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Info Service on Climate Change (Feb25/02) WHO: Developing Countries call for changes in Climate and Health Draft Action Plan Geneva, 11 February (Nithin Ramakrishnan) – Member States at the 156th Executive Board Meeting of the World Health Organization (EB156) stated on 8 February that the Draft Global Action Plan on Climate Change and Health needs further work. Developing countries in particular called for changes to reflect the operationalization of common but differentiated responsibilities and respective capabilities. In contrast, some of the developed countries called for changes, but focussed more on technical aspects. EB156 held at the WHO Headquarters in Geneva from 3 to 11 February 2025 discussed the Draft Global Action Plan on Climate Change and Health which the Director-General Dr. Tedros Adhanom Ghebreyesus had placed for consideration under Agenda Item 22. The Draft Action Plan is developed in five parts: (i) Introduction, (ii) consultation process, (iii) guiding frameworks and principles, (iv) structure, which includes action areas, global target, objectives, proposed action for Member States, Secretariat and Stakeholders, (v) coordination, monitoring and evaluation. Under Part (iv), there are three primary action areas: (i) leadership coordination and advocacy; (ii) evidence and monitoring; and (iii) country-level action and Capacity-building. Each action area contains 1-2 global targets and 3-5 objectives. However, the draft action plan does not provide for a strong linkage between the actions proposed to be undertaken by Member States, especially developing countries, and the provision of the means of implementation from developed countries to developing countries to support such proposed actions. There is also no talk about additional financial resources and technology for developing country health sectors for both climate change adaptation and mitigation. Thus, it is quite evident that the draft plan neglects the need to operationalize the key principles of the UN Framework Convention on Climate Change (UNFCCC) and its Paris Agreement such as common but differentiated responsibilities (CBDR) and respective capabilities, while undertaking climate-health interventions. At the same time, it requires health sector entities to lead by example by requiring them to reduce greenhouse gas emissions, and achieve net zero emissions targets, that too without examining the relative emissions of health systems of developed countries and developing countries. This could burden the ‘already stressed’ developing country health sectors with climate action, forcing them to divert resources from core health functions such as universal health care and strengthening core health system capacities to expenses towards decarbonisation through purchase of green technology, energy and reliance on greener supply chains. This situation led to several developing countries to call for several changes in the draft plan, more consultations in the lead up to the 78th session of the World Health Assembly (WHA78) in May 2025 as well as opportunities to provide written comments and suggestions. Some developed countries like Canada and the United Kingdom also indicated room for further improvement in the draft action plan. Targets and Objectives under action areas The action area “leadership, coordination and advocacy” has one global target: “Advocate for the integration of health in national and global climate agendas and vice versa”. The objectives under this action area are to:
The action area on “evidence and monitoring”, also has one global target: “Create a robust and relevant evidence base that is available and connected directly to policy, implementation and monitoring”. The objectives are to:
The action area on ‘Country-level action and capacity-building’ has two global targets. First, to “Promote climate change adaptation efforts to address health risks and support mitigation efforts that maximize health benefits”. Second, to “Ensure health systems and healthcare facilities are climate-resilient, low-carbon and environmentally sustainable.” The first target has three objectives to:
Similarly, the second target has two objectives to:
Concerns and calls for improvement and changes The Eastern Mediterranean Region in their group statement stated that upon their review of the draft action plan, they have several reservations, particularly concerning the absence of references to the foundational principles of the Paris Agreement and relevant climate change commitments. They emphasised the importance of the CBDR principle as highlighted in the 2024 WHA resolution 77.14. They added that they look forward to engaging constructively in the forthcoming consultations leading up to the WHA and trust that these discussions will lead to necessary amendments that address the concerns of all Member States. China said it supports the three areas of action mentioned in the report, adding however that “this draft action plan fails to adequately reflect the principles of common but differentiated responsibilities (CBDR), equity and respective capabilities. This is a significant oversight. China is of the view that the current draft still has much room for improvement. We hope that the secretariat, following this EB session, will convene consultations with Member States to further discuss this draft action plan and foster consensus. Additionally, China suggests that during these consultations the Secretariat should ensure meaningful participation of all Member States.” Ethiopia on behalf of the Africa Region said that “Africa bears a disproportionate burden of climate change in parts despite contributing minimally to global emissions, our region faces increased frequency of extreme weather events changing these patterns, food insecurity and water stress, always direct consequences for population health. The health systems in many African countries lack adequate resources and