“G7 in historic accord to phase out fossil fuel emissions this century”, ran the headline in theFinancial Timesearlier this month. Optimistic observers called this commitment “the end of the age of fossil fuels”. But waiting until the end of the century isn't good enough. Unless faster, deeper, and broader actions are taken over the next decade, global temperatures will likely rise somewhere between 2 and 5°C by 2100. The Conference of the Parties to the UN Framework Convention on Climate Change (COP21) will be held in Paris on Nov 30–Dec 11, 2015. Political leaders must finalise a new, universal, legally binding, international agreement that will keep global warming below 2°C. The agreement will come into force in 2020. COP21 will be the largest ever diplomatic event hosted by France, bringing together around 40 000 politicians, activists, and experts. The French Government will play a crucial part in framing and facilitating negotiations. Health should be a core part of the discussions. Last week, France's Ministry of Health led 2 days of debate in Paris onClimate, Health, Disparities: Solutions?(The Lancetwas a cosponsor.)
As set out in the latestLancetCommission on Health and Climate Change, published this week, the climate crisis is a medical emergency, one that demands action to resuscitate the future not only for our own species but also for the entire biosphere. The idea of climate as a medical emergency could be a powerful trope for public advocacy.
There remains a vast gap in knowledge between experts and the public. Bridging that gap in understanding is essential if we are to build a consensus for transformative changes in human behaviour. Air pollution might be one such bridge. Fine particulate air pollution from burning fuels is understood and well accepted as a cause of 3·7 million deaths annually.
Women are especially vulnerable to the health effects of climate change—their exposure to a larger burden of poverty means that women bear by far the greatest risk of climate instability.
Universal health coverage is the most important single intervention that could build resilience to protect communities from climate shocks.
The effects of climate change on existing health disparities will only deepen inequity still further. Therefore climate action is also about social justice.
The city will be the most important unit in any human response to climate change. By 2050, 70% of the world's population will be living in cities. As the capacity for cities to sustain the health of their populations comes under greater strain, so urban planners will have to consider ideas of health and wellbeing ever more carefully.
Real social and behavioural change will not come from the injunctions of Presidents and Prime Ministers. Change will come from within communities, especially from the leaders of those communities—from Mayors to, for example, women's groups.
Health professionals have an underestimated role in community leadership on climate change. As one of the most trusted professional groups in society, doctors could do a great deal more to make the public case for acting now to reduce greenhouse gas emissions.
Despite a growing political consensus, there remains a vast financing gap to fill. One objective of COP21 is to create, by 2020, a US$100 billion/year fund to help low-income countries at greatest risk from the effects of climate change. The Conference on Financing for Development to be held in Addis Ababa next month will be a critical test for heads of state to turn their words into outcomes.
Finally, independent accountability for results and resources could introduce the means by which progress is not only monitored but also reviewed in a transparent, participatory manner by all concerned constituencies in society, and the problems then remedied.
France has special reason to take climate change and health seriously. In August, 2003, about 15 000 people died from heat stress during an exceptionally hot summer. The French Government is now using its leadership of COP21 to reformulate the meaning of climate change and climate action. France has chosen sides. Now it is time for health professionals to do the same.