Guest Article #31

Healthy people, healthy planet

As we all take stock of the implications of the Copenhagen Climate Change Conference, one lesson is clear. If we are to maintain and expand public and political support to act on climate change, we need the headlines to be more about what we are aiming to achieve, and less about the process. We need to be clear that this is not just about targets and agreements, economy and costs, but about a better future for humanity.

In Copenhagen, the World Health Organization (WHO) outlined an additional proposal; to move from talking about “inconvenient” to “convenient” truths. Former US Vice-President Al Gore has done a tremendous service by describing the inconvenient truth that our current energy choices are threatening the planet. Over the past 20 years, WHO has also assembled and reported on the evidence that climate change endangers health. Indeed, the 1992 UNFCCC itself is based on such warnings, aiming to avoid “adverse effects” on human health and wellbeing, on the natural environment, and on economies.

But we believe that the time has come for more positive messages. The transition that we must make to address climate change should not be seen as a painful economic cost, but as a valuable investment in a more sustainable, fairer and healthier future.

From the health perspective, we see a range of good news stories. The first is that policies to mitigate climate change can be implemented through existing mechanisms to protect health and wellbeing. Last month, the US Environmental Protection Agency finalized its ruling that carbon dioxide and other greenhouse gas emissions endanger human health, and can therefore be regulated in the same way as conventional pollutants. The link between climate change and health, and existing health protection laws, have therefore become the cornerstone for regulation of greenhouse gases in the world's largest economy.

The second is that, in the short to medium term, we can protect people from climate change, and bring immediate health improvements. Proven, cost-effective interventions, from heatwave warning systems, to expanding access to water and sanitation, to vector control, could save millions of lives immediately, and improve resilience to future climate change. The strength of the global health community is now aligning itself behind this agenda, through a 2008 World Health Assembly Resolution adopted by 193 nations.

Thirdly, and perhaps most importantly, many of the changes that we need to make to address climate change could bring very large public health benefits. A series of studies, supported by WHO and published in the Lancet at the end of 2009, has now quantified some of the direct health benefits that would come from more sustainable energy, transport, and agricultural systems. These estimated, for example, that a 10 year programme to provide 150 million clean-burning cookstoves in India would not only reduce greenhouse forcing from black carbon, but would also save approximately two million lives - roughly equivalent to halving the national burden of disease from cancer. Shifting to more sustainable urban transport, with greater use of public and active modes, would be expected to reduce cardiovascular disease by between 10-25% in both developed and developing cities, and bring similar cuts in diseases from dementia to breast cancer. Such benefits are not only immediate and local, making them attractive to policy makers and public, but their economic value would partly or completely offset the costs of mitigation.

These positive messages all have practical implications. The success of the EPA ruling suggests that other countries should look closely at using existing health protection regulations to address greenhouse gases. The strong overlap between adaptation and public health prevention calls for greater engagement and strengthening of existing health services as a key resource in responding to climate change. And the potential for valuable health co-benefits calls for prioritization of those mitigation actions that would bring the largest health gains.

As we find our way forward after Copenhagen, we need to make clear that we aim to support the most effective polices, informed by the best possible science, but, most importantly, guided by our values. In WHO's view, the values that should guide our response to climate change are the same as those that guide our work in public health; the drive to improve lives, protect the weakest, and enhance fairness. The health community is a willing partner in addressing this challenge.