capacity to respond effectively to these mounting challenges. We recognize the positive effects in incorporating hills into broader climate change strategies and increase the awareness of climate change and health in the African region… For our region, Adaptation and resilience building are absolute priorities”. Ethiopia stressed that “While welcoming the draft global action plan we believe that it would benefit from strengthening before its adoption by WHA78, to include the principle of CBDR and respective capabilities. WHA Resolution 77.14. which guides development of this plan recalls CBDR as fundamental in operationalizing the Paris agreement. Operationalizing CBDR is crucial for equitable responsibility and action, particularly for Africa region member states who contribute least to global carbon emissions but are adversely impacted most by the Climate Change. We wish to see the following points … ● More substantial and accessible funding mechanisms to support climate and health integration mechanisms especially African in other developing countries ● Specific attention to address vulnerable populations who are often disproportionately affected by the impacts of climate change ● Stronger focus on building climate resilient systems including strengthening healthcare infrastructure to withstand extreme weather events, capacity building to healthcare workers and implementing adaptation strategies for greater resilience in Health systems”. Costa Rica also said that the draft action plan lacks sufficient strategy to promote access to resources required for climate action. Bangladesh stated that the current draft includes 4 frameworks and 15 principles, but CBDR and respective capabilities is not one of them. It also said that “it would be unfair, unjust and unacceptable to conceive an action plan in WHO leaving the historical responsibility of the big emitters out of its scope”. Bangladesh said it joins China and iterates that there is much room for improvement of the draft. It called for further discussion and provision for ‘written submission’ from the Member States to improve the draft. Malaysia stated that not operationalizing CBDR in the action plan “leads to a one-size-fits-all approach and it could place additional demands on developing country health systems, potentially requiring them to reallocate resources from essential public health functions such as universal health care to emissions mitigation”. Canada said “We would suggest there are opportunities to enhance the report’s impact by explicitly assuming a stronger public health approach, as others have said, greater emphasis on mental health impact, incorporation of indigenous knowledge and consideration of a distinct evaluation pillar. We will provide the secretariat with detailed feedback in writing”. The U.K. meanwhile asked for explanations on the assumptions and risks between targets, objectives, and actions. Additionally, it asked for clarification from the WHO Secretariat on how this plan complements other international frameworks. The U.K. also requested the Secretariat to suggest a plan, specifying expectations from other health actors. The Russian Federation, however, warned against inefficient use of WHO resources in this regard, while recommending a few changes to the report. It stated that “to begin with, we would once again like to express our concern about the gradual extension of the activities of WHO on climate-related issues. This risks diluting the mandate of the organization interfering with the activities of other competent international fora and there is inefficient use of the WHO resources which are already very limited. The organisation’s work already considers a number of relevant issues which are tied to climate change, for example, as part of the discussions on one health, on surveillance, infectious diseases and on antimicrobial resistance. We believe that in the draft global plan of action we should avoid activities that go beyond the mandate of the WHO”. The Russian Federation proposed changes it would like to see in the action plan: “… we should also reflect criteria for assessing target indicators and expected results. We should also indicate factual data to support the proposed measures to be implemented including examples of quantitative and qualitative analysis of the most significant consequences of anthropogenic climate change on health. These should be disaggregated by country, by groups of countries, by geographic regions and we should also have them globally… Furthermore, we propose to include in the draft global action plan the monitoring of the antimicrobial resistance of microorganisms in the environment and specifically in air particles as well as the detecting in these microorganisms of known and new genes of antimicrobial resistance”. Call for access to health products to address climate change driven diseases Namibia stated that “while the report references disease outbreaks and pandemics as climate-related health impacts, the draft plan does not sufficiently address equitable and affordable access to vaccines, diagnostics, or therapeutics necessary for combating these disease outbreaks. It is imperative that the action plan ensures equitable and timely distribution of medical countermeasures for public health emergencies, including those related to climate change”. Malaysia echoed the statement by Namibia and reiterated this emphasis within the context of WHO. It stated that “the draft lacks reference to ensure equitable access to medicines and treatments for addressing diseases that are emerging and re-emerging as a result of climate change; while it should be one of the areas upon which WHO should be placing additional emphasis”. Bangladesh also called for access to health products, the first key change they would like to see in the global action plan. It called for including “enablers to facilitate access to health products at an affordable cost needed for addressing diseases emerging