Why climate change is a health emergency: An urgent call to action on World Environment Day

Dr Christian Lueme Lokotola

In 2009, the UCL (University College London)-Lancet Commission on Climate Change declared that “climate change is the biggest global health threat of the 21st Century”. Since then, this statement has become foundational in planetary health and climate-health literature, arguing against any delay to action to protect the planet and safeguard life.The Intergovernmental Panel on Climate Change’s Sixth Assessment Report (2022) consistently identifies climate change as a severe and escalating threat to human health, food systems, water security, livelihoods, and ecosystems.

Climate change continues to have major impacts on humans, animals and plants. Several major international organisations, commissions, and global health bodies have proclaimed it as either the greatest or one of the greatest global health threats of the 21st century. However, the impact of climate change is often conflated with climate variability, which refers to short- to medium-term fluctuations in weather conditions resulting in El Nino and La Nina events in the Pacific Ocean and volcanic activities. Climate change consists of long-term changes in average climate conditions with periods of frequent and severe abnormal weather conditions lasting from decades to a century.

As we celebrate World Environment Day on 5 June, which focuses on climate action, we must also reflect on the urgent needs of such action to protect planetary health and health– human, animal and vegetation health.

Rising emissions

Scientists warn that greenhouse gas concentrations in the atmosphere have reached their highest levels on record. Rising greenhouse gas emissions come from cars, coal-fired powerplants, industrial operations, ships, airplanes and healthcare services. The healthcare sector accounts for around 5% of global greenhouse gas emissions. Unfortunately, we still rely on fossil fuels. Even electric cars depend on materials derived from fossil fuels. Recent decades have seen record high temperatures, approaching 1.5 degrees Celsius above the pre-industrial periods. Exceeding this threshold will push natural systems toward irreversible ecosystem collapse, biodiversity loss and severe environmental instability. This means that the frequency and duration of storms, flash floods, droughts, heatwaves, wildfires, and air pollution will intensify.

Health impacts

The problem is becoming increasingly urgent as climate change-related extreme weather events considerably affect agricultural systems leading to a decrease in crop production, fishing, water availability and biodiversity, as well as increase in food insecurity. Climate change affects the major determinants of health such as clean air, safe water and food systems. This is causing major health problems, death, displacement, migration, and mental health trauma.

The 2023 Lancet report on the burden of diseases shows peaks in cardiovascular, respiratory and infectious diseases. No healthcare system in the world is immune to the strains of climate change. We see this in the growing demand for healthcare, especially in low- and middle-income countries where healthcare systems are nearing their breaking point.

Insufficient and delayed actions

Despite alarming evidence on the impacts of climate change, many countries still lack adaptation plans. Where they do exist, local activities are either fragmented, underfunded or poorly integrated across all sectors. Local initiatives are often delayed, and this will unfortunately increase future harm, the burden of disease, and deepening socio-economic loss and damage. This will, in turn, make it more difficult to develop and implement adaptation and mitigation plans. Insufficient and delayed actions have contributed to increasing environmental and social injustice with low-income countries and marginalised communities facing increased poverty, social instability and health inequities.

Limited understanding

Despite increasing scientific evidence and international attention, many communities still have a limited understanding of the causes, health impacts, and local risks of climate change, as well as appropriate adaptation strategies and sustainable solutions. Many vulnerable communities also face digital exclusion, weak public communication systems, limited access to information, low levels of education, and misinformation. Global climate messages may not resonate with local lived experiences. Several communities, even those most affected by climate change-related extreme events, have very little knowledge of climate resilience and environmentally sustainable actions such as disaster preparedness and emergency response. Climate resilience often involves expecting vulnerable populations to adapt rather than addressing the root causes of their existing  sufferings.

Many actions to reduce the impact of climate change are focused either on adaptation or mitigation. High-income countries tend to prioritise mitigation to build sustainable societies and healthcare systems while reducing their carbon footprint. Low- and middle-income countries, which are disproportionately affected by climate change-related extreme weather events, focus on resilience, disaster preparedness and emergency response. But evidence shows that neither adaptation nor mitigation can fully protect health and social care systems.

Knowledge mobilisation

Much of the knowledge on climate change and health, sustainable healthcare and climateresilience remains largely within academic literature and policy documents. It often does not reach frontline healthcare workers, educators and communities. There is a gap between knowledge generation and practical implementation. We need knowledge mobilisation—generating, sharing, translating, adapting, and applying knowledge to improve policy, practice, education, decision-making and capacity building—to bridge this gap.

Several criticisms have been raised regarding existing resilience and sustainability strategies. Many resilience and sustainability frameworks are ambitious on paper but weak in implementation. They involve assessing climate and capacity vulnerabilities to develop simple operational plans without clear steps for implementation. Frameworks and strategies from high-income countries are often adopted in low- and middle-income countries without considering local contexts and community participation.

They are not part of an integrated systems-thinking approach that generates knowledge through inter disciplinary collaboration. Climate change is no longer a scientific projection made by experts. Both climate variability and climate change affect society, health and healthcare services in many ways. Lasting climate action requires a systems-thinking approach rooted in intersectoral, interdisciplinary and community-centred collaboration. There is already enough evidence of climate risks.What we need is sustained action.

*Lueme Lokotola is a planetary and public health medical lecturer andresearcher at the School for Climate Studies and in the Division of Family Medicine andPrimary Care at Stellenbosch University.

Weekend Argus