The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels

Abstract

With the worsening health impacts of climate change compounding other coexisting crises, populations worldwide increasingly rely on health systems as their first line of defence. However, just as the need for healthcare rises, health systems worldwide are debilitated by the effects of the COVID-19 pandemic and the energy and cost-of-living crises. Urgent action is therefore needed to strengthen health-system resilience and to prevent a rapidly escalating loss of lives and to prevent suffering in a changing climate. However, only 48 (51%) of 95 countries reported having assessed their climate change adaptation needs (indicator 2.1.1) and, even after the profound impacts of COVID-19, only 60 (63%) countries reported a high to very high implementation status for health emergency management in 2021 (indicator 2.2.4). The scarcity of proactive adaptation is shown in the response to extreme heat. Despite the local cooling and overall health benefits of urban greenspaces, only 277 (27%) of 1038 global urban centres were at least moderately green in 2021 (indicator 2.2.3), and the number of households with air conditioning increased by 66% from 2000 to 2020, a maladaptive response that worsens the energy crisis and further increases urban heat, air pollution, and greenhouse gas emissions. As converging crises further threaten the world’s life-supporting systems, rapid, decisive, and coherent intersectoral action is essential to protect human health from the hazards of the rapidly changing climate. Despite decades of insufficient action, emerging, albeit few, signs of change provide some hope that a health-centred response might be starting to emerge. Individual engagement with the health dimensions of climate change, essential to drive and enable an accelerated response, increased from 2020 to 2021 (indicator 5.2), and coverage of health and climate change in the media reached a new record high in 2021, with a 27% increase from 2020 (indicator 5.1). This engagement is also reflected by country leaders, with a record 60% of 194 countries focusing their attention on the links between climate change and health in the 2021 UN General Debate, and with 86% of national updated or new NDCs making references to health (indicator 5.4). At the city level, local authorities are progressively identifying risks of climate change on the health of their populations (indicator 2.1.3), a first step to delivering a tailored response that strengthens local health systems. Although the health sector is responsible for 5·2% of all global emissions (indicator 3.6), it has shown impressive climate leadership, and 60 countries had committed to transitioning to climate-resilient and/or low-carbon or net-zero carbon health systems as part of the COP26 Health Programme, as of July, 2022. Signs of change are also emerging in the energy sector. Although total clean energy generation remains grossly insufficient, record high levels were reached in 2020 (indicator 3.1). Zero-carbon sources accounted for 80% of investment in electricity generation in 2021 (indicator 4.2.1), and renewable energies have reached cost parity with fossil fuel energies. As some of the highest emitting countries attempt to cut their dependence on oil and gas in response to the war in Ukraine and soaring energy prices, many are focusing on increasing renewable energy generation, raising hopes for a health-centred response. However, increased awareness and commitments should be urgently translated into action for hope to turn into reality.

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Affiliated Institutions

• Harvard University US
• The University of Melbourne AU
• London School of Hygiene & Tropical Medicine GB
• Umeå University SE
• Yale University US
• University College London GB
• National University of Singapore SG
• Virginia Tech US
• Systemic Risk Centre GB
• Energy Institute GB
• Cooperative Institute for Research in Environmental Sciences US
• University of Reading GB
• Universitat Politècnica de Catalunya ES
• University of Copenhagen DK
• Centre for Mental Health GB
• Technical University of Munich DE
• Mercator Research Institute on Global Commons and Climate Change DE
• Finnish Meteorological Institute FI
• Columbia University US
• Technical University of Denmark DK
• Nelson Marlborough Institute of Technology NZ
• Tsinghua University CN
• Barcelona Supercomputing Center ES
• The University of Sydney AU
• University of Sussex GB
• Universitat de Barcelona ES
• University of Greenwich GB
• London School of Economics and Political Science GB
• University of Cambridge GB
• University of Geneva CH
• Universidad Peruana Cayetano Heredia PE
• Emory University US
• Iran University of Medical Sciences IR
• Northeastern University US
• University of Oxford GB
• University of Colorado Boulder US
• University of London GB
• CMCC Foundation - Euro-Mediterranean Center on Climate Change IT
• International Institute for Applied Systems Analysis AT
• Tampere University FI
• Universiti Malaysia Terengganu MY
• Centre for Sustainable Energy GB
• Agricultural Biotechnology Research Institute of Iran IR
• University of York GB
• University of Hong Kong HK
• Institució Catalana de Recerca i Estudis Avançats ES
• Universidade de Santiago de Compostela ES
• University of Birmingham GB
• MRC Epidemiology Unit GB
• University of Leeds GB
• MRC Unit the Gambia GM
• University of Washington US
• Natural Resources Institute GB
• World Health Organization CH
• Heidelberg University DE
• Center for Environmental Health US
• Hertie School DE
• Max Planck Institute for Human Development DE

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