Tackling climate change is the greatest global health opportunity of the 21st century, a team of 60 international experts today declared in a special report for The Lancet medical journal.
The 2015 Lancet Commission on Health and Climate report comes six years after the groundbreaking first Commission report – a collaboration between The Lancet and University College London – which described climate change as the “biggest global health threat of the 21st century”.
The latest report shows many mitigation and adaptation responses to climate change can directly reduce the burden of ill health, boost community resilience, and lessen poverty and inequity.
In particular, switching to clean renewable energy sources, energy-efficient buildings and active transport options will reduce air pollution and have flow-on health benefits. This includes reducing rates of heart disease, cancer, obesity, diabetes, mental illness and respiratory disease.
The commission also reveals these health co-benefits associated with emissions reduction strategies offer extraordinary value for money. The financial savings associated with avoided ill-health and productivity gains can outstrip the costs of implementing emissions-reduction strategies – if they are carefully designed.
What if we wait?
The commission makes it plain we cannot afford to wait. There are limits to the level and rate of warming humans and other species can adapt to.
With “just” 0.85°C warming since the pre-industrial era, many predicted health threats around the world have become real. Long, intense heatwaves and other extreme weather events such as storms, floods, fires and drought are having direct health impacts. The impacts on ecosystems affects health indirectly, through agricultural losses, as well as contributing to spread of disease.
Climate change is affecting economies and social structures, which also cause health impacts, particularly when associated with forced migration and conflict. Given the risks of climate change-induced “regional collapse, famine and war”, the commission notes mitigation-focused investment “would seem to be the prudent priority at a global level”.
How does this affect Australians?
Climate change is driving record temperatures in Australia, with heatwaves now hotter, longer and more frequent. People die from heat exposure during these events. Many others seek medical attention, leading to massive surges in demand for ambulances, emergency services, and health-care services. Deaths from heatwaves in Australian cities are expected to double in the next 40 years.
Hotter summers are leading to more bush fires, which cause injuries and fatalities. People lose their homes and businesses. Communities lose schools and health care. After bush fires, communities also face a higher rate of general illness, increased in alcohol and drug abuse, and more mental illness.
Extreme rainfall and cyclones cause direct fatalities and injuries. Floods and cyclones can severely affect health care services. In 2011, floods in Queensland caused the cancellation of 1,396 surgical cases, increasing waiting times for vital procedures by 73%.
Rising temperatures are leading to increases in deadly foodborne illnesses, disruptions to food production and water security, and worsening air quality, increasing respiratory illnesses.
Finally, infectious diseases are becoming more common, as are vector-borne diseases such as Ross River fever and zoonotic diseases, which are spread from animals to humans.
What does the future hold?
The report notes that since the first commission six years ago, emissions have risen beyond the “worst case scenario”.
Without mitigation, the authors warn “large-scale disruptions to the climate system” (not currently included in climate modelling and impact assessments) could “trigger a discontinuity in the long-term progression of humanity”.
In lay terms, they mean “wipe us out”.
At the very least, or at least put another way, the authors suggest likely temperature rises may be “incompatible with an organised global community”.
A prescription for action
Cutting emissions, the commission says, will limit health damages, as well as bring important health improvements associated with improved air quality, increased mobility from better public transport, and better physical and mental health from greener spaces and more energy efficient homes.
There is no need to wait. The commission says it is technically feasible to transition to low-carbon infrastructure now. The technologies have been available for at least 40 years, and some since the 19th century.
There is potentially significant economic savings associated with the health benefits of climate policies. One study suggests savings from avoided ill-health arising from the implementation of an emissions trading scheme could return up to ten times the cost of implementation.
Policies to achieve this must include carbon pricing, the commission argues – either carbon taxes or emission trading schemes. Where these are not appropriate, it recommends taxes on energy products. Feed-in tariffs (for electricity fed back to the grid) should drive renewable energy deployment, while perverse subsidies to fossil fuels should be abolished.
A key recommendation is the rapid phase out of coal – part of “an early and decisive policy package” to target emissions from the transport, agriculture and energy sectors.
Timing is everything
In order to have a 66% likelihood of limiting global warming to less than 2°C, the remaining global carbon budget will be used up in the next 13 to 24 years.
As all good health professionals know, treatment is of most value when it addresses the cause – in this case, largely fossil fuels. Scaling of low-carbon technologies policy options is vital.
The commission doesn’t spell this out, but in order for global emissions to begin to fall, we must use our remaining carbon budget to make the switch to low-carbon technologies and resources. Doing so will create many new jobs, and help avoid expensive adaptation costs.
Questions for Australia
The Lancet commission makes a clear case for climate action based on health benefits alone. This raises important questions for the Australian government, which abolished the carbon price, wound back policies to support renewable energy, and committed to supporting coal as an energy source:
Why is it failing to protect the health of Australians from this very serious threat? And why are the health benefits associated with climate policies not being factored into policy decisions, given the billions of dollars in savings for health budgets?
Australians should themselves be asking these questions, but at least now we know the Commission will also be listening for the answers.
Fiona Armstrong is the founder and Executive Director of the Climate and Health Alliance, a national not-for-profit coalition of healthcare stakeholder groups that work together to advocate for climate action to protect and promote health. Climate and Health Alliance is a member of the Global Climate and Health Alliance and Australian partner of the international non-government organisation, Health Care Without Harm.