Better Health For All

Mosquitoes winging their way north across Europe bringing dengue. Floods and drownings. Heat stress. Despair. We are all aware of the health impacts of climate change. But how do we get governments to act? Ballot box pressure (in democracies) does not guarantee results as shorter-term concerns distract from our overheating planet. No easy answers, but experience from the environmental movement provides clues and inspiration.

On 7 October the Faculty of Public Health co-hosted a webinar on Public Health, Climate Change and Strategic Litigation (recording now available online). It aimed to alert public health academics and practitioners to the opportunities for legal action to hold governments and private sector polluters to account for health-harming pollution and climate change.

Moderated by Dr Farhang Tahzib, the webinar attracted over 800 registrations from around the globe. Starting close to home, Rosamund Adoo-Kissi-Debrah recounted how air pollution in London led to the death of her daughter, Ella. Sir Stephen Holgate gave expert testimony at the coronial enquiry into Ella’s death. He noted how air pollution is now largely invisible and hence neglected – yet ‘breathing clean air is a right, just as we have the right to clean water.’ Dr Maria Neira, WHO’s climate change and health champion, presented the ‘health argument for climate action’ that WHO will take to CoP26.

But governments have long been aware of the short- and long-term health impacts of pollution. What else can be done? Strategic alliances between public health actors, environmental activists and legal academics and practitioners are using court action to highlight government inaction and industry abuses. Marlies Hesselman, lecturer at the University of Groningen, Netherlands, gave a ten-minute ‘strategic litigation 101’, noting four recent and current cases where governments have been called to answer before international courts and tribunals for health harms related to climate change. Irmina Kotiuk, senior lawyer with ClientEarth’s Clean Air Program, noted the huge role for public health specialists as experts in strategic litigation – building on the experience of tobacco and asbestos. She urged nurses and doctors to collect and record evidence in medical files which can later be used in expert testimony.

Richard Harvey, barrister and legal counsel for Greenpeace, drew parallels between tobacco companies’ now infamous denials of the link between smoking and ill-health, and today’s spin from fossil fuel companies. The Dutch District Court in The Hague was not fooled – in a landmark 2021 decision it ordered Shell to reduce CO₂ emissions by 45% by 2030, globally. Dr Marina Romanello, Research Director for Lancet Countdown, reiterated the health impacts of climate change and the continuing financing of the destruction of our health through fossil fuel industry subsidies.

Yet the Lancet Countdown 2021 report on health and climate change: code red for a healthy future, makes no reference to the role of the law (other than to the International Health Regulations), let alone to the hundreds of current and recent legal cases on climate change alone, easily searchable through online databases. Restating the problem in ever greater detail is not a strategy for change. We need to combine the credibility of hard science with the legal skills of seasoned national and international litigators and the experience in social mobilization tested and proven by other social movements – all adapted to today’s online, COVID-19 constrained world. Dr Neira remarked that ‘People working in the environment say we need to hear more from the public health community – because you are still trusted – politicians will listen to you.’

Bridges between the public health, environmental and legal communities must be strengthened if we are to ‘keep 1.5 alive.’ The 7 October webinar was co-hosted by the Global Health Law Groningen Research Centre and the ‘law and public health’, ‘environment and health’ and ‘ethics and public health’ sections of the European Public Health Association. Section membership is free and not limited to public health practitioners or people resident in Europe.

David Patterson LLM. MSc.
PhD. Candidate
Global Health Law Groningen Research Centre
Netherlands

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Today (Sunday) is a day of rest at COP 26.  That is, in the formal Presidential Programme, but there are still plenty of ‘side’ events happening.

I have had a few interesting days at COP 26 so far. It is VERY busy with many parallel sessions and activities going on, both inside the main blue zone and in the green zone and at satellite meetings. It is quite hard (maybe impossible!) to follow the president’s programme and the negotiations as the ‘agenda’ for each day only appears late the night before, so it is difficult to plan. Also many of the ‘negotiation sessions’ are not really negotiations, but are a series of announcements about various initiatives and commitments that countries (and / or organisations) have signed up to, but the real question is whether they will deliver on them, as there is often only a headline and no tangible substance about delivery given.

There has been a calculation made that if ALL the pledges made so far are enacted then the figure reached would be 1.9 degrees Celsius, which is better than the calculated 2.7 for which we were previously on track  BUT still does not reach 1.5 degrees, AND there are certainly doubts that all the promised actions will be fulfilled. Previous promises have not been fulfilled.

At the Paris COP there was agreement that $100bn would be transferred, by 2020, from global north to those countries who needed to address climate change most (i.e. LMICs in global south) but that promise has not been fulfilled, although there is now a commitment to do so by 2023. (We shall see!) 

