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Climate action is ‘the greatest opportunity’ to redefine global health, per Lancet Countdown

30 November 2022

By Ian Evans

family in a beach with windmilss

“When you intervene on climate change, you have a co-benefit for people’s health,” says The Lancet EiC Richard Horton, summing up new Lancet Climate Countdown report

Is the climate crisis a threat to human health, or is it an opportunity? The latest Lancet Countdown on health and climate change reportopens in new tab/window from The Lancet calls climate action “the greatest opportunity to redefine the social and environmental determinants of health.”

On a topic that is often loaded with apocalyptic language and imagery, the positive message of the report stands out. But Richard Horton, Editor-in-Chief of The Lancet and Publisher of The Lancet Group, argued that when it comes to the intersection of climate and health, acting on the former has substantial benefits for the latter.

“When you intervene on climate change, you have a co-benefit for people’s health,” he said.

Richard pointed out that in the initial discussions around climate change, some commentators equated acting with taking a step backwards in terms of convenience and comfort:

Image of Richard Horton, FRCP, FMedSci

Richard Horton, FRCP, FMedSci

It was suggested that we would go from being a rich, developed country to somehow going back to medieval times, because we’ve previously relied on coal and electricity. That’s not the case — if we intervene on climate change, we will become a healthier society with healthier individuals. A more sustainable society will benefit our survival as well as our health. There’s no bad news here.

By way of example, Richard pointed to the EAT-Lancet Commission on Food, Planet, Healthopens in new tab/window, published by The Lancet in 2019, which asked the question, ‘Can we feed a future population of 10 billion people a healthy diet within planetary boundaries?’ He elaborated:

Look at the food we eat — by changing your diet to a more plant-based diet from a more meat-based diet, you can make a huge difference. If we all did that, it would reduce the incentives of the meat industry, a major source of greenhouse emissions. Fairly rapidly, you can make a big difference in the climate crisis, and health improves as well.

What is the Lancet Countdown on health and climate change?

Bringing together more than 50 collaborating organizations and nearly 100 experts, the latest Lancet Countdownopens in new tab/window report monitors the evolving health profile of climate change and provides an independent assessment of the delivery of commitments made by governments worldwide under the Paris Agreement.

Discover moreopens in new tab/window

Dr Marina Romanelloopens in new tab/window, a senior research fellow at the UCL Institute for Global Health and Executive Director of the Lancet Countdown on health and climate change, agreed:

It’s important that we’re clear that what we’re asking for is a transformation of our societies, economic systems, energy systems and health systems that will be for the better. Grasping the opportunity allows us also to find a way forward to deliver a healthier, more equitable future.

Image of Marina Romanello, Ph.D

Marina Romanello, PhD

Marina added that the argument that climate action means giving up comfort and well-being amounts to misinformation:

It’s clearly a strategy to retain our dependence on fossil fuels by scare-mongering — a claim that the alternative would be disastrous, it would mean going back in time and giving up on our high standards of living.

Instead, Marina reiterated the central argument of the Lancet Countdown: that acting on climate has substantial co-benefits for people’s health:

We have the technology to deliver a future in which we can live more healthy, better lives, and taking action on climate can create a much better future for us in the immediate term.

To illustrate the point, Marina drew from another example: reducing the use of fossil fuels:

If we increase access to clean, renewable energy, (we) can reduce all the negative impacts of depending on dirty fuels or the exposure to air pollution they generate. We could have much healthier air, even inside people’s homes.

The Lancet initiated the Climate Countdown to track the health dimensions of climate change, bringing together some of the most high-profile scientists in the world to address the issue. As with all Lancet Commissions, the 2022 report emphasizes action, covering topics from heat adaptation strategies with sustainable low-energy cooling, to strategies for accelerated decarbonization. Given the Countdown’s emphasis on opportunity rather than catastrophe, where do Maria and Richard see good instances of positive action?

Marina immediately suggested the National Health Service (NHS) in the UK:

The NHS is a great example. They have a very ambitious plan to reach full net zero by 2045 across not only their direct emissions but also their indirect and induced damage. That’s the most ambitious decarbonization plan in the health sector, for sure, and that has opened the way for other health systems to follow suit.

So we do see this cascading effect where one big institution acts and others follow. As it happens, the person leading that change is the former executive director of the Lancet Countdown, Dr Nick Wattsopens in new tab/window. That really does inject a lot of hope to the science and medical community that change is possible.

