TWN Info Service on Climate Change (Jun25/01)
9 June 2025
Third World Network

WHO: CBDR central to climate and health action plan; Germany and U.K. dissociate

Kochi, 8 June (Nithin Ramakrishnan) – Member States at the 78th World Health Assembly (WHA78) adopted the WHO's Global Action Plan on Climate Change and Health anchoring the principle of common but differentiated responsibilities and respective capabilities (CBDR-RC) as a central pillar, along with principle of equity.

The Action Plan was passed with 109 votes in favour, none against, and 19 abstentions, after attempts for consensus failed. Germany and the United Kingdom dissociated from the application of CBDR-RC, prompting several countries to reaffirm the principle's importance.

WHA78 took place at the United Nations Office in Geneva, from 19 to 27 May.  The draft action plan was prepared and tabled by the WHO Secretariat for the consideration of Committee B of the World Health Assembly (WHA) for adoption.

The Action Plan contains five parts: (i) Introduction, (ii) consultation process, (iii) guiding frameworks and principles, (iv) structure, which includes action areas, global targets, objectives, proposed action for Member States, Secretariat and Stakeholders, (v) coordination, monitoring and evaluation.

Under Part (iv), there are three primary action areas: leadership coordination and advocacy; evidence and monitoring; and country-level action and capacity-building. Each area contains 1-2 global targets and 3-5 objectives.

The guiding frameworks and principles section specifically states the following:

“As in resolution WHA77.14, the draft Global Action Plan aligns with the UNFCCC [United Nations Framework Convention on Climate Change] and the Paris Agreement. It recalls Article 2, paragraph 1, of the Paris Agreement, which provides that the Agreement, in enhancing the implementation of the UNFCCC, including its objective, aims to strengthen the global response to the threat of climate change, in the context of sustainable development and efforts to eradicate poverty; and Article 2, paragraph 2, of the Paris Agreement, which provides that the Agreement will be implemented to reflect equity and the principle of common but differentiated responsibilities and respective capabilities, in the light of different national circumstances. In addition, other relevant frameworks and principles help establish a supporting political environment for the launch and operationalization of this work (Table 1)”.

The Action Plan integrates health considerations into climate actions, while at the same time press for climate change actions within the health sector. Given the developmental divide between developing and developed countries, as well as health inequities, in particular access to technologies and health products such as vaccines, diagnostics and therapeutics, the Action Plan would have overburdened developing countries in the absence of the CBDR-RC principle, in terms of expectations they have to meet, in particular in the health sector.

The action points before the WHA were already written in a one-size-fits-all language without much differentiation between developed and developing countries. Thus, the incorporation of CBDR-RC as a key principle was inevitable. It would then allow for the policy space for developing countries as well as WHO regarding implementation of the Action Plan to further align with national circumstances and priorities.

During the 156th Session of the WHO Executive Board in February 2025, this was the major demand of developing countries. The new draft of the action plan incorporates CBDR-RC as a key principle, along with equity. All other principles were marked as “additional” in the action plan. Despite this, the proposed actions and targets etc. did not clearly reflect by themselves the principle of CBDR-RC.

After several attempts to generate consensus, particularly through an informal drafting group on 26 and 27 May, the Chair of Committee B, Mrs. Katarzyna Drążek-Laskowska (Poland), at her own discretion, put forward a draft decision to adopt the Action Plan as contained in document EB156(40) for voting. Of 181 eligible Member States, 109 supported the decision, 19 abstained, and 53 were absent. None voted against the decision.

On one hand, Eastern Mediterranean Region (EMR) Member States dissociated from the decision. They cited three concerns: (i) limited inclusive consultations, (2) inadequate reflection and lack of meaningful integration of the CBDR-RC principle in the action plan, and (3) use of contested language that may hinder implementation.

In addition, Japan also dissociated from paragraph 1 of the action plan which states: “... Despite increases in climate finance since 2020, funding remains inadequate – especially for developing countries – and less than 1% is directed towards health protection...”

Similarly, the Russian Federation said it was dissociating itself from various wordings such as “climate crisis” that are not subject to consensus. Actions that are overlapping with climate action are not efficient, according to Russia, and it called for better utilization of WHO resources.