I was going to outline some highlights for me from the past few days, but I was just distracted listening (on you tube) to the first session of the People’s Health Hearing. It was amazing. Stories and testimonies from people who have suffered directly the impact of climate change. A testimony from the Philippines about the massive floods a year ago (November 2020), stories of having to sit on their roof until the water went down, of raw sewage and water pouring into their houses and trying to clear it up, of rashes and scars from contact dermatitis, of the mental health impacts of having to move house 4 times in the last year and most particularly of the inequalities (as we in Public Health would call it)  – of the peoples who have contributed least to global emissions being the most affected. Calling for ‘climate Justice’.

 And another story of how it was the removal of massive areas of trees, by extraction industry (mining etc. for natural resources including gold and fossil fuel), that caused the area to flood, and how the indigenous people, losing their homes and communities, livelihoods and lives, are now being gagged by their (and global north) governments who are still supporting the industries.

And yet another concerning mining, in an indigenous region – West Papua (west part of Papua New Guinea) about the devastation and pollution ruining their water supply and crops and an anthropologist from the community who was murdered, (together with 130 others from the community) – and how the family had to flee to the Netherlands – and that the anthropologist was the storyteller’s father. No wonder he is now an indigenous activist. But how does this link to Climate change, well through the need to protect forests and the staggering statistic that indigenous people populate 5% of the world’s land but their forests are responsible for nearly 90% of biodiversity. They have maintained that for 1000’s of years, living in harmony with nature, unlike western societies. We must learn from them and protect indigenous people and their lands, if we want to avert the climate crisis.

Very powerful stories, I do not do them justice here. And what I learn from this is that we must use stories and storytelling and we, as PH professionals, should learn more about storytelling, find the people who are directly affected and listen and learn from their experiences and utilise their experiences to influence policy makers and the climate and health agenda

Professor Sue Atkinson CBE
Chair, FPH Climate and Health Committee

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So here I am on the train to Glasgow, on my way to COP 26, which started earlier this week and ends on 12^th November 2021.

I am excited to be one of the FPH group with ‘observer’ status, so able to attend the main conference where negotiations take place, though I suspect many actually take place in whatever is the 2021 equivalent of ‘smoke filled rooms’! Or in fact have already taken place prior to coming to Glasgow.

 By the way COP stands for Conference of the Parties of the UKFCCC, which is the international mechanism to address climate change across 197 countries.

The first two days of COP is when the world leaders attend and many of them have made declarations as to what action their countries will take to address climate change and cut emissions, in order to reach no more than 1.5 degrees, as agreed at the Paris COP in 2015. Unfortunately the plans (NDCs) currently in place will still not go far enough or fast enough, so hence the urgently at this COP to get countries to sign up to increased targets and faster action. The science has shown that action is NOW really urgent.

The following days of the Presidents Programme are devoted to specific topics, so yesterday was on finance and today is on energy. You will have seen in the news various reports from yesterday with announcements about the financial sector agreeing to take action on fossil fuel investment, though clarity is needed on exactly what it means in practice. There were also announcements about engagement of the private sector to help finance climate action I think to the tune of $ trillions,

For the first time there is a ‘health pavilion’ at this COP and very many of the international health community are attending (including ourselves from FPH) to make the case for health being part of the agenda and that there are already major impacts on health, both direct and indirect, due to climate change. But also to demonstrate that health can be part of the solution; both health systems – the greener NHS is a strong example – and we anticipate a number of other countries may announce similar initiatives during COP. But also climate action can also improve health- for example active travel, with increased cycling and walking, reduces emissions, reduces air pollution (improving health) and improves physical activity, which improves people’s health.

Similarly more plant based, sustainable food is better for people and better for the planet.

But we are also here to remind everyone that there is a climate justice / health equity issue, both across the UK and globally. The most vulnerable are likely to be hit hardest by climate change – poor housing is least resilient to higher temperatures or flooding and internationally global south has contributed least to the current emissions but are already feeling the impact of climate change with increased extreme weather and its sever impacts.

So what do I expect to do at COP?

• Hopefully contribute to that health voice, both informally and collectively in speaking to country delegates. Or really just anyone who might listen

• Certainly listen and learn both from other countries and from other sectors such as energy and transport. We, in public health, need to hear where they are coming from and what language they use and see how our agenda on health and inequalities etc. can fit in and contribute to what they want to achieve. That way we can work together for a win win.

• Feel the buzz of collaborating with the international health community working together to address climate change and all its health ramifications

That will do for now.  

Sue Atkinson

4.11.21 at COP 26 in Glasgow

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