A CALL TO ACTION FOR EUROPEAN HEALTH PROFESSIONALS

Given the urgency of developing and deploying climate change preventive and protective measures worldwide, now is the time for health professionals around the world—to develop and rapidly scale up our efforts to protect the public’s health.

Efforts are already under way in many nations to activate health professionals as advocates for climate and health. Each of these efforts is important, but they are not yet tightly focused on achieving the global goal of limiting warming to no more than 2 °C.

For a myriad of reasons, the world’s health professionals, including doctors, nurses, midwives, and other allied health professionals and public health professionals are uniquely suited to lead the effort to persuade nations of the world to double their emission reduction commitments. They are among the most trusted members of every society worldwide. They speak with not just scientific but also ethical and moral authority. They have—or can get—the attention of their nation’s leaders. They are free of conflicts of interest with regard to climate change and health and are scrupulously evidence-based. And most importantly, they are powerful advocates for the very thing that people worldwide care about most and is most threatened by climate change: our health and well-being and that of our children and their children.

The world’s health professionals have—or should have—ample motivation to play this role. The health harms of climate change are already significant contributors to many of the leading causes of morbidity and mortality worldwide, and as the planet continues to warm, these impacts are projected to become far worse.

Efforts are already under way in many nations to activate health professionals as advocates for climate and health. These include the work of the Climate and Health Alliance (Australia), the Canadian Association of Physicians for the Environment, the UK Health Alliance on Climate Change, the US Climate and Health Alliance, Physicians for Social Responsibility (US), the American Public Health Association, the Alliance of Nurses for Healthy Environments (US), and the Medical Society Consortium for Climate and Health (US). Many of these organizations collectively represent a substantial proportion of their national health and medical workforces. At the regional or global level, the Health and Environment Alliance is engaging health actors around energy choices across the European Union, and the Healthy Energy Initiative is working with health professionals globally on shifting public funds away from fossil fuels and into health and climate action. Also at the global level, the Global Climate and Health Alliance is working to tackle climate change and protect and promote public health, and through its Global Green and Healthy Hospitals Network, Health Care Without Harm is working to transform hospitals and health systems worldwide so they reduce their environmental footprint and become anchors for sustainability and leaders in the global movement for environmental health and justice.

Strategy One: Engage

The first and most important action that must occur is to engage with and recruit the support of a broad cohort of health stakeholders to build on and amplify the current set of climate and health initiatives and activities around the world. This should include the following groups of professionals.

Many medical societies and medical society consortia already understand and focus on this issue. Some of these consortia and their participating medical societies have substantial global reach. For example, the American College of Physicians has chapters in 19 nations (including Brazil, Canada, India, Mexico, and Saudi Arabia), and the American Academy of Pediatrics, the American Academy of Allergy, Asthma, and Immunology, the American Thoracic Society, and the American College of Obstetrics and Gynecology also have chapters in many nations around the world. Other important medical organizations with global footprints—including the World Medical Association and the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians—have strong climate change policies and can be brought into the movement. Other medical organizations with a substantial international presence, such as the Interacademy Medical Panel and the International Pediatric Association, are also excellent candidates to join the movement.

Nurses and midwives constitute the largest group of health professionals globally, with approximately 19.3 million nurses and midwives worldwide. These professionals—who provide care to almost every person in the world at some point during their lives—offer the potential for influencing significant global change through their size and scale and through their capacity to reach a large and diverse proportion of the global population.

Along with other allied health professionals (e.g., psychologists, physiotherapists, social workers, occupational therapists), these professions offer the opportunity to bring large numbers of health professionals to the movement, people who are on the ground providing health care and who possess organizational clout in virtually every community worldwide.

Around the world, nurses are often at the top of the list of the public’s most trusted sources on health issues. Nurses are taking the lead in supporting climate action in many nations, such as the Association of Nurses for a Healthy Environment in the USA that is developing the Nursing Collaborative on Climate Change and Health, which aims to engage national nursing organizations and elevate nursing leadership in addressing climate change; the Australian Nursing and Midwifery Federation that offers educational and professional development training on climate change to thousands of nurses each year; and the Canadian Nurses Association Code of Ethics that supports and encourages nurses to promote climate adaptation and mitigation.

Globally, in 2018 the International Council of Nurses (ICN)—with members in 130 countries, representing nearly 20 million nurses around the world—issued a position statement calling for government action and nursing leadership on climate change; this followed a focus on the health impacts of climate change at its inaugural Health Policy Summit in 2017. This cohort, including organizations such as ICN, can add significant size, scope, and power to the global climate and health movement.

