A new narrative of hope

A new narrative of hope

The effects of climate change on health and well-being can be direct or indirect – but all are devastating, and we have in our hands the power to do more, and do better

As a young medical doctor, I witnessed the impacts of climate change on the health of my community. I vividly remember a two-year old girl with asthma and persistent wheezing due to exposure to high levels of air pollution. It had detrimental effects on her growing body and brain, and it prevented her from undergoing the surgery she needed. We had to wait until her overall condition improved.

This is just one anecdote about the rising impacts of climate change on health and well-being. The effects can be direct through deaths and injuries from extreme weather events such as wildfires, flooding and heatwaves, or indirect through air pollution leading to heart and lung diseases, as 9 of 10 people, like this child, breathe in polluted air globally. Climate change also leads to sudden losses in food production and access to food, aggravating hunger and poverty in the most vulnerable countries. Climate-driven flooding overwhelms sanitation systems; droughts prevent access to water, where one in five children around the world currently lack access to safe drinking water. Climate change is worsening inequalities in access to healthcare services, education and decent job opportunities – especially for women and girls, who make up more than 80% of the climate migrant population. Women continue to face increasing gender-based violence and discrimination aggravated by higher temperatures and scarcity of resources.

Climate change is also affecting the mental health of communities. Farmers are dying by suicide, communities are experiencing ongoing distress and post-traumatic stress disorder, and people living with mental health conditions are three times more likely to die during a heatwave. Young people feel distress and despair at the unpredictable climate disasters affecting the future they face. These feelings are heightened by the disconnect between the necessary climate action many young people want and what is being done by their governments and public institutions.

However, action for a safer climate fosters the conditions for a world that supports better health – creating resilient societies with cleaner air, safer energy and infrastructure, access to green spaces, and connected communities. Climate adaptation and mitigation actions are central to protecting health and well-being. For affected communities to adapt and respond to climate threats, integration of and investment in psychological resilience must be prioritised.

Urgent action required

The science behind the planetary health crisis makes it clear that urgent, integrated and transformative action is needed across all sectors and disciplines. The health sector is fundamental to adopting an integrated approach, as the first and last line of defence in the face of unprecedented climate impacts, to provide the healthcare services equitably required under all circumstances.

But progress is hindered by several pressing challenges. First, decisions about climate change and health are made in silos. Policymaking and funding are commonly considered independently, ignoring the hidden costs of climate inaction on health and the co-benefits of climate action for health. Second, the experiences of the most affected groups, including youth and women, are persistently sidelined despite their being on the frontline of climate-driven impacts and the widespread calls for environmental justice.

Youth, in particular, have leveraged their activism to hold governments and corporations accountable for violating their right to a safe, clean and healthy environment. Moreover, young health professionals are working with their institutions to include climate change in curricula and young practitioners are prescribing connecting with nature to improve patients’ mental well-being. They are also catalysing the decarbonisation of their healthcare systems by integrating climate mitigation actions within service delivery, governance and workforce training. Many use their voices in community-led movements to highlight that the climate crisis is a health crisis and that climate action is action for health.

Nevertheless, youth continue to face multiple challenges that restrict their meaningful participation and their identification beyond only beneficiaries or victims of policymakers’ decisions and lethargic responses in matters of existential importance. There is a growing need to reorient institutional structures to integrate youth, not as add-ons, but as natural stakeholders in formal roles such as youth advisory groups and councils such as the World Health Organization’s Youth Council. Climate and health policies should be grounded in the needs and insights of the most vulnerable youth, including young women, refugees and internally displaced youth in armed conflict. This requires establishing sustainable and intergenerational mechanisms for their participation and also for the emergence of youth-led solutions and implementation pathways.

To respond to this, Egypt’s presidency of the United Nations Climate Change Conference (COP27) in 2022 took progressive action to listen to young people and demonstrate that the inclusion of health and intergenerational equity is far from optional. This was exemplified by my appointment as the first official youth envoy of the president of the Conference of the Parties, a critical turning point for meaningful youth engagement in the highest level of climate decision-making. I worked on integrating young people’s ideas and perspectives into the design and delivery of COP27 and on facilitating opportunities for diverse youth voices to be heard and valued. A dedicated children and youth pavilion was set up for the first time, strategically positioned in the negotiation zone to empower young delegates to leverage their frontline experiences, intergenerational solidarity and equity-based values at the negotiations, as well as constructive technical and policy inputs.

The right to health

The COP27 presidency also recognised the right to a clean, healthy and sustainable environment in the Sharm El Sheikh Implementation Plan. This was the first such mention of health in a COP outcome decision. The presidency also established the breakthrough agreement to provide loss and damage funding to the most affected countries in response to the catastrophic impacts of climate-related events.

To further elevate the political profile of the climate-health nexus and respond to the health-related losses and damages communities are experiencing from climate hazards, COP28 in the United Arab Emirates will host the first-ever Health Day in 2023, and an inter-ministerial meeting on climate and health that will bring health ministers together for the first time with ministers of the environment and finance. This presents an opportunity to call attention to the science and evidence-based interventions that protect the health of populations as the climate changes and to reduce carbon emissions with proven benefits to health. In addition, technical assistance and finance mobilisation will be generated for climate and health interventions.

Climate justice and intergenerational equity can be a new ‘narrative of hope’ and only through intentional integration and collaboration can we address the climate and health emergency and the systemic inequalities my generation is living through. We must connect, listen and work together across silos and generations to build the healthy and secure world we all want and deserve.