2015: Health Care in the Age of Climate Change

After two weeks of intense negotiations, the world’s governments have signed a landmark global treaty that – for the first time in history – will commit nations to reducing their greenhouse gas emissions. 

And while the world followed the Paris climate negotiations with intense interest, time and again throughout this past year, we have seen the health sector use its position as a moral leader to take action on climate change. 

In June, the Obama Administration held a Summit on Climate Change and Health where the Surgeon General became a spokesperson for the issue. This was followed in the summer by the Clean Power Plan, which was framed as a strategy to prevent asthma in America’s children and cut health care costs as well as carbon emissions. In Britain, the prestigious Lancet Commission released a report that described climate change mitigation as the greatest public opportunity of the 21st century.

And in Paris just these past two weeks, an unprecedented alliance of doctors, nurses, and other health professionals representing over 1,700 health organizations, 8,200 hospitals, and 13 million health professionals came together to call on governments to reach a strong climate change agreement that protects public health. The health sector also committed to leading the way toward climate solutions, promoting low carbon health care, climate resilient health systems, and health care leadership in support of policies that combat climate change. 

Throughout 2015, we’ve seen climate change challenge the health sector to redefine its mission and scope.

What is health care for in a world where residents in Beijing are advised to stay indoors because the air is so poisoned it’s too dangerous to go outside? What is health care for in a world where millions of people in Pakistan get flooded out of their homes and where environmental refugees wash up on the shores of already stressed public health systems? What is the role of health care in addressing the enormous reliance on fossil fuels, which contributes to 7 million deaths every year and costs nearly $3 trillion in health care costs?

Our imperative to address climate change will transform health care in fundamental ways over the next two decades. But what will this look like?

First, our health care facilities need to be places of refuge during the coming storms and rising tides of climate change. They need to be designed and operated with on site power so they can continue to operate when the grid fails in an extreme weather event. 

Clinicians need to be prepared for the shifting burden of diseases and be able to address surges of people that suffer respiratory and heat related illnesses. The health sector in developing countries will need to access funds to build resilience into its facilities and supply chains. Imagine thousands of clinics in Africa and Asia powered by renewable energy, where medicines are refrigerated by solar power and vehicles are powered by biodiesel that is produced locally.

Second, health care can lead in reducing its reliance on fossil fuels and help transform the economy toward a low carbon future. Health care is 18% of the entire U.S. economy and 10% of the global economy. By leveraging its purchasing power, hospitals and health systems can support low-carbon technologies and products, sustainable agricultural products to feed their patients and employees, and remove toxic chemicals from their supply chains. In this way, they create health not only in clinical practice but as economic engines in the communities they serve. They can become anchors for community wealth creation as well as community health. They can move upstream and reduce the very illnesses linked to our reliance on fossil fuels and toxic chemicals in the communities they serve.

In the lead up to COP21, 60 health care institutions from 16 countries representing over 8,000 hospitals adopted a 2020 Health Care Climate Challenge to dramatically reduce their greenhouse gas emissions and exercise leadership on climate change. In this way, they are forging a new social contract with society, publicly acknowledging their responsibility to heal the environment as core to their mission.

Finally, health leaders can amplify their voices as respected messengers in society and advocate for policies that will rein in climate change and help re-brand it as the medical emergency that it represents. In Paris, Dignity Health, one of the largest U.S. Catholic hospital systems, announced that it was divesting from coal in its portfolio, demonstrating that fossil fuels are out of alignment with the mission of health care. Dignity has joined other institutional investors worth $3.4 trillion in committing to divest from coal and other dirty energy sources and will likely provide political space for other hospital systems to follow their lead.

Ultimately, the only way we are going to solve this crisis is developing a just price on carbon that reflects the full public health and social costs of our reliance on fossil fuels. In that policy fight, the health sector can bring its moral clout to bear to ensure that health costs related to fossil fuels are reflected in the price of carbon.

In this new era of climate change, health leaders need to become human rights advocates, defending peoples’ right to clear air, clean water, healthy food, and adequate shelter as the fundamental conditions for health. These rights are already being violated by our addiction to fossil fuels and toxic chemicals and the situation is only going to become more dire. 

Health care needs to renew its commitment to its core mission, understanding that it is impossible to support healthy people on a sick planet. Health leaders need to become healers not only within their institutional walls but in the communities they serve and for the Earth that sustains us all.

Gary Cohen is President and Co-Founder of Health Care Without Harm.



December 14, 2015Global

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Paris Round-up | The New Climate Treaty and Health Care Action

COP 21 is over. Government ministers from around the world have completed work on the Paris Treaty and have headed home after two weeks of intense negotiations. The accord they finalized, while far from perfect is a major step in the direction of moving the world away from fossil fuels and toward 100% renewable energy in the coming decades. 

If truly implemented, this treaty could become known as the greatest public health accomplishment of our time. Indeed, the Paris Moment may well be remembered as that instant in history when civilization changed course and took on its greatest existential threat. That, of course, depends on how well the agreement can be both implemented and then ratcheted up over time.  

There are many analyses emerging of what happened in Paris and its implications for the future, including from the Global Coalition for Climate Action.   