In the USA, the American Public Health Association declared 2017 the year of climate and health. Other public health organizations, such as the World Federation of Public Health Associations (WFPHA)—with member associations in over 100 countries—and many of their national counterparts, have also been active on the issue. WFPHA’s 2015 World Congress on Public Health had a strong focus on climate change, energy policy, and health. Also in 2015, WFPHA conducted the first ever global survey on national climate change and health policy, with a subsequent report documenting the actions of 38 respondent countries on addressing the health impacts of climate change.

Several important organizations are already working at the intersection of climate and health worldwide—including Health Care Without Harm, Health and Environment Alliance (HEAL), Global Climate and Health Alliance, the Lancet Countdown, and the Global Consortium on Climate and Health Education. Each has established architectures and missions that are synergistic with this initiative and will provide it with a cadre of leaders and bridge builders.

While the aim is to quickly recruit medical, nursing and midwifery, allied health, and public health professionals and organizations worldwide to actively participate in the initiative, there are obvious advantages to initially targeting institutions and individuals in those nations that emit the highest levels of carbon pollution (e.g., the top 15 emitting nations: China, the USA, European Union, India, Russia, Japan, Brazil, Indonesia, Canada, Mexico, Iran, South Korea, Australia, Saudi Arabia, and South Africa).

Strategy Two: Organize

A team must be assembled to work directly with health professionals, organizations, and consortia to organize and empower health professionals and institutions to build this movement. They must also recruit and mobilize significant communication and advocacy assets for the initiative.

The organizing team—to be composed of the organizations that have the greatest strategic and operating capacity to build and lead the movement—should be guided by an advisory board of leading climate and health, strategy, and communication experts worldwide. The advisors will help provide guidance and insight on strategy, while the organizing team will help implement the strategy and tactics. With the help of these experts and collaborators, the organizing team will take the lead in planning, organizing, and implementing the movement’s activities in each participating country and in identifying health leaders in each country who will be supported to become the public face of the movement locally and nationally. They will also work to ensure the visibility of these efforts and those of the broader movement and work to embed key messages on climate change and health in global and regional news media outlets.

Strategy Three: Empower

Health professionals should be empowered to deliver key messages on climate change and health—repeatedly and forcefully—with the aim of reaching audiences in every nation of the world. Through educational meetings, materials development, research, information sharing, and media relations support, concerned health professionals should  be empowered to become powerful advocates for the health and well-being of their patients and the public at large.

Key Messages and Engagement Strategies

1. The health harms of climate change and air pollution are happening now. Our health is already being harmed by climate change and air pollution, and it’s almost certain to become dramatically worse unless we take action now. This is especially true of medically vulnerable people including pregnant women, children, the elderly, people with chronic illnesses, disadvantaged persons of color, and the poor.

2. We must take immediate action to protect our communities. Communities should be taking action to protect people’s health from the impacts of climate change that are already with us. For example, communities can reduce the health harms associated with climate change by developing early warning systems for impending heat waves, providing resources to protect vulnerable populations, and educating their members about the health effects of climate change.

3. Prevention offers the most powerful protection against future harms. To prevent these harms from getting worse, the most important actions we must take—as individuals, communities, businesses, and nations—are those that will greatly accelerate the inevitable transition to clean energy and limit emission of toxic short-lived carbon pollutants.

4. Preventive actions will create immediate health and economic benefits. Taking these actions will not only protect the health of the population and our offspring—and their offspring—from a dangerously unstable climate in the future, they will also help clean up our air, soil, and water almost immediately, thereby enabling everyone alive today to enjoy better health for the remainder of our days and ensuring the well-being of future generations.

5. We must double our commitment to reducing carbon pollution—and then live up to it. The most important action every country can take is to ensure it is committing to—and then delivering—its fair share of the global responsibility to emissions reductions in order to collectively achieve our shared goal under the Paris Climate Agreement. This is the surest path to ending air pollution, limiting climate change, promoting health and well-being, and ensuring a prosperous future for humanity.

The building of political calls for complementary national strategies:

1. Educating the public, other health professionals, the media, business leaders, and policymakers about the relevance of air pollution, climate change, and climate solutions to human health.
2. Advocating for a doubling of their nation’s emissions reduction commitment.
3. Mobilizing individual health professionals to join the effort.
4. Building or joining coalitions of other national, regional, and local organizations that will support the advocacy goal and spread the initiative’s key messages.

