Sandy Dechert :
(From previous issue)
However-and this is odd in the context of last week’s encyclical from Pope Francis-they neglect the power of the pulpit and religious gatherings, citing only “family and friends, environmental groups, scientists, and the media” as the most trusted sources. Local and city-level authorities may provide an important conduit for information, the writers say. However, to engage effectively with the public, scientists need communication skills radically different from those of academia. They must convey a big picture of climate change for the public to engage and internalize for future discussions of new scientific results and their consequences.
Climate change and exposure to health risks. Reexamines causal pathways between climate change and human health. Offers up-to-date estimates of exposure to climate health risks in the coming decades.
Action for resilience and adaptation-measures that must be instituted to lessen unavoidable health impacts. Adaptation strategies will reduce human vulnerability and enhance resilience. Institutional and decisionmaking challenges exist related to uncertainty, multicausal pathways, and complex interactions between social, ecological, and economic factors. The section also reveals tangible adaptations that provide clear no-regret options and co-benefits related to food insecurity, human migration and displacement, and dynamic infectious disease risks. Transition to a low-carbon energy infrastructure. Immediate analyses needed: epidemiology, options for scaling up low-carbon technologies and responses, measures required to facilitate their deployment, health implications of various mitigation options, with particular attention to actions that both promote public health and mitigate climate change.
Financial, economic, and policy options for decarbonization. Mitigation policy should be to reduce cumulative and annual greenhouse gas emissions in order to delay climate disruption. It will also reduce the overall cost of abatement by avoiding drastic and expensive last-minute action. Immediate action offers more technological options, allows economies of scale, promotes learning, will reduce costs over time, and holds the window of opportunity open for longer so that new technologies can develop, be commercialized, and deploy.
Delivering a healthy low-carbon future. The authors examine the political processes and mechanisms that might play a part in delivering a low-carbon economy here. They consider multiple levels, including the global response (UNFCCC), national and subnational (cities, states, and provinces) policy, and the role of individuals, with emphasis on the interaction between these levels and lessons learned from public health.
Bringing the health voice to climate change. The Commission proposes forming an international Countdown to 2030: Global Health and Climate Action. An international, multidisciplinary coalition of experts should monitor and report on the following:
Malnourished child suckling, from Costello et al, 2009 (thelancet.com/journals/lancet/)
Malnutrition and disease, from Costello et al, 2009 (thelancet.com/journals/lancet/)
Health impacts of climate change,
Progress in policy to reduce GHG emissions and synergies used to promote and protect health; and
Progress in health adaptation to reduce population vulnerability, build climate resilience and to implement climate-ready low-carbon health systems.
The Countdown process would complement rather than replace existing IPCC reports and would bring the full weight and voice of the health and scientific communities to this critical public health challenge. The Commission also offers 10 underlying recommendations to accelerate action within the next 5 years. The timeline corresponds exactly with the UN’s 2015-2020 scenario. Many international players view this stage of preparations as inadequate. Here are the Commission’s recommendations. The report begins by stating that effects of climate change are being felt today, and that future projections represent an unacceptably high-and potentially catastrophic-risk to human health. The Commission recommends that over the next 5 years, governments:
Invest in climate change and public health research, monitoring, and surveillance. Scale up financing for climate-resilient health systems worldwide, including strengthening health systems in low-income and middle-income countries that will ultimately play into overall health. Protect cardiovascular and respiratory health by ensuring a rapid phaseout of coal from the global energy mix. Over 2000 coal-fired plants are currently proposed for construction worldwide that will damage health unless we find cleaner energy alternatives, the Commission reports. Transitioning to renewable energy will require a cautious use of natural gas (presumably also its withdrawal).Connections between global energy system and health impacts (thelancet.com/journals/ lancet/)
Encourage a transition to cities that support and promote lifestyles healthy for the individual and for the planet. Develop highly energy-efficient building stock, low-cost and easy transportation, and more access to green spaces.
