Negotiating to Protect Health and Lives

Climate change is poised to undermine decades of progress in global health1 and development, and exacerbates inequities. Ambitious climate decision making in all areas of UNFCCC negotiations is therefore vital to protect and promote human physical and mental health, as well as to prevent biodiversity loss as a core component of the planetary crisis, and to foster thriving societies and productive economies. At the same time, health is a unifying shared goal of decisionmakers around the world, and can drive ambitious outcomes at COP30 and beyond. Embedding health across UNFCCC negotiations serves both people and the planet, and is aligned with the COP30 Presidency’s call to connectthe climate regime to real people’s lives2.

The IPCC and the Lancet Countdown on Health and Climate Change3,4 find that climate change drives injury, disease and deaths from hazards such as heatwaves, wildfires, floods, droughts, storms, displacement, infectious disease transmission including pandemics, food and water insecurity, non-communicable diseases (NCDs), mental health impacts, and threats to maternal-child health and sexual and reproductive health and rights (SRHR). These impacts are compounded by ecosystem degradation leading to massive biodiversity loss and rising antimicrobial resistance, which further impacts human wellbeing. Costs are mounting, with labour capacity reduction due to heat exposure leading to US $1.09 trillion in global potential income losses in 2024, and the monetised value of air pollution-related mortality reaching US $4.84 trillion in 2023 - equivalent to 4.7% of global GDP4. Health systems are challenged to deliver universal health coverage even at current levels of warming, with the majority of countries (108/194) experiencing worsening or no significant improvement in service coverage since the launch of the Sustainable Development Goals (SDGs) in 20155. The cost of adaptation in the health sector alone is estimated to reach US $11.1 billion per year in 2030 for developing countries6, with finance from developed countries being vital for implementation. These costs will continue to rise without accelerated emissions reductions, with highest emitters taking responsibility to act most rapidly. Without investment in climate action, by 2050, the costs of climate-related health impacts could far exceed these levels, surpassing US $20.8 trillion in low- and middle-income countries (LMICs) alone7.

Climate change disproportionately affects the health of populations who are made vulnerable by factors relating to their geographic location or social determinants, undermining human rights. While impacts are felt in all world regions, people in the Global South, especially small  islands and climate-frontline States and communities, bear the brunt of health impacts. Women, children, Indigenous Peoples, BIPoC communities, people living with disabilities and health conditions, older people, low-income communities, migrants, displaced persons, the LGBTQIA+ community, other marginalized groups, and any intersection of these, are most impacted. Climate inaction exacerbates existing inequities. The realisation of climate justice requires the experience, knowledge, priorities, and realities held and faced by these communities to be reflected in UNFCCC decision-making. COP30 must recognise that community partnership is a cornerstone of sustainable climate and health action, ensuring that climate action is grounded in local realities, protects human rights, and fosters community stewardship to support implementation that is locally relevant, culturally appropriate, cost-effective, and scalable.

Health is embedded in articles 1.1 and 4.1.f of the UNFCCC and the preamble and article 108 of the Paris Agreement8,9. It has gained increasing traction, including through the adoption of the COP26 Health Commitments10 (the foundation for the Alliance for Transformative Action on Climate and Health, now comprising 100 countries), the first ever Health Day at COP28 and accompanying Ministerial and Declaration on Climate and Health, the Baku COP Presidencies Continuity Coalition, and the Belém Health Action Plan11,12. Health impacts, healthcare sector planning, and health-promoting actions across sectors feature widely in NDCs 3.0 submitted to date, but alignment of NDC emissions reduction targets to 1.5°C and finance for implementation will be critical for health-protecting actions. To translate this growing momentum into life-saving action, the potential of climate action to protect and improve health must now be holistically addressed in, and streamlined throughout, UNFCCC negotiations. In July 2025, the International Court of Justice, building on developments from other international courts and tribunals, issued an Advisory Opinion (ICJAO) which referred to the interdependence of the human right to a clean, healthy and sustainable environment with other rights, noting that “in so far as States […] are required to guarantee the effective enjoyment of such rights, it is difficult to see how these obligations can be fulfilled without […] ensuring the protection of the right to a clean, healthy and sustainable environment”13,14,15.

Ambitious and inclusive climate action can reduce health impacts, by preventing acceleration of health hazards and reducing vulnerabilities. Additional physical and mental health gains of climate action across sectors include clean air, nutrition security, safe water, increased physical activity, protective living environments, decent jobs, energy security, ecosystem services and social protection, with associated returns on investment16,17,18,19. A One Health and wider planetary health-informed approach which recognises the interconnectedness of human, animal, ecosystem and environmental health is vital to protect the health of people and the planet, should be embedded both in UNFCCC decision making and national climate plans such as nationally determined contributions (NDCs) and national adaptation plans (NAPs).