Climate change has wide implications for our ecosystems, economies and societies. Yet, key aspects to halt and reverse climate change are only targeted separately, in restricted political domains. The (global) health domain may be one of them. Andrew Harmer recently posted a thought-provoking blog about a possible solution and puts it as the question: ‘Should the WHO declare climate change a Public Health Emergency of International Concern?’ My short answer is: no.
While the World Health Organisation (WHO) convenes the ministers of health, from the perspective of political economy one can wonder whether the World Health Assembly is the right place with the right political power for change. At the same time I applaud that WHO has taken up ‘health, environment and climate change’ as a main topic of concern and wants to show leadership.
I think that the World Health Assembly (WHA) could be an arena where ministers of health and other members of the delegations exchange information and share tactics to include the public health costs into ‘economic costs calculations’ of policy measures to halt and reverse climate change. Because, I agree with WHO, this is currently a major flaw. WHO could do more, but I doubt Andrew Harmer’s call to action provides a solution to that part.
Dutch example – missing link between climate change policies, economics and public health
In the Netherlands policy measures regarding mitigating against and adapting to climate change are debated with the House of Representatives and decisions are made within the domain of the Ministry of Economic Affairs and Climate Policy. Political debates about (public) health take place within the domain of the Ministry of Health, Welfare and Sports.
When I search for ‘climate’ or ‘climate change’ within the debates of the standing committee on Health, Welfare and Sport I end up with 43 references. None of them refer to the climate change that we are concerned about impacting our health and well-being (but ‘climate’ meaning ‘ambience’). But when I do a quick scan within the reports of the standing committee on Economic Affairs and Climate Policy for references to ‘health’ or ‘public health’ I can’t find any reference to the link between climate change and (public) health, either.
However, I recall the statement of the Dutch delegation last year at WHA71 on the topic of ‘Health, environment and climate change’. The delegation’s youth representative provided a strong statement on the health consequences of climate change for especially the young people (‘accumulation of effects through time’).
So, the recently proposed Dutch Climate Agreement under the auspices of the Ministry of Economic Affairs and Climate Policy would have been an excellent opportunity to calculate for instance the benefits in terms of reduced air pollution and associated health gains from strategies to mitigate the effects of greenhouse gas emissions. But: Health in All Policies is dismissed by politicians concerned with economics in this Dutch case, too (in line with Colin David Butler’s observation in his comment to Andrew Harmer’s blog).
Something’s got to change.But I don’t think that WHO declaring climate change a Public Health Emergency of International Concern would do the trick.
Public health emergency measures are usually taken on a temporary basis. But putting measures in place to halt and reverse climate change requires a longer-term perspective. Also, public health measures are typically placed within the health (and security) domain, whereas we need measures that crosscut sectors – and especially involve the economic sector.
WHO well describes the current ‘failure to reflect costs of all consequences of policies, technologies and products in pricing structures’ because it ‘will merely continue to transfer costs to the health sector and to citizens.’ WHO also points out root causes of disease being policies or activities directly leading to increased environmental risks to health. And it provides apt examples such as ‘choices in energy generation, agricultural practices, industrial production or business and land use planning leading to increased emissions, harmful exposures or greater vulnerability, fostering unhealthy behaviours, or accelerating climate change.’
I would like to see WHO as a great role model for stakeholders, health authorities and communities at national and local level and show us how it addresses with its knowledge these root causes of disease in the (macro-)economic domain. Perhaps we can learn from the Wellbeing Economy Alliance and get WHO, its members and observers, involved in changes ‘reoriented to what an economy should actually deliver: an equitable distribution of wealth, health and wellbeing, while protecting the planet’s resources for future generations and other species.’