Richard, meanwhile, looked to the indicators in the Climate Countdown itself. He noted that when it started a decade ago, health wasn’t seen as an important component of the discussion on climate, but this has changed substantially:

Now when we measure through the Climate Countdown, we measure media coverage, scientific engagement, government attention. What you see is a massive scale up of interest in health as a dimension of climate action. People and decision-makers are realizing that there is this co-benefit when you intervene.

Of course, the global situation is far from rosy: many challenges remain, and new challenges are emerging. The recent COP27 conferenceopens in new tab/window demonstrated how difficult it can be to drive unified action. The energy crisis is causing many countries to lose focus on climate and instead retreat into familiar ways of guaranteeing energy supply. This is despite the fact that the energy crisis itself should be an argument for a transition to clean energy. As the UK MP Ed Milibandopens in new tab/window noted at COP, it is now cheaper to save the planet than to destroy it.

Marina commented:

There’s a risk that because fossil fuel prices have risen so much, they have become ever more profitable as an industry, and we’re seeing many countries taking investment in fossil fuels with the excuse of solving the energy crisis. The risk is that they will reverse their commitments to the Paris agreements rather than invest in a healthier future and long term decarbonization.

As Marina puts it, the energy crisis has exposed the dependency countries have on the fossil fuel giants — and the power that they wield as a result:

It’s become very obvious, the opportunity we’ve missed in terms of transitioning sooner to renewable energy, diversifying our energy grids and providing access to stable, renewable energies for people around the world, reducing energy poverty and its health impacts.

The energy crisis is also driving a rise in energy poverty, itself a health issue as people cannot afford to keep their homes at a healthy temperature, refrigerate food, or keep essential medicine at the correct temperature. But for Marina, the urgency of the situation still translates into the opportunity to improve on the status quo of the past decades:

It shows we need to rethink our energy systems. We’re at a new opportunity to increase our production of renewable energy and transition very fast to clean energy production.

The climate crisis has also been a major target for misinformation campaigns. As Marina and Richard both mentioned, pushing the myth that climate action means a drop in living standards is a way of keeping people dependent on fossil fuels. But the misinformation goes much further than that, including outright aggression for researchers.

Richard acknowledged that this was a difficult area but thinks it’s a struggle the scientific community can overcome:

The misinformation discussion is really hard, because as soon as you open social media there’s just this avalanche of it. But again, I think the Countdown can play a valuable role because we have this stake in the ground just before COP every year, and we can draw attention to progress or lack of progress. In that way, we’ve won over the media, the government, and other scientists to the importance of these issues. I think you have to play the long game, but by being persistent and tenacious you can win over the sceptics.

In the recent survey Confidence in research: researchers in the spotlightopens in new tab/window, conducted by Economist Impact with support by Elsevier, 51% of researchers surveyed say they feel a responsibility to engage in online/social media discussions. Marina noted that when it comes to climate, that responsibility can lead to people attacking researchers, even on a personal level:

Those attacks aren’t casual — it’s intentional intimidation of climate scientists. So while I recognize that it’s important for people to go out and speak their truths, it is sometimes very difficult for climate scientists to do that. I struggle to say that it’s a responsibility because it requires courage, which should not be the case, and can end in an orchestrated attack. 

Marina believes that scientists need to be helped and supported in communicating their research in the public domain: “I think the work The Lancet does provides a platform from one of the most respected medical journals in the world to help scientists talk about their findings in a way that is a bit more validated than if the were left on their own.”

Richard himself goes further, calling on publishers — including Elsevier — to ensure that researchers have the support they need:

We should see ourselves as a very activist component of society, collaborating with scientists to make sure the work that is published is put to good use. I think now and in the future, publishers like Elsevier have to be much more energetic and much more engaged in these big issues. We need to embrace them because they are existential threats to our society.

The Climate Countdown is one example of that, and as always with a Lancet Commission, the next question is, “Where does it go from here?” Richard already has the next steps in mind:

We presented this year’s Countdown at COP27, and we will continue every year to present our reports and continue to persuade governments to take climate action seriously. In addition, we have our journal The Lancet Planetary Healthopens in new tab/window, which exists not just to draw governments’ attention to these issues but the role they can play in solving them.

I think this is where publishers can make a big difference. We have 24 journals at The Lancet Group, and I want to make sure every one of them is thinking about their contribution to climate action in their particular discipline. What matters is that everyone is thinking about the environmental crisis and how it affects their specialty.


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Ian Evans

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