Call to Action of the Global Climate and Health Forum
San Francisco, CA
September 12, 2018
Climate change is a global health emergency. It is impacting the health of our communities today. A growing number of health organizations around the world are taking climate action – from working on the front lines to take care of communities impacted by climate-related threats, to responding to health emergencies, to taking ambitious steps towards reducing the carbon footprint of our health systems. We must do more.
As the world faces unprecedented heat, droughts, fires, and storms, this is a crucial moment for global leaders to ratchet-up their commitments to climate action. To achieve the ambition of both the Sustainable Development Goals and the Paris Agreement, the global community must accelerate action to protect our health and that of future generations. We call on our health sector colleagues, and on leaders in all sectors and at all levels of government, to act now to support healthy people, in healthy places, on a healthy planet.
Climate Change threatens to undo decades of health and development gains and is the “greatest public health challenge of the 21st century”.  Extreme heat and weather events caused thousands of deaths and displaced over 200 million people between 2008 and 2015; air pollution, whose primary driver–fossil fuel combustion– is also the primary driver of climate change, caused over 7 million deaths in 2016; vector-borne diseases are spreading to new communities; the agricultural, food, and water systems we depend on for our survival are under threat; and the frequency and severity of droughts, floods, and fires are increasing.   
Action to reduce climate change can dramatically improve health. Many policies that move us towards our climate goals have demonstrable and significant health benefits. Climate action in the energy, transportation, land use, agricultural, and other sectors has the potential to avoid millions of preventable deaths each year. Shifting to renewable energy, sustainable food production and diets, active transportation, and green cities will lower climate pollution while simultaneously reducing the incidence of communicable and non-communicable disease, improving mental health, and bringing significant health care cost savings.
Climate action offers a path to sustainable and healthy development for all. All countries have a shared but widely varying responsibility in their role in causing climate change, and differing capabilities to address its impacts. To meet their development and health goals, many low and middle-income countries must invest in a significant expansion of energy generation capacity while adapting to a changing climate. Wealthy countries and those historically responsible for the most carbon emissions must take the lead in reducing their emissions and supporting both the clean energy transition and global adaptation initiatives. Prioritizing health in climate and energy policy can help ensure sustainable development and greater global equity.
By mobilizing climate action for health and health action for climate, health professionals and health organizations can become leaders in achieving emissions reduction goals and building healthy communities that are resilient in the face of climate risks. We must also proactively protect the most vulnerable among us – children and women, the poor, marginalized people of all races and ethnicities, the aged and people with disabilities and chronic illness.
As leading health professionals and organizations from around the world, we call on local, national, and global policymakers to act now to significantly reduce climate pollution and build climate resilience. We also call on people of all nations to engage their governments and demand a robust response. With the right policies and investments today, we have the opportunity to realize our vision of healthy people in healthy places on a healthy planet. The ten priority actions outlined below are urgent and essential steps to protect health and advance human well-being in the era of climate change.
CLIMATE ACTION FOR HEALTH
Making health integral to climate policymaking at all levels and across all sectors offers a major opportunity to strengthen support for climate action, advance climate solutions, and achieve ambitious health targets through win-win strategies that promote climate justice and health equity.
(1) Meet and strengthen the commitments under the Paris Agreement. A large and rapid reduction in carbon emissions is essential for our health and the health of future generations. All nations must meet and exceed their commitments under the Paris Agreement and strengthen these commitments in coming climate negotiations. Subnational governments, business, and civil society must actively contribute to and support aggressive emissions reductions, which must be sufficient to achieve a target of 1.5° above pre-industrial levels.
(2) Transition away from the use of coal, oil and natural gas to clean, safe, and renewable energy. With the technology available today, we can dramatically change our energy use and systems to meet growing energy needs affordably, while reducing climate and air pollution. Key policies include:
- Set ambitious goals for renewable energy, energy efficiency, and energy conservation in electricity production, energy systems and buildings. Establish mechanisms to track and enforce progress towards these targets.
- Phase-out investments in and subsidies for fossil fuels for energy generation. Transition financing to the technologies and infrastructure needed for development, adoption, and scale-up of renewable energy sources and investments in energy efficiency.
- Ensure that climate policies support energy access and sustainable energy for all by promoting distributed renewable energy technologies in energy-poor communities while enabling countries to meet energy needs for development.
- Maximize health benefits by reducing conventional air pollutants alongside reductions in carbon emissions, ensuring climate justice and improving health equity.
(3) Transition to zero-carbon transportation systems with an emphasis on active transportation. By moving our transportation systems from fossil-fuel centered models to ones based on renewable energy and human health, we can significantly reduce air pollution and carbon emissions. Shifting from driving to active modes of travel – walking, bicycling, and public transit – can substantially reduce rates of non-communicable diseases and injuries. Key policies include:
- Increase investments in infrastructure and programs to promote safe walking and bicycling.
- Increase investments in affordable, accessible and convenient public transit infrastructure, maintenance, and operations.
- Set ambitious targets and create incentives to increase fuel efficiency and ultimately replace gasoline and diesel vehicles with electric vehicles powered by renewable energy sources.
(4) Build local, healthy, and sustainable food and agricultural systems. By changing what we eat, and how we grow, harvest and transport our food, we can protect our health and significantly reduce our carbon footprint. Practices that conserve and regenerate our soil, conserve our water, and sustain our fisheries are essential to safeguard our food supply in the face of climate impacts. Building resilient local food systems can support the livelihoods of agricultural communities, expand access to healthy food, and reduce carbon emissions. Key policies include:
- Reduce meat consumption and production, and expand plant-based diets.
