WMA DECLARATION OF DELHI ON HEALTH AND CLIMATE CHANGE
Adopted by the 60th WMA General Assembly, New Delhi, India, October 2009
and amended by the 68th WMA General Assembly, Chicago, United States, October 2017
PREAMBLE
1. Human influence on the climate system is clear, and recent emissions of green-house gases are the highest in history. Recent climate changes have had widespread impacts on human and natural systems.
2. Compelling evidence substantiates the numerous health risks posed by climate change, which threaten all countries. These include more frequent and potentially more severe heatwaves, droughts, floods and other extreme weather events including storms and bushfires. Climate change, especially warming, is already leading to changes in the environment in which disease vectors flourish. There is reduced availability and quality of potable water, and worsening food insecurity leading to malnutrition and population displacement. Climate Change is universal but its effects are uneven and many of the areas most affected are least able to manage the challenges it poses.
3. Tackling climate change offers opportunities to improve health and wellbeing both because of the health co-benefits of low carbon solutions and because mitigation and adaptation may allow action on all the social determinants of health. Transition to renewable energy, the use of active transport, and dietary change including a reduction in consumption of beef and other animal products, may all contribute to improving health and wellbeing.
4. The social determinants of health are those factors that correlate to health through exposure before and after people are born and as they grow live, and work. They vary between and within countries. Those with generally the poorest health and lowest life and health expectancy will be least able to adapt to the adverse effects of climate change thereby exacerbating adverse social determinants of health.
5. Climate change research and surveillance is important. The WMA supports studies that describe the patterns of disease attributed to climate change, including the impacts of climate change on communities and households; the burden of known and emergent disease caused by climate change, and those diseases projected to occur with new development activities (Health Impacts Assessment). Such studies should also define the most vulnerable populations.
6. The Paris Agreement highlights a transition to a new model of global collaboration to address climate change and is an opportunity for the health sector to contribute to climate action. It includes a series of actions to be undertaken by each party to achieve a long-term goal of keeping the increase in global average temperature to less than 1.5 C above pre-industrial levels. Whether or not individual states are parties to the Paris agreement, NMAs have an obligation to consider the effects of climate change on the planet and on human, animal, and environmental sustainability and to take action as follows.
RECOMMENDATIONS
7. The World Medical Association and its Constituent Members:
· Urge national governments and non-state actors to recognize the serious health consequences of climate change and to adopt strategies to adapt to and mitigate its effects;
· Urge national governments to ensure the fulfilment of national commitments to international agreements, including both mitigation and adaptation measures as well as action on losses and damage;
· Urges national governments to provide climate financing that includes designated funds to support the strengthening of health systems, and health and climate co-benefit policies and, provide sufficient global, regional and local financing for climate mitigation, adaptation measures, disaster risk reduction, and the attainment of the Sustainable Development Goals (SDGs);
· Urge national governments to facilitate the active participation of health sector representatives in the creation and implementation of climate change preparedness plans and emergency planning and response on local, national and international levels;
· Urge national governments to provide for the health and wellbeing of people displaced by environmental causes including those becoming refugees due to the consequences of climate change;
· Asks national governments to invest in public health and climate change research to ensure of better understanding of adaptation needs and health co-benefits at national level;
· Urge national governments to facilitate collaboration between Ministry of Health and other ministries to ensure that health is considered in their national commitments and sustainable strategies.
8. National Medical Associations and their physician members should:
· Advocate for sustainable, environmentally responsible low-carbon practices across the health sector to reduce the environmental impact of health care facilities and practices;
· Prepare for the infrastructure disruptions that accompany health emergencies, in particular by planning in advance for the delivery of services and increased patient care demands during these crisis situations;
· Encourage and support advocacy for environmental protection and greenhouse gas emissions reductions including through emissions trading systems and/or carbon taxes;
· Become educated as to the health effects of climate change and be prepared to treat and manage them in individual patients;
· Promote medical research into improved use of antibiotherapy to be able to respond, in the future, to the new infectious diseases linked to climate change.
9. The WMA and its Constituent Members should:
· Encourage sustainable low-carbon living respectful of planetary limits including active lifestyle and sustainable production and consumption patterns;
· Seek to build professional and public awareness of the importance of the environment and climate change to personal, community and societal health;
· Work towards the integration of key climate change concepts and competencies in undergraduate, graduate and continuing medical education curricula;
· Collaborate with the WHO and other stakeholders as appropriate, to produce educational and advocacy materials on climate change for national medical associations, physicians, other health professionals, as well as the general public;
· Advocate for their respective governments to finance, promote research into the effects of climate change on health and collaborate with NGOs and other health professionals;
· Work collaboratively with government, NGOs, businesses, civil societies and others to create alert systems to ensure that health care systems and physicians are aware of climate-related events as they unfold, and receive timely accurate information regarding the management of emerging health events;
· Have climate change as a priority issue on their agendas and actively participate in the creation of policies and initiatives that mitigate the effects of climate change on health.
10. The WMA urges National Medical Associations to:
· Work with health-care institutions, and individual physicians to adopt climate policies and act as role models by reducing their carbon emissions;
· Recognize environmental factors as a key social determinants of health (SDH), and encourage governments to foster collaboration between the health and non-health sectors in addressing these determinants.
> See also the WMA statement on divestment from fossil fuels (2016)