This blog post focuses on what happened around health in Paris and what Health Care Without Harm (HCWH) and our allies achieved on the road to Paris and particularly during the “Paris Moment.”  

In the lead-up to and during the Paris negotiations HCWH played a leadership role, working with allies and partners around the world, to mobilize health care to address climate change—a multi-faceted problem that The Lancet has called a growing “health emergency,”   as well as the “greatest health threat” and “greatest health opportunity” of the 21st century.

While some of our allies have rightly focused on influencing the language in the Treaty itself,  and while we had a presence at a number of side events in Le Bourget, HCWH saw the Paris Moment primarily as an opportunity to focus health care’s attention around the world on this crucial issue. Our aim was to use Paris as a pivot point to build worldwide health care action on climate well into the future.    As HCWH Co-Founder and President, Gary Cohen points out in his blog post, "Our imperative to address climate change will transform health care in fundamental ways over the next two decades."

The 2020 Challenge

Our primary vehicle to mobilize healthcare for Paris and beyond on climate was and is the 2020 Health Care Climate Challenge which we launched in April, 2015. Based on three pillars of mitigation, resilience and leadership, the 2020 Challenge aims to bring together health care institutions from around the world who are already leading the charge on climate change, with the goal of scaling it up to a broader swath of the health care community and measuring carbon footprint reduction around the world in coming years.

By the time Paris rolled around we were well on our way. On December 3 we were able to announce that a total of 67 participants, representing more than 8200 hospitals and health centers in 19 countries had joined—setting targets for emissions reduction, and pledging to exert leadership on climate change.  

HCWH is also calling on the US health care sector, which, if it were a country would have greenhouse gas emissions greater than all of France’s, to lead the way and reduce its emissions by 25% by 2020 and 50% by 2025.  Several members of the US Health Care Climate Council were with us in Paris; leaders in carbon mitigation all, they provided examples of just how feasible such a target is. 

Many 2020 Challenge participants joined us in Paris on December 3 for the first Health Care Climate Leadership Roundtable. The Roundtable took place at the oldest hospital in Paris, Pitié-Salpêtrière, in a building built before the French revolution.   We were hosted by APHP—Paris’ prestigious public hospital system.   The Roundtable, a 30 person closed-door meeting, was the first global gathering ever of health systems working on climate change. Major health care systems and organizations from Europe, the U.S., and Asia, along with representatives from WHO and other UN agencies came together to share experiences and strategies, while forging plans to scale-up health care engagement on climate change.

At the Roundtable, the U.S. system, Dignity Health, announced that it was divesting from coal.By doing so, Dignity joined the British and Canadian Medical Association, as well as Gundersen Health System as health leaders in the fossil fuel divestment movement.  

Several health systems also signed the 2020 Challenge at the Roundtable itself, including  our French hosts APHP, the global health care group BUPA, Vivantes Hospital in Berlin, BUND—a group of 25 hospitals leading the low carbon health care movement in Germany, and the Public Health Foundation of India.

The following day, December 4, we co-organized a day-long conference on Climate Change and Health Care together with the French Hospital Federation and several other partners at the Georges Pompidou Hospital, one of the most modern hospitals in Paris, and also part of the public system. The event featured a rich series of panels with speakers from a diversity of regions sharing in depth experiences on how to foster low carbon health care, including renewable energy, purchasing, economics and policy.  

At the Conference, we issued our First Annual 2020 Challenge Climate Champion Awards to 15 Challenge participants from 5 continents for their achievements in carbon mitigation, climate resiliency, and climate leadership. From health systems in Taiwan preparing for the impacts of climate change; to systems in the US making major in energy from renewable sources such as wind, solar, geothermal, and biomass; to New Zealand, where major work has been undertaken to improve efficiency and reduce energy use in existing facilities, the 2020 Challenge Climate Champion award winners for 2015 are made up of leaders from the global health sector at the forefront of the movement towards low-carbon health care.

The conference was the culmination of a series of events HCWH had organized around the world in preceding months, which were designed to build momentum for the 2020 Challenge and health care engagement on climate change in general.   For instance, at a Latin American regional conference on climate and health care organized by the Bogota City government, WHO, PAHO and HCWH, participants called “upon health sector colleagues and governments to act to protect population health from the effects of climate change and air pollution, and to promote development based on clean, renewable and healthy energy.” At an Asia regional conference in Seoul, health systems gathered there called on  “the entire healthcare sector in the region to come together and act as one in mitigating climate change.” And the US Health Care Climate Council, meeting in Washington DC, called on global leaders to take decisive action that will protect human health from climate change, both now and for future generations. HCWH also co-organized or participated in similar events in the lead-up to Paris in Sao Paulo, Beijing, Manila, Durban, and more.  

The Paris Platform for Healthy Energy

Parallel to all of our work with hospitals and health systems, HCWH’s Healthy Energy Initiative was also actively engaged in the lead-up to Paris and during COP21 as well. The Healthy Energy Initiative is a collaborative effort with partners in eight countries to address the health impacts of energy choices. Recognizing that more than 7 million people die every year from air pollution, much of it related to fossil fuel combustion, particularly coal, the Health Energy Initiative seeks to engage the health sector in advocating for a rapid transition to clean, renewable energy. 

