Climate and health links – let’s stop dancing around the issue

File photo of heavy smog covering parts of New York City on June 7, 2023. The average American had already been exposed to 450 micrograms of smoke per cubic metre by early July, worse than the entirety of the years from 2006-2022, according to calculations by Stanford University’s Environmental Change and Human Outcomes Lab. — AFP

AS I mentioned last month, in December 2023 the great and the good will assemble in Dubai in the United Arab Emirates to, once again, wring their hands and talk about the climate crisis (“The planet is boiling, and we’re turning up the heat by burning fossil fuels”).

If we’re really lucky, some sort of progress will be made – if our politicians and negotiators are sufficiently clear-eyed and understand that, as United Nations secretary-general Antonio Guterres said in June, we have already tipped into an era of global boiling. And that we are here because of our insatiable appetite for fossil fuels.

But perhaps the most significant event at COP28 – in full, Conference of the Parties (COP) to the United Nations Framework Convention on Climate Change – will not be played out in the wranglings of the negotiating hall. Sadly, we’re all just a bit too cynical now to believe that transformation will come from there. For me, the confirmation that COP28 will dedicate an entire day to discussions on health is already a modest win.

Oil makes us ill. Coal makes us wheeze. Plastics (made from fossil fuels, don’t forget) are clogging our rivers and oceans and breaking down into bite-sized pieces and, worse still, microplastics that we are all ingesting. The connection between the climate crisis and human health has never been clearer. And yet, like any other addiction, kicking the fossil fuel habit is proving very difficult.

Climate change is no longer an isolated environmental issue; it has far-reaching implications for human health. Malaysia’s growing susceptibility to extreme weather events means that we are increasingly experiencing this connection. Rising temperatures, changing rainfall patterns, and more frequent heatwaves are already exacerbating existing health challenges such as heat- related and respiratory illnesses, and the spread of vector-borne diseases like dengue.

And so we should welcome the fact that the decision to devote a day at COP28 to climate and health issues underscores the critical connection between climate change and public health. For Malaysia, where we are vulnerable to both climate impacts and health challenges, this development is important.

But it’s also easily wasted.

When we look at the climate-health connection we’re actually recognising that everything is joined up. And this is where the significance of what we are doing on developing a National Planetary Health Action Plan becomes so important.

It is my hope that we can brief delegates at COP28 on the monumental work that the Academy of Sciences Malaysia is leading to ensure that we have a clear forward plan on incorporating planetary health priorities into the workings of our country by next year.

But beyond Malaysia demonstrating to the world what science, policy and popular action can do together, it will also be important that the discussions in Dubai accelerate international agreement on several issues.

Firstly, there is the develop-ment of climate-resilient healthcare systems. As the world gets hotter, we need to make sure that our medical facilities are prepared to handle climate-related health challenges, such as heatwaves and disease outbreaks.

Investment in infrastructure, medical equipment, and training for healthcare professionals is needed to bolster the capacity to respond effectively to health crises exacerbated by climate change. So too is rapidly reducing the carbon footprint of global healthcare which, if it was a country, would be the fifth largest emitter in the world.

Secondly, we all know that the planet faces significant air quality issues, including from factors that don’t have immediately visible connections to air pollution, like the acceleration in urbanisation and how we grow food.

Focusing on how we can develop common and collective air quality management strategies at COP28 should bring us closer to the development of transboundary regulations and policies that reduce air pollution and improve respiratory health. The current spotty and nationally-focused laws and regulations don’t consider that air pollution travels between countries.

Thirdly, we are seeing a rise in vector-borne diseases like dengue and zika due to warmer temperatures and changing rainfall patterns. As the planet warms, we should expect to see more of this, and so cooperating across the planet to manage vector borne diseases has a clear resonance with COP28’s Health Day agenda.

And finally, we need an urgent focus on public awareness and education. We’re looking closely at this as we develop the National Planetary Health Action Plan – trying to understand why it’s so difficult to communicate about the health implications of climate change. At COP28, the health community needs to work with global leaders to crack this nut.

An outcome of Health Day should be agreement on developing and overseeing a far more effective global public relations and public information campaign rather than relying on scientists to publish reports that, frankly, have limited resonance with the end-users of fossil fuels.

As Malaysia gets ready for COP28’s Health Day discussions, we need to be brave, to exercise leadership which is perhaps outside our comfort zone. The links between climate and health are as clear as the light of day, and the time for dancing around the issue is over.

We must be grateful to the United Arab Emirates (UAE) for getting health onto the agenda. But Dubai’s bad air quality reminds us that the UAE and other governments need to walk the walk as well as talk the talk. Making sure something meaning-ful emerges at COP28 is strongly aligned with Malaysia’s work on planetary health, and of course, with our (in my view still too limited) commitment to the Paris Agreement.

In line with Malaysia *Madani the demand is clear: equity, solidarity, environmental stewardship and peace in the face of a planetary crisis. The opportunity is here. We can lead. The question is, will we?

*Madani is an acronym for the Malaysian government’s overarching policy that embraces six core values: keMampanan (sustainability), KesejAhteraan (prosperity), Daya cipta (innovation), hormAt (respect), keyakiNan (trust) and Ihsan (compassion).

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Dr Jemilah Mahmood, a physician and experienced crisis leader, was appointed the executive director of the Sunway Centre for Planetary Health at Sunway University in August 2021. She is the founder of aid organisation Mercy Malaysia and has served in leadership roles internationally with the United Nations and Red Cross for the last decade. She writes on Planetary Health Matters once a month in Ecowatch. The views expressed here are entirely her own.