On December 03, a momentous declaration was signed in Dubai at the 28th conference of parties of the United Nations Framework Convention or the COP28 as public health was added to the climate change talks for the first time. The declaration signed by 124 countries plans to reveal links between climate change and its impact on health.
The day witnessed a support fund of $1 billion for mitigation and implementation of programs emphasising upon transformation of health systems, notifying environmental determinants of health and protecting those at risk. The consensus aims to prepare healthcare systems to cope with climate change while acknowledging the government's role in protecting the health of its people.
In the Paris Agreement signed At COP21 in 2015, nations pledged to reduce their carbon footprint to limit the global temperature rise to 1.5 degrees Celsius compared with pre-industrial levels. According to a UN report, this mark was breached on 86 days in 2023 which the experts say is partly due to the global carbon footprint and partly due to the El Nino effect.
According to The Lancet’s Countdown Health and Climate Change report 2023, extreme weather events are becoming more frequent with transmission of fatal infectious diseases rising due to climate suitability for the vectors to breed. The life-threatening events are causing food and shelter insecurity in millions of people around the world, the report says. But the question is will combining health to climate make any difference in slowing down the destruction that climate change is causing?
A Welcome But Delayed Step
Climate change experts believe that the inclusion of health in climate change has been long overdue that was finally taken at COP28 as nations globally continue to witness increasing industrialisation, carbon emissions from fossil fuel usage and irresponsible practices by individuals and organisations.
“This a great welcome step but a delayed step - climate change has a direct impact on human health and with the inclusion of health at COP28, public health has gone from margins to mainstream. The global community has come together to understand the impact of climate change which will result in building adaptations to fight it,” says Abinash Mohanty, Sector Head, Climate Change and Sustainability, IPE Global.
Dr Vikram Vora, Medical Director, Indian Sub-Continent, International SOS states that having health included in the main climate action agenda has the potential to inform, educate and concert a global effort towards reducing the risks that such actions pose to human health.
“Whether this leads to a positive change in global emissions and related public health consequences will be dependent upon the commitment that nations exhibit in managing their carbon footprints and in helping other countries adopt,” Dr Vora adds.
The Prime Minister, Narendra Modi attended the COP28 and outlined the nation’s carbon emission targets by committing to reduce the emission intensity by 45 per cent by 2030. He also said that India will increase the share of non-fossil fuels to 50 per cent and will achieve the net zero target by 2030.
The Indian government, along with the US, did not sign the climate and health declaration in Dubai, despite both countries being among the top carbon contributors globally.
Climate policy experts say that the declaration will augment new aggressive steps towards cleaner energy and sustainable cooling from the members. But for India, the road is not that easy as access to clean, green and affordable energy is still a bigger challenge.
“Although we will double our solar capacity by 2030 and have improved our renewable energy bucket, we are still in the leapfrogging stage striving to be a five trillion economy and we cannot aggressively change everything as this will lead to a disbalance between creation of jobs and sustainability,” explains Mohanty.
Is Indian Healthcare Climate Ready?
Climate change is already displaying its wrath in India by way of extreme heat waves, rising air pollution and increasing infectious diseases. Experts say that climate change will also lead to job losses and a decrease in agricultural productivity.
“Due to extreme heat waves, India is going to lose 30 million jobs by 2030 and the country’s agricultural productivity will also come down by 10 per cent. Further, as people get exposed to prolonged heat it will result in different kinds of health ailments,” says Mohanty.
Industry voices further contend that there is a significant urban-rural healthcare resource gap in India demanding an urgent need to ensure healthcare availability for all. “Striking a balance between setting up this health infrastructure using climate-friendly methods while simultaneously ensuring healthcare access for all is a climate health resiliency challenge that India faces,” Dr Vohra explains.
Moving Towards Green Healthcare
According to a report by Health Care Without Harm (HCAH), the healthcare sector of India on the other hand is the seventh biggest emitter contributing 2 per cent of the global healthcare emissions.
While India is listed among the top 10 countries contributing to healthcare emissions, its per capita emissions are the lowest among the top 43 contributor countries, say industry elites.
Although they say that the differences in sustainability reporting standards being used by Indian healthcare providers make it difficult to estimate greenhouse gas emissions on comparable metrics. “Positive action is warranted and could begin with the adoption of uniform sustainable reporting to be able to accurately assess and then solve the problem,” Dr Vora points out.
On the other hand, experts also believe that there is a disparity in active reporting by the providers with the government mandating the requirement of Green Rating for Integrated Habitat Assessment (GRIHA 3) among public hospitals, while private hospitals have no such mandatory norms.
“Most private hospitals are not inclined to add green features as there is a lack of 'environment consciousness' and they find it to be a high capital cost which can be better spent for revenue-generating medical equipment," states Dr Vivek Desai, Founder & Managing Director, HOSMAC.
Dr Desai further says that to incentivise green technologies in private healthcare, the government must provide a reduction in electricity or property tax bills, and at the same time make it mandatory for all hospitals to have a GRIHA 3 rating.