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With COP28 Approaching, Public and Private Officials Hold Roundtable to Discuss Impact of Climate Change on Human Health

By Kathryn Miles

On November 30, the United Nations Climate Change Conference, COP28, will bring the world together in Dubai, United Arab Emirates, for almost two weeks. For the first time, COP28 organizers—along with the World Health Organization (WHO), Wellcome Trust, and partners—will host the first-ever Health Day as part of that meeting. The day will recognize the significant effects of climate change on human health and the relationship of health to the broader climate crisis conversation.

To prepare for COP28 and this seminal day, Dr. Victor Dzau, President of the 911������ Academy of Medicine (NAM), and Dr. Judith Rodin, former President of the University of Pennsylvania and The Rockefeller Foundation and Chair of the NAM Grand Challenge on Climate Change, Human Health, and Equity, convened a roundtable discussion, “Countdown to COP28”, on behalf of the NAM Climate Grand Challenge on November 8. The event, held at the 911������ in Washington, D.C., brought together health leaders from public and private sectors to discuss how their organizations are approaching their work in the leadup to and attendance at COP28.

In his introductory remarks, Dzau pointed out the historic significance of their meeting. “Today is a chance to make a collective difference,” he noted. “As advocates of human health, we must ask ourselves: how do we want to shape the COP28 conversation?”

A Unique Opportunity to Shape a Global Discussion

The common theme throughout the roundtable discussion emphasized that the climate crisis is a public health and equity crisis—climate change is impacting our health today and these effects will continue to escalate. Most experts maintain that the crisis continues to increase in severity, intensifying catastrophic and widespread devastation across the world. The from the Intergovernmental Panel on Climate Change (IPCC) are clear. The IPCC report found: “It is unequivocal that climate change has already impacted humans and nature, pushing them beyond their abilities to adapt; and the impacts of climate change are not felt equally, with approximately 3.3 billion people living in ‘highly vulnerable’ contexts.”

Moving the dial to communicate the climate crisis as a public health and equity crisis is a priority in the run-up to COP28. Rodin moderated the discussion and steered conversations toward the development of an actionable proposal for COP28, as well as ways to sustain momentum beyond the summit, citing the urgency for sustained action. She noted, “I firmly believe that if we really do think about a few critical, action-shaping items that we would help accelerate the COP28 agenda and make a very significant difference.”

She offered attendees an encouraging and relevant case study that set an optimistic tone for the roundtable meeting by showing what they might accomplish at COP28.

“The Rockefeller Foundation funded a very large global initiative called 100 Resilient Cities. We worked with cities around the world to build their resilience capacities to be better prepared for shocks and stressors to respond more quickly and effectively when and if they occurred, and to be able to rebound more quickly and effectively. The Mayor of Paris led a meeting on cities and climate change that is very similar to the meeting we’re having with relation to health this year [at COP28]. What they were able to do that day was first put resilience building on the global agenda, and it is now discussed at every COP that has happened and [has driven] investments in it. And it was important because it was a bridge between the rhetoric around adaptation and the rhetoric around mitigation.”

“Secondly, cities committed to action on all six continents with old and new collaborations strengthened,” Rodin added. “And third, the World Bank committed to directly financing climate resilience projects for the first time at the city level, not just at the national level. Finally, the International Finance Corporation, with the participation of other groups at that meeting developed a resilience infrastructure screen through which they put all their financing going forward so that [all future infrastructure would be built] resiliently.”

The Crisis is Upon Us, But Hope Still Prevails

Admiral Rachel L. Levine, Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS), outlined key initiatives from the Biden Administration’s Office of Climate Change and Health Equity (OCCHE), which was established by executive order to inspire action across HHS on climate and health, advance policy, and galvanize others in the health sector to address climate change. She added that “threats of climate change aren’t just in the future, they’re here right now.”

Supporting the Biden Administration’s goal of reducing U.S. greenhouse gas emissions by 50% by 2030 and achieving net zero emissions by 2050, Admiral Levine said OCCHE is “small but mighty,” focusing on partnerships between the government and a variety of stakeholders. To date, the White House-HHS Health Sector Climate Pledge has brought together 116 organizations, including providers, suppliers, pharmaceutical companies, insurers, and others, to commit to achieving climate goals.

