Health hangs in the balance

To say that the conduct of the 29th Conference of the Parties (COP29) of the United Nations Framework Convention on Climate Change in Baku, Azerbaijan, is anti-climactic is an understatement.

The Trump reelection in the United States heralds a possible departure from the provisions of the Paris Agreement. All the science that we know about climate change can be thrown out the window when leaders who are climate deniers occupy the top echelons of power.

The absence of world leaders representing developed economies that contribute the most to global emissions is bothersome. This does not bode well for political will and a sense of urgency that are important catalytic elements of climate actions.

The criticisms hurled against the COP29 host country with its leader quoted to be romanticizing fossil fuels as a “gift from God” bring to the fore the power of enterprises in greenwashing, and the baffling politics involved in the transition to clean energy. Walking the talk is a powerful message and call to action that every COP presidency must aspire for.

The lackluster climate finance deal forged at this COP consists of funding pledges that are not commensurate to the massive toll on human lives and economic losses that vulnerable countries like the Philippines experience. Worse, it is gravitating toward loans that can further spiral poor countries into deeper debt.

At this COP, hopes of health driving climate actions are dampened with geopolitical factors and business interests taking center stage. Human lives and losses are the price we pay for lack of adaptation and ambition, if not excessive hypocrisy and greed.

This COP also set back the huge progress made last year when ministers of health, including our own, endorsed the Declaration on Climate and Health at the COP28 in Dubai, United Arab Emirates.

It extinguished the fire of ambition and actions meant to counter the record-breaking heat and emissions, and the concomitant bleak health scenarios and issues headlined by the latest Lancet Countdown Report on health and climate change.

As this disappointing COP came to a close though, we, as the world’s most at-risk country in terms of climate change, cannot afford to delay and dilute our climate change actions. Disgruntlement should breed bolder, more urgent resolve and should catalyze clear actions to benefit Filipinos, especially those most vulnerable.

Building on the key health message this year—that health is THE argument for climate actions for our well-being, productivity, and development—we, in the health sector, still have the unique opportunity to do something significant outside the rarefied halls and meeting rooms where COP formal negotiations take place.

Putting a cap on the global average temperature and limiting greenhouse gas emissions are main climate change strategies. But these should be underpinned by health outcomes.

The main takeaway from this COP is that it is not only about the moral imperative of putting health at the center of the climate agenda, but also about linking it with the language of money, the economic imperative.

Instead of focusing only on deaths, injuries, and illnesses due to heat waves, extreme weather, and climate-sensitive diseases that cause staggering impacts to our health system, the health sector should also look at health risks in terms of labor productivity, lost income, learning outcomes, quality of life, and other human development parameters. These can be more relatable, thus actionable for other policymakers and business leaders.

More importantly, to strengthen the cornerstone of health actions for climate change, much has to be done in terms of promoting health equity and in addressing the multifactor determinants of health—from sociopolitical to commercial. This should be the rallying point for cross-sectoral collaboration.

Our fight for scarce financial resources, uneven technical capacities in the face of the consummated, growing, and disproportionate health risks due to climate change is something we have to win on the local and international fronts.

Aside from strengthening our health system, we must overcome political barriers, sharpen our climate change negotiations acumen, and secure much-needed resources to allow us to be more ambitious and hopeful in the next few years.

The ultimate imperative that is health must become a top and sustained priority of every COP, of every country, at any time in this era of climate change. Making this happen starts with all of us. This will tip the balance.

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Ronald Law is a public health physician, academic, and health emergency and climate change specialist at the Department of Health. He was part of the Philippine delegation to COP28 and COP29.