Today medical, nursing and public health journals across the world have simultaneously published an editorial calling for world leaders to take emergency action to transform societies and limit climate change, restore biodiversity, and protect health. The editorial will be published in over 220 leading journals, including The Lancet, the East African Medical Journal, the Chinese Science Bulletin, the New England Journal of Medicine, the International Nursing Review, the National Medical Journal of India, The British Medical Journal, the Revista de Saúde Pública (Brazil), and the Medical Journal of Australia. Never have so many journals combined to publish the same editorial.
The editorial is being published in advance of the UN General Assembly, one of the last international meetings taking place before the (COP26) climate conference in Glasgow, UK in November. This is a crucial moment to urge all countries to deliver enhanced and ambitious climate plans to honor the goals of the Paris Agreement. In a year of COVID-19 and crucial environmental conferences, the editorial warns that the greatest threat to global public health into the future is the continued failure of world leaders to take adequate action to keep the global temperature rise below 1.5°C and to restore nature.
Current promises are not enough:
For decades, health professionals and health journals have warned of the severe and growing impacts on health from climate change and the destruction of nature. Heat-related mortality, health impacts from destructive weather events, and the widespread degradation of ecosystems essential to human health are just a few of the impacts that we are seeing more of due to a changing climate. These impacts disproportionately affect the most vulnerable, including children and the elderly, ethnic minorities, poorer communities, and those with underlying health conditions.
The editorial warns that while recent targets to reduce emissions and conserve nature are welcome, they are not enough and are yet to be matched with credible short and longer-term plans. It urges governments to intervene to transform societies and economies, for example by supporting the redesign of transport systems, cities, production and distribution of food, markets for financial investments, and health systems. Such investments will produce huge positive benefits, including high-quality jobs, reduced air pollution, increased physical activity, and improved housing and diet. Better air quality alone would realize health benefits that easily offset the global costs of emissions reductions. These measures will also improve the social and economic determinants of health, the poor state of which may have made populations more vulnerable to the COVID-19 pandemic.
Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said: “The risks posed by climate change could dwarf those of any single disease. The COVID-19 pandemic will end, but there is no vaccine for the climate crisis. The IPCC report shows that every fraction of a degree hotter endangers our health and future. Similarly, every action taken to limit emissions and warming brings us closer to a healthier and safer future.”
Global cooperation hinges on wealthy nations doing more
The editorial argues that sufficient global action can only be achieved if high-income countries do far more to support the rest of the world and to reduce their own consumption. Developed countries must commit to increasing climate finance: fulfilling their outstanding commitment to providing $100 billion a year, have a dual focus on mitigation and adaptation, including improving the resilience of health systems. Crucially, the editorial argues that this money should be provided in the form of grants, rather than loans, and should come alongside forgiving large debts, which constrain the agency of so many low-income countries. Additional funding must be marshaled to compensate for inevitable loss and damage caused by the consequences of the environmental crisis.
Any warming makes our planet more unsafe, and the recent IPCC report shows that until the world has reached net-zero greenhouse gases the planet will continue to warm. We are already seeing these impacts globally and we already know that the consequences of the environmental crisis fall disproportionately on those countries and communities that have contributed least to the problem. A business as usual scenario would spell disaster for the planet. Governments must seize this opportunity to put forward ambitious climate goals for the sake of our health, for people worldwide, and for future generations.
Professor Lukoye Atwoli, Editor-in-Chief of the East Africa Medical Journal, and one of the co-authors of the editorial, said: “While low and middle-income countries have historically contributed less to climate change, they bear an inordinate burden of the adverse effects, including on health. We, therefore, call for equitable contributions whereby the world’s wealthier countries do more to offset the impact of their actions on the climate, beginning now, and continuing into the future.”
Ambassador Aubrey Webson, Chair of the Alliance of Small Island States (AOSIS) and Ambassador, Antigua and Brabuda, and Permanent Representative to the United Nations, said: “Our world is on the brink of climate chaos from the ravages of a warming world, and it will take extraordinary action to turn this around. Even at 1.5˚C of warming, nobody is more at risk than the Small Island States. This editorial reiterates the demand that governments need to be doing more on reducing emissions and to ensure that we all transition to a just, equitable, and fairer world. Equitable funding must be at the core of our response so that vulnerable nations like the Small Islands can have a fighting chance. We need developed countries to keep their promise to provide US$ 100 billion in finance with a higher goal by 2025, and we also need to re-look the reality of what it will actually cost developing countries to implement the commitments we have undertaken in the Paris Agreement. This is not simply a matter of money. It is a matter of our actual survival.”