The Admiral also noted the landmark Inflation Reduction Act (IRA) through which tax credits, grants, technical assistance programs, and more make billions of dollars available that the health sector can leverage for clean energy and building efficiency projects. In addition, she shared that an HHS delegation at COP28 will share updates on the work of the Department and federal health systems and offer updates on international collaborations.

Jacquelyn Bombard, Chief Federal Relations Officer at Providence, provided an example of the impact of the IRA. Working together with OCCHE, Providence, which serves communities that have been marginalized, is now able to fortify their resilience to the health crisis posed by climate change. For example, the integrated insurance and hospital system can now proactively reach out to patients who might have COPD or asthma and offer breathing-assistance machines or other supportive devices under the patients’ health plan to optimize their health.

Dr. Bruce Gellin, Chief of Global Public Health Strategy for The Rockefeller Foundation, indicated that every aspect of his foundation, including health, energy, and food, is now focused on climate. The foundation’s tactics include consolidating fragmented resources and generating new financial resources for developing countries. Rockefeller’s role as a philanthropy-oriented institution gives them a unique opportunity to be a catalyst in generating new resources for climate change initiatives and making those resources more readily available.

Partnerships Prompt Progress

Industry can play a significant role in mitigating health-related emissions as well, making public-private partnership critical.

Following Gellin’s remarks, Pam Cheng, Executive Vice President of Global Operations and IT, and Chief Sustainability Officer at AstraZeneca, noted that, “each year globally, seven million people die from air pollution and five million from extreme temperatures,” a trend that will likely increase as the effects of climate change worsen. While the purpose of the health care industry is to keep people healthy, Cheng pointed out that the health sector itself emits almost 9% of the pollution that contributes to greenhouse gases in the United States. The NAM and AstraZeneca hosted a roundtable in June 2023 with leaders from health care, policy, academia, and sustainability to identify actions that could be taken to reduce health care sector emissions.

AstraZeneca’s progress in its Ambition Zero Carbon program is one such example. Cheng reported that the company has reduced its scope 1 (direct) and 2 (indirect) emissions by 59.3% since 2015 and is targeting 98% emissions reductions from scopes 1 and 2 by 2026. AstraZeneca also aims to halve its entire value chain footprint by 2030, on the way to science-based net zero by 2045 at the latest. As a part of Ambition Zero Carbon, the company has dedicated $400 million to planting and maintaining the health of 200 million trees worldwide through its AZ Forest initiative, a mission anticipated to create local economic co-benefits to support sustainable livelihoods.

Also, in partnership with Vanguard Renewables, AstraZeneca is developing ways to convert farm and food waste into renewable natural gas to make its cost competitive with fossil fuels. As part of AstraZeneca’s transition to renewable energy sources, Cheng also shared that the company’s Newark Campus in Delaware is already purchasing renewable natural gas produced by Vanguard Renewables. At COP28, the company is looking to raise awareness of the health and climate intersection, share learnings and best practices with other companies to accelerate progress in mitigating emissions, and inspire other private sector accelerate their climate action. She believes that “COP28 will be a milestone moment for climate and health.”

Cheng closed by noting that, after overseeing the manufacturing of 3.2 billion doses of COVID-19 vaccine, she knows first-hand when public and private partnerships come together, they can act fast and scale.

While individual stakeholders have an integral role in addressing climate change, there is a need to activate all parts of the health sector—from government and philanthropy to nonprofits and industry, which was further evidenced during the discussions at the roundtable.

Josh Glasser, Foreign Affairs Officer at the U.S. Department of State, shared his three guiding priorities for the COP28 agenda from his vantage point in the Bureau of Global Health Security and Diplomacy: minimize, weatherize, and catalyze. First, he noted that minimizing long supply chain emissions on a global level can be challenging, but incorporating new approaches and technologies to shorten supply chains is expected to have a significant impact. Second, he highlighted the importance of making health care delivery itself more resilient, as well as understanding how climate and health intersect so issues can be anticipated and better managed. Lastly, he stressed optimizing existing flows of financial aid resources for climate projects and health through educational outreach and partnerships.

