The Lancet CommissionsHealth and climate change: policy responses to protect public health
Section snippets
Executive summary
The 2015 Lancet Commission on Health and Climate Change has been formed to map out the impacts of climate change, and the necessary policy responses, in order to ensure the highest attainable standards of health for populations worldwide. This Commission is multidisciplinary and international in nature, with strong collaboration between academic centres in Europe and China.
The central finding from the Commission's work is that tackling climate change could be the greatest global health
The physical basis
The Intergovernmental Panel on Climate Change (IPCC) has described the physical basis for, the impacts of, and the response options to climate change.2 In brief, short-wave solar radiation passes through the Earth's atmosphere to warm its surface, which emits longer wavelength (infrared) radiation. Greenhouse gases (GHGs) in the atmosphere absorb this radiation and re-emit it, sharing it with other atmospheric elements, and with the Earth below. Without this effect, surface temperatures would
The health impacts of climate change
The resultant climate change poses a range of threats to human health and survival in multiple, interacting ways (figure 1). Impacts can be direct (eg, heatwaves and extreme weather events such as a storm, forest fire, flood, or drought) or indirectly mediated through the effects of climate change on ecosystems (eg, agricultural losses and changing patterns of disease), economies, and social structure (eg, migration and conflict). After only 0·85°C warming, many anticipated threats have already
Non-linearities, interactions, and unknown unknowns
The magnitude and nature of health impacts are hard to predict with precision; however, it is clear that they are pervasive and reflect effects on key determinants of health, including food availability. There are real risks that the effects will become non-linear as emissions and global temperatures increase. First, large-scale disruptions to the climate system are not included in climate modelling and impact assessments.18 As we proceed rapidly towards 4°C warming by the end of the century,
The health co-benefits of emissions reduction
Acting to reduce GHG emissions evidently protects human health from the direct and indirect impacts of climate change. However, it also benefits human health through mechanisms quite independent of those relating to modifying climate risk: so-called health co-benefits of mitigation.26
Reductions in emissions (eg, from burning fossil fuels) reduce air pollution and respiratory disease, whilst safer active transport cuts road traffic accidents and reduces rates of obesity, diabetes, coronary heart
This Commission
6 years ago, the first Lancet Commission called climate change “the biggest global health threat of the 21st century”.1 Since then, climate threats continue to become a reality, GHG emissions have risen beyond worst-case projections, and no international agreement on effective action has been reached. The uncertainty around thresholds, interactions and tipping points in climate change and its health impacts are serious enough to mandate an immediate, sustained, and globally meaningful response.
Section 1: climate change and exposure to health risks
No region is immune from the negative impacts of climate change, which will affect the natural world, economic activities, and human health and wellbeing in every part of the world.31 There are already observed impacts of climate change on health, directly through extreme weather and hazards and indirectly through changes in land use and nutrition. Lags in the response of the climate system to historical emissions means the world is committed to significant warming over coming decades.
All
Section 2: action for resilience and adaptation
Adaptation measures are already required to adapt to the effects of climate change being experienced today. As shown in section 1, these risks will increase as worsening climate change affects more people, especially in highly exposed geographical regions and for the most vulnerable members of society.
This section outlines possible and necessary actions to limit the negative impacts and burden on human health, including direct and indirect impacts within and beyond the formal health system.
Section 3: transition to a low-carbon energy infrastructure
It is technically feasible to transition to a low-carbon infrastructure with new technologies, the use of alternate materials, changing patterns of demand, and by creating additional sinks for GHGs. This requires challenging the deeply entrenched use of fossil fuels. Any significant deployment to meet demanding CO2 targets will require the reduction of costs of mitigation options, carbon pricing, improvement in the research and development process and the implementation of policies and
Main sources of GHG emissions
In 2010, annual global GHG emissions were estimated at 49 GtCO2e.201 The majority (about 70%) of all GHG emissions can be linked back to the burning of fossil fuel for the production of energy services, goods or energy extraction (figure 8).202 Global emissions from heat and electricity production and transport have tripled and doubled respectively since 1970, whereas the contribution from agriculture and land-use change has slightly reduced from 1990 levels.203
When upstream and electricity
The global energy system
We know that the global energy system is heavily dependent on the extraction, availability, movement, and consumption of fossil fuels, and this system shows vulnerabilities when stressed. For example, the 1972 Organization of the Petroleum Exporting Countries (OPEC) oil embargo (which resulted in a cut of global production by 6·5% over 2 months) or the first Persian Gulf War (which caused a doubling of global oil prices over 3–4 months) each caused major pressure on the access and security of
The health burden of the current energy system
Although linked to a historical transformation in health, a fossil-fuel-based energy system also imposes significant health burdens (figure 10). The direct burden occurs through emissions of particulates and solid wastes (coal, oil, gas, biomass), risk of flooding (hydroelectricity), accidents and injuries (all), and emission of radioactive materials (coal, nuclear). But as the main driver of anthropogenic climate change, an energy system based on fossil fuels will also have indirect effects
Pathways to (GHG emissions reduction) pathways
Over the last two centuries, the prevailing pattern of national development has involved dramatic increases in productive capacity, supporting transformations in nutrition and housing, underpinned by development of fossil-fired energy supply, conversion, and distribution systems. Three overlapping stages of development can be identified:
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Stage 1: typically low technology, relatively inefficient and with little regard for damage due to pollution and other externalities.
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Stage 2: locally clean. As
The total economic cost of fossil-fuel use
Past failures to reduce GHG emissions mean that remaining within the required carbon budget is becoming progressively challenging. We are increasingly committed to a certain level of climate disruption, requiring adaptation measures to reduce the impact this is likely to have. Given that the world is already committed to some degree of climate change, and given too that the combustion of fossil fuels also emits a variety of other pollutants, the total external costs of burning fossil fuels (ie,
Standards and engagement
Energy efficiency standards may take many forms. However, all act to push a market, product or process to higher levels of efficiency (or lower levels of emission intensity), through regulation. Such regulations help to overcome market failures such as split incentives, a prominent example of which is the landlord–tenant problem, when the interests of the landlord and tenants are misaligned. The problem arises because, whilst the installation of energy efficiency measures would benefit the
Section 5: delivering a healthy low-carbon future
Central to this Commission's work is the question of whether human societies can deliver a healthy, low-carbon future. Sections 1 and 2 have explained the scientific basis for concern, the potential health dimensions of impacts, and the adaptation responses required. Sections 3 and 4 have demonstrated the technological and economic feasibility of tackling the problem. Yet over the past decade, global emissions have still risen sharply. The evidence to date of humanity's ability to respond
Section 6: bringing the health voice to climate change
Our studies point to multiple ways in which the health agenda may help accelerate the response to climate change. First are the positive lessons for international cooperation. No-one would suggest that national action to protect health should depend on a global, all-encompassing treaty. Yet few would deny that WHO and numerous other fora of international cooperation are important in accelerating, coordinating, and deepening responses to health challenges—particularly, but not exclusively, those
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Co-chairs