The Commission points out that achieving a decarbonized global economy and securing the public health benefits it offers is no longer primarily a technical or economic question. It is now a political one. The authors recommend that over the next 5 years, governments:
Establish a framework for strong, predictable, and international carbon pricing.Carbon pricing schemes as of 2015 (thelancet.com/journals/lancet/) Rapidly expand access to renewable energy in low-income and middle-income countries. This will provide reliable electricity for communities and health facilities, unlock substantial economic gains, and promote health equity. A global development pathway that fails to expand here will come at a detriment to public health and long-term economic growth.Health expenditures related to national GDPs (thelancet.com/journals/lancet/)
Support accurate reporting of avoided burdens of disease, reduced healthcare costs, and enhanced economic productivity associated with climate change mitigation.
Because the health community has a vital part to play in accelerating progress to tackle climate change, the Commission recommends that over the next 5 years, governments:
Adopt mechanisms to facilitate collaboration among government departments. This will empower health professionals and ensure that climate and health are thoroughly integrated in government-wide strategies. “A siloed approach to protecting human health from climate change will not work.” Additional global environmental changes like deforestation, biodiversity loss, and ocean acidification must be addressed.
Agree and implement an international agreement that supports countries in transitioning to a low-carbon economy. This recommendation should be pursued in the international agreement expected in Paris this December. It will replace the Kyoto Protocol. The Commission adds: “While the negotiations are very complex, their goals are very simple: agree on ambitious and enforceable global mitigation targets, on adaptation of finance to protect countries’ rights to sustainable development, and on the policies and mechanisms that enable these measures. To this end, international responsibility for reducing greenhouse gas emissions is shared: interventions that reduce emissions and promote global public health must be prioritized irrespective of national boundaries.”
To help drive the transition, the 2015 Lancet Commission on Health and Climate Change will develop a new, independent Countdown to 2030: Global Health and Climate Action. This program will both provide expertise in implementing policies that mitigate climate change and promote public health, and monitor progress over the next 15 years. The Commission will report in The Lancet every two years on a range of indicators in global health and climate change.
A very important contribution of this week’s Lancet Commission report is its excellent discussion of “tail risks,” a concept difficult to understand (even for the experts) but critical to any analysis of potential effects of climate change.
Tail risks (thelancet.com/journals/lancet/)
Health as percentage of gdp (thelancet.com/journals/ lancet/)Also interesting: Vulnerability, adaptation, and resilience; decarbonization pathways in the IK and China; social costs; health as a percentage of GDP; high-impact mitigation techniques; total external costs of burning fuels (formula and explanation); and heatwave, flooding, and drought scenarios. The study ends with a section called “Optimism” that explains why people should not approach the phenomenon of climate change with fear. Paraphrase being inadequate, we quote it here.
“We should draw considerable strength in the face of the challenges of climate change from the way in which the global community has addressed numerous other threats to health in the recent past. Although the threats are great and time is short, we have an opportunity for social transformation that will link solutions to climate change with a progressive green global economy, reductions in social inequalities, the end of poverty, and a reversal of the pandemic of non-communicable disease. There are huge opportunities for social and technological innovation. We have modern communications to share successful local learning. At the highest levels of state, there are opportunities for political leaders to grasp the global challenge with transformative climate initiatives of a scale and ambition to match the Marshall plan, the Apollo and Soyuz space programmes, and the commercial success of mobile telephony.
Scalable, low-carbon, and renewable energy technologies require billions of dollars of new investment and ideas. In cities, municipal governments are already bringing energy and innovation to create connected, compact urban communities, better buildings, managed growth, and more efficient transport systems. In local communities transformative action creates greater environmental awareness and facilitates low-carbon transition. And within local government, civil society, and business, many people aim to bring about social and economic transformation. All of us can help cut GHG emissions and reduce the threat of climate change to our environment and health. At every level, health must find its voice. In health systems we can set an example with scale up of renewables, combined heat and power generation in health facilities, decentralisation of care and promotion of active transport, and low-carbon healthy lifestyles.
But time is limited. Immediate action is needed. The Countdown to 2030 coalition must begin its work immediately.”
(Sandy Dechert covers environmental, health, renewable and conventional energy, and climate change news.)
(Concluded)