Physicians as a group (and presumably other professionals), and many individual physicians—especially those with unique climate- and health- relevant expertise, such as pulmonary and infectious disease specialists, and those practicing in affected regions have a professional responsibility to speak out about the health impacts of climate change. Medical organizations must divest from investments in fossil fuel companies—because the (e)vidence that fossil fuels pose serious threats to public and planetary health is overwhelming” and “(t)he fossil fuel industry has a long record of undermining climate science and continues to spread misinformation and obstruct climate action.” A growing number of medical organizations are leading by example in this way, including the Royal College of General Practitioners, the American Medical Association, the Royal Australasian College of Physicians, the Canadian Medical Association, the Australian Medical Students’ Association, the UK Faculty of Public Health, and the British Psychological Society. (Other organizations that are leading in this manner include the American Public Health Association, the British Medical Association, the Chicago Medical Society, Gunderson Health System, Healthcare Without Harm, Mediabank, Practice Greenhealth, the Royal Australasian College of Physicians, Society for the Psychology Study of Social Issues, the UK Health Alliance on Climate Change, UNISON Cambridge Hospitals, and the World Medical Association.)

Conclusion

The voice of health professionals in putting an end to politics as usual regarding climate change is particularly important because, for many people, recognizing the need for—and appreciating the promise of—dramatically decarbonizing our energy future has been hampered by a perceived “distance” from climate change. It is seen as something that will happen far in the future, somewhere else, and not to people but rather to plants, polar bears, and penguins. In contrast, the fundamental message of our proposed initiative is that climate change and air pollution are happening now, everywhere, and are harming us in profound ways—and that we have an extraordinary opportunity, right now, to ensure a better, healthier future for ourselves, our children, and their children. Achieving the goal of the Paris Climate Agreement will lead to better health and more sustainable wealth.

By making clear what’s at stake and what must be done about it, the world’s health professionals can create a lever long enough (using their trusted voices, en masse), and a fulcrum on which to place it (the Paris Agreement), to move the world.

Philanthropic foundations, corporations, and agencies for international development (to support work in developing nations) should step forward to provide the necessary funding for this vitally important initiative. The health and well-being (and the future) of humanity may depend on it.

Most Active Associations

1. Alliance of Nurses for Healthy Environments (US) https://envirn.org/
2. American Academy of Allergy, Asthma, and Immunology
3. American Academy of Pediatrics
4. American College of Obstetrics and Gynecology
5. American College of Physicians
6. American Medical Association
7. American Public Health Association
8. American Thoracic Society
9. Association Internationale de la Mutualité
10. Association of Nurses for a Healthy Environment in the USA (Nursing Collaborative on Climate Change and Health)
11. Australian Medical Students’ Association
12. Australian Nursing and Midwifery Federation
13. British Medical Association
14. British Psychological Society
15. C2DS- Comoté pour le Développement Durable en Santé
16. Canadian Association of Physicians for the Environment (CAPE) https://cape.ca/
17. Canadian Medical Association
18. Canadian Nurses Association Code of Ethics
19. Chicago Medical Society
20. Climate and Health Alliance (Australia)
21. Doctors for the Environment Australia (DEA) https://www.dea.org.au/
22. European Academy for Environmental Medicine (EUROPAEM)
23. European Cancer Leagues (ECL)
24. European Child Safety Alliance (ECSA)
25. European Federation of Allergy & Airways Diseases Patients' Association (EFA)
26. European Lung Foundation (ELF)
27. European Public Health Alliance (EPHA)
28. European Respiratory Society (ERS)
29. Global Climate and Health Alliance https://climateandhealthalliance.org/
30. Global Consortium on Climate and Health Education
31. Global Green and Healthy Hospitals Network
32. Gunderson Health System
33. Health and Environment Alliance (HEAL) https://www.env-health.org/issues/climate-energy/
34. Health and Environment Justice Support (HEJSupport)
35. Health Care Without Harm https://noharm-global.org/content/global/about
36. Healthy Energy Initiative
37. Health for Future (Germany) https://healthforfuture.de/
38. Interacademy Medical Panel
39. International Council of Nurses (ICN)
40. International Network on Children's Health, Environment and Safety (INCHES)
41. International Pediatric Association
42. International Society for Doctors for the Environment (ISDE)
43. Irish Doctors for the Environment https://www.ide.ie/
44. Lancet Countdown
45. Médecins du Monde
46. Mediabank,
47. Medical Society Consortium for Climate and Health (US)
48. New Zealand Climate and Health Alliance (Ora Taiao) https://www.orataiao.org.nz/
49. Pesticides Action Network (PAN) Europe
50. Physicians for Social Responsibility (US)
51. Practice Greenhealth
52. Royal Australasian College of Physicians
53. Royal College of General Practitioners
54. Society for the Psychology Study of Social Issues
55. UK Faculty of Public Health
56. UK Health Alliance on Climate Change
57. UNISON Cambridge Hospitals
58. US Climate and Health Alliance https://usclimateandhealthalliance.org/
59. Women Engage for a Common Future (WECF)
60. World Federation of Public Health Associations (WFPHA)
61. World Medical Association
62. World Organization of National Colleges, Academies and Academic Associations of General Practitioners