Regarding funding, Rodin observed that the public supports health initiatives; she encouraged linking health and climate to facilitate conversations about funding climate initiatives.

When the Costs of Inaction Are Just Too Great

The costs associated with changing the way we do business are daunting, but Dr. Tamer Rabie, Lead Health Specialist in the World Bank’s Health, Nutrition and Population Global Practice, explained that the World Bank calculates that the cost of inaction is far greater. It sees climate solutions as investments and is actively identifying and prioritizing the solutions that have the highest return on investment. The best funding requests are those with the greatest potential to deliver outsized impacts.

Knowing the private sector can play a vital role in addressing climate problems, the World Bank is also actively pursuing partnerships with private companies—as is the pharmaceutical industry.

Michel Demaré, Chair of the Board of AstraZeneca, explained discussions held by the company with health care system stakeholders on this topic and how early diagnosis and treatment can also reduce outputs that contribute to climate change. He noted that public and private partnerships, such as the Partnership for Health System Sustainability and Resilience, are extremely important for financial resilience and health equity and that we cannot have a global solution without addressing these issues at the local level. “What we are trying to do here is look at health systems in a holistic way, so not only talking about climate change, but also [through the lenses of] financial resilience and health equity.” He presented the idea that initiatives should check all three of those boxes, using the example that early detection of disease or digital clinical trials, which save money, lead to better health outcomes and lessen the burden on the community to travel long distances to access that care.

Communicating the Right Message

From the communication perspective, Dr. Edward Maibach, Director of George Mason University’s Center for Climate Change Communication, emphasized the imperative to speak of climate change as a human health threat. According to Maibach, “health voices have a unique opportunity” because, regardless of political persuasions, people will listen. Dr. Maureen Lichtveld, Dean of the University of Pittsburgh’s School of Public Health, called out the need for climate and health literacy that engages people in culturally appropriate ways to build community resilience. She also observed that if a work force is sick from climate impacts, they cannot do the work of implementing climate solutions. “The health of the environment is inextricably linked to that of people. Climate change exacerbates environmental health threats”.

Cecilia DeLoach-Lynn, Sector Performance and Recognition Director of Practice Greenhealth—a source for resources and expert technical support on sustainability initiatives for the health industry—raised awareness of the challenges that health care executives face when considering sustainable initiatives. She advocates leading by example and identified several tactics to drive sustainability choices. One is to highlight tangible examples of success, such as showing where health care organizations have made sustainability changes that have lowered operating costs and improved operational efficiency and resiliency. She also stressed the importance of factoring in climate change when planning for future health care needs and allocations. Members of Practice Greenhealth will attend COP28 with the aim of maintaining the focus of discussions on mitigation of fossil fuels, not only adaptation, and to “keep connecting the dots between health and climate.”

Dr. Lynn Goldman, Dean of the Milken Institute School of Public Health and professor of environmental and occupational health at George Washington University, noted that “climate change exposes weakness in systems” and intensifies already existing health care problems. Effective initiatives should help strengthen systems to prepare for future amplifications that climate change will bring. She also suggested that, to expand their impact, the group at this meeting should identify solutions that can be translated to other sectors.

Bringing the Discussion to COP28

Insights, suggestions, and guidance gleaned from the NAM roundtable will help craft discussions and shape sessions that will be instrumental in focusing COP28 health sector conversations. An overarching imperative will be to consistently stress the intersection between health and climate change. It will be critical to fully explain these threats and inspire action by deploying credible statistics and metrics for success and showcasing already-demonstrated successful climate initiatives in the health care sector to inspire others. To support the financing of climate initiatives, the experts advocated for streamlined funding applications and prioritizing initiatives most likely to have an impact. Lastly, the attendees agreed that partnerships are key to achieving climate goals, especially those tailored to local communities.

In his closing remarks, Dzau reminded the participants, “It’s about human rights, human suffering, and that’s what matters, and that in fact is a message we need to get out.” He added: “When I look at the group here, we have government, industry, foundations, health care systems, academia, and everybody together to a large extent. Why are we doing this? Because we all care about this issue, right? And the only way to make a difference is if we all work together.”

COP28 takes place November 30 until December 12, 2023, in the United Arab Emirates.