or re-emerging owing to climate change”. Bangladesh in addition called for the inclusion of details on building climate resilient health systems, sources of sustainable financing for addressing health impact of climate change, and provision for access to technology and know-how for adaptation and mitigation measures related to health. Developed countries keen to move forward Norway stated that it is fully supportive of the draft action plan and stands ready to adopt the same. It said that “It is paramount that the global action plan on climate change and health is adopted at the 78th World Health Assembly and that implementation is a priority for the secretariat and among Member States. The impact on health caused by climate change should be seen from a One Health perspective … Health systems globally account for 5% of global greenhouse emissions, mitigating and adapting to climate change in the health sector must include reducing the carbon footprint of the sector itself. The global action plan on climate change and health represents welcome progress and will promote climate change as a core priority in future national health policies, we fully support the draft plan”. However, Norway also recalled that climate change “disproportionately affects vulnerable populations, threatens food security and access to clean water”. It stated: “It contributes to the rise in infectious diseases, the emergence and re-emergence of pathogens, and the spread of vector-borne diseases to new geographic areas. Not least will it contribute to an increase in antimicrobial resistance. Air pollution and heat waves have detrimental effects on non-communicable diseases. Furthermore, children and adolescents are particularly vulnerable to the health impacts of climate change, affecting almost every aspect of their health and well-being, including mental health. We believe that universal health coverage, social services and resilient health systems are key in mitigating the effects of climate change on health. Therefore, strengthening health systems is fundamental in limiting the effects of climate change on health. Local communities and health care workers have an important role to play in this transformation”. Poland speaking on behalf of the European Union expressed that they are pleased with the draft action plan. The E.U. also placed a lot of emphasis in the activities in the EURO region and called for decarbonisation of health systems: “We encourage health-centered cross-sectoral cooperation guided by the one health approach and acknowledging in interlinkages of human animal and environmental health the EU endorses that COP28 (UNFCCC’s 28th meeting of the Conference of Parties) declaration on climate and health and welcome addressing climate driven health risks. We also look forward for the outcomes of the work of the WHO secretariat in terms of developing clear norms, standards, policy guidance, and capacity building in countries to reduce carbon emissions from the health sector and as outlined in the GPW 14 (WHO’s 14th General Programme of Work, 2025-2028). We hope for ambitious common targets and strong containment with sectors such as food and beverages, transport and energy”. However, in the light of the current financial circumstances, the E.U. asked the WHO Secretariat to provide information on how many people in WHO work on climate change and health and how much funds are available. Countries like the Slovak Republic and Moldova, aligned with the E.U. statement, and expressed interest in future consultations. While reaffirming its commitment to collaborating with WHO and Member States to implement the Global Action Plan on Climate Change and Health by addressing financing gaps, building health system resilience, and fostering cross-sectoral collaboration. Switzerland on the other hand made a very brief statement supporting the draft action plan. “We are at a crucial point in time as climate change is emerging as one of the greatest health challenges of our time. Not surprisingly the GPW 14 includes climate change as one of the key priorities, recognizing that the climate crisis is also a health crisis…We believe the draft global action plan is a very good basis that will foster more synergies and ensure greater awareness about the health challenges posed by climate change. It will also strengthen efforts to reduce the carbon footprint of the health sector. Switzerland therefore supports the way forward described in report EB156/25.” Secretariat maintains silence on CBDR emphasis Despite many developing countries calling for the inclusion of CBDR and criticizing the draft plan for not reflecting the principle, the WHO Secretariat who responded to the comments clearly omitted any reference to the CBDR principle once again. While highlighting a few points as response to the Member States and Non-State actors who spoke during the discussion on agenda item, the WHO Secretariat said that it heard several members mentioning co-benefits, systems strengthening and one health approach, making the silence on CBDR once more conspicuous. The Secretariat highlighted “a few points after listening to you. First, on strategic sustainable approaches to adjust the health impact of climate change, we work together to integrate health into national regional and global climate policy. We also support country implementation based on the country's priority needs for example adaptation, mitigation or both measures, and based on unique country context such as in small island countries”. The Secretariat expressed its commitment to work cross-programme in a more coordinated and efficient manner. It raised its achievement in terms of mobilizing resources for low income countries, and said that the action plan will facilitate WHO’s country's support to building climate resilient health systems in particular for the countries and the population in vulnerable situations, aligned with GPW14.
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