- Reduce food waste.
- End deforestation for the expansion of industrial agriculture.
- Promote legal, trade, and financing policies that prioritize and enable sustainable agro-ecological practices and reduce reliance on industrial animal-based agriculture and environmentally damaging agricultural and fisheries practices.
(5) Invest in policies that support a just transition for workers and communities adversely impacted by the move to a low-carbon economy. Sustainable and equitable climate solutions must focus on providing economic and energy security for all, including fair employment and economic opportunities for workers and communities that rely on fossil fuel industries. Investing in a low-carbon economy and marginalized communities can move us away from unhealthy energy systems and build shared prosperity.   Key policies include:
- Address the health impacts of resource extraction on vulnerable populations including rural, remote, and indigenous communities.
- Engage affected workers and communities in climate and energy policymaking.
- Build social protection through investment in green jobs and programs that support worker and community transition to good jobs in a green economy, particularly in communities affected by climate mitigation policies.
(6) Ensure that gender equality is central to climate action. Women are particularly affected by poverty, are more vulnerable to climate impacts, and have less access to the political, economic, and social resources that enable them to cope with climate threats.   Climate policies must respond accordingly. Key policies include:
- Engage women proactively in the design and implementation of climate solutions.
- Build considerations of gender, gender inequality, and gender vulnerability, into all climate and health policymaking.
- Ensure women and girls have access to financial, educational and other resources for climate adaptation and resilience.
HEALTH ACTION FOR CLIMATE
Health professionals and health organizations must play a leading role in tackling climate change. We pledge – and we call on our health colleagues to commit – to urgently and aggressively reduce greenhouse gas emissions in health facilities; to build resilience through the integration of climate considerations in health systems, policies, programs, and investments; and to proactively communicate the health threats of climate change together with the health benefits of climate action.
(7) Raise the health sector voice in the call for climate action. Successfully addressing climate change will require that the health sector proactively engages in strong and sustained advocacy and communications with policymakers and the public. Key policies include:
- Raise awareness about the health impacts of climate change and the health benefits of climate action through local and national education campaigns.
- Speak out on climate change and health, and advocate for healthy climate solutions with subnational and national policymakers.
- Ensure health professionals have the knowledge and training to communicate effectively to patients and policymakers alike about climate change and health by integrating climate change into all public and environmental health and medical training and certification curricula.
(8) Incorporate climate solutions into all health care and public health systems. Hospitals, health care systems and health organizations can lead by example by implementing climate-smart health care, reducing their carbon footprint, building facility resilience and leveraging their economic power to decarbonize the supply chain and promote equitable local economic development. Key policies include:
- Reduce health care systems’ emissions in alignment with the Paris Agreement.
- Develop low-carbon care pathways and models of care, including community-based interventions that address social determinants of health, thereby reducing the need for more environmentally impactful acute and clinical care.
- Implement energy efficiency, deploy renewable energy, and implement sustainable water, transportation, food, anesthetic gas, and waste management practices.
- Build low-carbon healthcare product manufacturing facilities, supply chains, and procurement systems, while also sourcing products from and investing in local environmentally sustainable economic initiatives that support community health.
- Invest in healthcare facilities’ resilience to extreme weather, with their construction and siting following best practices in sustainability.
(9) Build resilient communities in the face of climate change. Climate change is a global phenomenon, but it is people and communities at the local level that experience its consequences. Climate and health action will be most effective when those most impacted have the voice, power, and capacity to be full partners in building a healthy, equitable, and climate resilient future. Health professionals, systems and organizations must support communities to prepare for, respond to, and be resilient in the face of climate change. Key policies include:
- Invest in strong and equitable health systems as an essential step to reducing the health impacts of climate change.
- Assess and monitor the health impacts of climate change and climate vulnerability and the health benefits of climate action at the community level.
- Promote social cohesion and build the capacity of frontline health and community organizations to respond to climate threats, maintain operations during climate emergencies and bounce forward after climate disasters.
- Fund and implement national, state and local climate-health risk assessments, expanded disease surveillance systems, research and early warning systems that enable an effective response to climate threats. Make all data publicly available.
- Emphasize nature-based solutions and restoration of ecosystem services that support community health and resilience.
- Integrate climate, health, and equity considerations into land use planning and infrastructure standards to ensure climate resilience.
FINANCING CLIMATE ACTION FOR HEALTH AND HEALTH ACTION FOR CLIMATE
Turning these recommendations into reality and achieving global goals for health, climate, and sustainable development will require greater financial investment. Current investments in climate solutions fall far short of what is needed to protect health, and current investments in health do too little to take climate considerations into account.
(10) Invest in climate and health. Development agencies, multilateral organizations, governments, civil society, and business must expand their investments in healthy and equitable climate solutions, climate-smart health systems, community adaptation and resilience, and climate-health research.
Together, these ten policy recommendations provide a roadmap that governments and communities worldwide can use as they develop comprehensive and coordinated strategies for tackling climate change and health.
As physicians, nurses, hospital and healthcare system representatives, public and environmental health officials, and other health professionals and health care workers, we have dedicated our lives to improving the health of our communities. We believe that all people, including future generations, have the right to the environmental, economic and social resources needed to live healthy and productive lives. As we step up to the challenge of building a health sector free from climate pollution and supportive of resilient communities, so we also call on leaders in all sectors and at all levels of government to act now to reverse climate change and support healthy people on a healthy planet.