Dr. Fiona Godlee, Editor-in-Chief of The BMJ, and one of the co-authors of the editorial, said: “Health professionals have been on the frontline of the COVID-19 crisis. And they are united in warning that going above 1.5C and allowing the continued destruction of nature will bring the next, far deadlier crisis. Wealthier nations must act faster and do more to support those countries already suffering under higher temperatures. 2021 has to be the year the world changes course – our health depends on it.”
Dr. Richard Horton, Editor-in-Chief of The Lancet, said: “Urgently addressing the climate crisis is one of the greatest opportunities we have for advancing the wellbeing of people worldwide. The health community must do more to raise its critical voice in holding political leaders accountable for their actions to keep global temperature rises below 1.5°C.”
HE Sheikh Hasina, Prime Minister of Bangladesh and Chair of the Climate Vulnerable Forum, said: “Every country must pursue an ambitious target to curb Greenhouse gas emissions to keep the global temperature-rise below 1.5ºC. Developed nations should facilitate the green recovery of the CVF-V20 countries. Dedicated support is required for reducing the cost of capital and encouraging private sector participation. Strict implementation of the Paris Agreement is the only way to check global emissions and thereby global warming. The time to take action to save the planet is not tomorrow, but today.”
Eric J. Rubin, M.D., Ph.D., Editor-in-Chief of The New England Journal of Medicine, and one of the co-authors of the editorial, said: “The environment and health are inextricably intertwined. The changing climate is endangering us in many ways, including its critical impacts on health and health care delivery. As medical and public health practitioners, we have an obligation not only to anticipate new health care needs but also to be active participants in limiting the causes of the climate crisis.”
Dr. Peush Sahni, Editor-in-Chief of the National Medical Journal of India, and one of the co-authors of the editorial, said: “The recent examples of extreme weather all over the globe have brought into focus the reality that climate change is. We must act now lest it is too late. We owe it to the future generations.”
Dr. Richard Smith, Chair of the UK Health Alliance on Climate Change, and one of the co-authors of the editorial, said: “Health professionals have long been concerned about the harm to health from climate change, but our voices have not been heard clearly in the global debate. This unprecedented joint publication shows our global concern and how we want to be part of acting on climate change.”
Not peer-reviewed / Editorial
The editorial has been coordinated by the UK Health Alliance on Climate Change (UKHACC), a coalition of leading UK health bodies including The Royal Colleges of Physicians, GPs and Surgeons, the Royal College of Nursing, the British Medical Association, the British Medical Journal, and The Lancet. Together UKHACC advocates on behalf of health professionals for responses to climate change which simultaneously protect and promote public health.
This editorial was co-authored by 19 people, listed below, including the editors in chief of 17 health journals based around the world. It is supported – and will be published – by an international group of over 220 health journals.
The editorial co-authors are as follows (a full list of their declarations are available in the editorial):
- Lukoye Atwoli, Editor-in-Chief, East African Medical Journal
- Abdullah H. Baqui, Editor-in-Chief, Journal of Health, Population and Nutrition
- Thomas Benfield, Editor-in-Chief, Danish Medical Journal
- Raffaella Bosurgi, Editor-in-Chief, PLOS Medicine
- Fiona Godlee, Editor-in-Chief, The BMJ (British Medical Journal)
- Stephen Hancocks, Editor-in-Chief, British Dental Journal
- Richard Horton, Editor-in-Chief, The Lancet
- Laurie Laybourn-Langton, Senior Adviser, UK Health Alliance on Climate Change
- Carlos Augusto Monteiro, Editor-in-Chief, Revista de Saúde Pública (Brazil)
- Ian Norman, Editor-in-Chief, International Journal of Nursing Studies
- Kirsten Patrick, Interim Editor-in-Chief, CMAJ (Canadian Medical Association Journal)
- Nigel Praities, executive editor, Pharmaceutical Journal
- Marcel GM Olde Rikkert, Editor-in-Chief, Dutch Journal of Medicine
- Eric J. Rubin, Editor-in-Chief, NEJM (New England Journal of Medicine)
- Peush Sahni, Editor-in-Chief, National Medical Journal of India
- Richard Smith, chair, UK Health Alliance on Climate Change
- Nicholas J. Talley, Editor-in-Chief, Medical Journal of Australia
- Sue Turale, Editor-in-Chief, International Nursing Review
- Damián Vázquez, Editor-in-Chief, Pan American Journal of Public Health