To this end, we created the Paris Platform for Healthy Energy as a way to reflect this common agenda across borders and to engage ever greater numbers of health sector actors in this advocacy. In Paris we were able to announce that the platform was endorsed by 44 organizations representing the health sector in more than 80 countries, demonstrating a commitment to leadership and advocacy for clean, renewable, healthy energy choices in order to protect public health from both climate change and local pollution. With both Beijing and Delhi covered in deadly shrouds of coal-induced smog while negotiators met to determine how to best address climate change, the Paris Platform became a particularly poignant public health pronouncement.

On December 7, three Healthy Energy Initiative partners --  groundWork, South Africa; Climate and Health Alliance, Australia; and HCWH-Asia -- all screened films at the Cost of Coal Film Festival, held at an art gallery in the Marais in central Paris, an event organized by the NGO Pacific Environment.

Prior to Paris the Healthy Energy Initiative also co-organized the India launch of the Lancet Commission Report together with a national meeting on climate, energy, and health  with the Public Health Foundation of India. The Initiative’s partners around the world also organized events, released reports, and issued calls to action in the Philippines, South AfricaAustraliaGermany, Poland, Turkey, and globally to build support for clean air, healthy energy, and climate action.   

The Climate and Health Summit and the Global Climate and Health Alliance

When HCWH organized the first Climate and Health Summit at COP 17 in Durban back in 2011, we had hoped it would become an annual event. Thanks to the Global Climate and Health Alliance, of which we are a founding member,  and the World Health Organization, that wish has virtually come true.

The fourth Climate and Health Summit took place in Paris on December 5. The event, moderated by the Guardian’s John Vidal, featured leading health voices from around the world. Health Care Without Harm featured prominently in the event,  with three of our representatives speaking on panels. The Summit concluded with a closing plenary where HCWH President Gary Cohen spoke, and then a ceremony marking the various health initiatives that were organized in relation to COP21, including the Paris Platform and the 2020 Challenge. All told, an unprecedented alliance of doctors, nurses, and other health professionals representing over 1700 health organizations, 8,200 hospitals and 13 million health professionals came together around the Paris Moment.

In the lead-up to the Summit, HCWH also co-sponsored two reports: one with the World Federation of Public Health Associations and others that reveals the need for national governments around the world to strengthen their policy planning efforts to address the health risks of climate change. The other, entitled Health and Climate at COP21 and Beyond, was published by the Global Climate and Health Alliance, and provided analysis of what is needed from a global climate treaty to protect public health. 

Following the Summit, the Global Climate and Health Alliance met and began making plans for not only 2016’s Summit, but also for more concerted collaborative health sector action on climate change.  

Beyond Paris

With the Paris moment behind us, the health sector is gaining momentum. Never have so many health professionals, organizations, institutions, hospitals and systems come together to advocate on climate change. Never has there been so much media coverage of the health impacts of climate change and the health sector response.   The momentum has been building over the past five years.   Paris is an inflection point. It is now time to take action.

Health Care Without Harm stands committed to continue to mobilize the health sector to implement and build on the Paris accord by working with hospitals and health systems around the world to reduce their own carbon footprint, prepare for the already growing impacts of climate change, and play a leadership role to foster policy and economic measures that protect local and global health from climate change. (see HCWH statement on the final Paris Agreement).     
Join us in protecting public health from climate change.  
Josh Karliner, for the HCWH team

December 14, 2015Global

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HCWH Applauds New Paris Treaty and Calls on Health Sector to Mobilize for Implementation

The Paris climate agreement is a prescription for a healthy planet that can address the world's greatest public health threat. Now we will need to go on a crash renewable energy and low carbon diet that both stabilizes the climate and reduces diseases related to our addiction to fossil fuels.” Gary Cohen, President, Health Care Without Harm

The new Paris climate treaty is far from perfect, but it takes a major step to move the world away from fossil fuels and toward 100% clean, renewable energy in the coming decades.   

It represents a turning point in history; the world’s governments have recognized the need to protect the health of people and the planet by keeping fossil fuels in the ground and shifting the world economy toward a path of greater sustainability and equity. 

If implemented in a progressive fashion, this accord could become known as the greatest public health accomplishment of our time by forestalling what is widely acknowledged as the greatest public health threat of this century.

The agreement itself does not go far enough to achieve the change necessary to forestall some of the most serious impacts of climate change.   Nor does it usher in an immediate transformation that would protect public health from the acute consequences of fossil fuel combustion such as air pollution which is killing millions of people every year.   Nor does it provide adequate financing for such a transition in developing countries.   Yet it takes important steps in all of those directions.

The Paris agreement provides a foundation—agreed upon by all the world’s governments—to address climate change.   It is a foundation that can be built upon by all parties in coming years.  

Health Care Without Harm stands committed to continue to mobilize the health sector to implement and build on the Paris accord by working with hospitals and health systems around the world to reduce their own carbon footprint, prepare for the already growing impacts of climate change, and play a leadership role to foster policy and economic measures that protect local and global health from climate change.

December 14, 2015Global

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