energy capacity than fossil fuel capacity being installed in 2017, a decrease in fossil fuel subsidies and growing numbers of people employed in the renewable energy industry. In both mainstream and professional media there is a continuing increase in the amount of coverage given to health and climate change, with a tripling of the number of academic articles on health and climate change between 2007 and 2017, and health organisations disinvesting from fossil fuels.
But coming at the same time that the Met Office predicts that summers in the UK could be as much as 5.4 0C hotter by 2070, this is a salutary report. There is no room for complacency.