Following its adoption, countries including Peru, Mexico, Singapore, Saudi Arabia, Russia, Bangladesh, Iran, Bolivia, and Egypt explained their votes. Most highlighted the need for application of CBDR-RC principle in the implementation of the plan.

Peru welcomed the decision but expressed regrets that this decision was put to a vote. It reiterated that the Action Plan is fundamental in aligning international efforts in favour of public health and climate resilience.

Recognising climate change is not only an environmental issue but also a health issue, said Mexico stating it voted in favour of the decision. However, it called for better improvement in the consultation process relating to the development of technical documents such as the Action Plan and better communication to Member States regarding how their inputs have been incorporated. It said this will improve the legitimacy of these documents.  

Singapore welcomed the decision but placed on record that different obligations of Member States have to be based on Common and Differentiated Responsibilities. Bolivia, who also voted in favour of the Action Plan, stated that its vote is to protect “Mother Earth”, and reiterated the call for the implementation of the Action Plan to be based on CBDR.

Bangladesh who abstained from voting stated that the Action Plan does not operationalize health equity and its abstention is to send this message out. Bangladesh stated: “We are disheartened to see the dissociation of some countries from CBDR-RC and equity as well as from paragraph 1 of the Action Plan. This is an apparent manifestation of non-commitment in climate actions”.

[Earlier during the debate, before voting, the U.K. and Germany had declared their dissociation with this principle.  Australia had also questioned the way the principle was incorporated in the text which gives “a hierarchical” superior position to the principle amongst other principles.]

Bangladesh explained that it is one of the most vulnerable countries who are suffering most from the impact of climate change, despite being the least polluting. Bangladesh reasserted that it does not accept the argument that CBDR-RC is not applicable in WHO-related climate actions. It pressed for the need to apply CBDR-RC “in all climate actions to realize climate justice in all manifestations”.

Saudi Arabia reaffirmed its commitment to address the health challenges arising from climate change, in line with the UNFCCC and Paris agreement, specifically with the CBDR-RC principle. “We are in favour of collective action which is transparent amongst the Member States. We abstained because we believe the needs and aspirations of various Member States have not been taken into consideration in the Action Plan”, it further said.

Iran expressed concerns over implementation of the Action Plan, since the plan may not be able to address the concerns of all Member States.

Egypt on behalf of the EMR region stressed that there was neither consensus in process nor in substance. It stated that, “Our position reflects a principled and constructive stance, and should not be interpreted as an opposition to climate and health in action, rather for a call of a more inclusive balance and consensus-based path forward”.

Malaysia speaking to Third World Network said that they think the Action Plan has improved since the Executive Board meeting in February 2025, in particular the explicit inclusion of CBDR as well as the mandate given to WHO for identifying a region-specific, climate-sensitive list of diseases.

Under the new draft that was approved, WHO is mandated to “develop a list of region-specific yet globally relevant health risks and diseases that are particularly sensitive to climate change, in support of national efforts to detect, prevent, prepare for and respond to climate-sensitive health outcomes, and of the development of national adaptation plans, which should be reviewed and updated periodically”.

A civil society observer from the Global South said that the draft action plan was still mitigation centric, and without clear delineation of actions that might be pursued by the developed countries and developing countries. “There is also little reference to equitable access to health products required for addressing climate-sensitive diseases,” the delegate added. 

UK and Germany reject CBDR, undermines Climate and Health Action Plan

On the penultimate day of the WHA78, the UK and Germany disassociated themselves from the principle of CBDR-RC, even as they urged swift adoption of the Global Action Plan.

Australia also in the same spirit wanted the adoption of the Action Plan but expressed its disagreement with singling out the CBDR principle in paragraph 1 of the guiding frameworks and principles as this creates a hierarchy with other principles.

Japan, which did not want to accept that there is a gap in climate financing, also pressed for adoption of the Action Plan, dissociating itself from an assertion regarding the gap in climate financing.

Meanwhile, Egypt on behalf of EMR Region called for postponement of the adoption of the Action Plan for further inclusive consultations and revisions of the plan.

The UK, thanking the WHO, stated that, “we support the adoption at this Assembly and welcome the focus on systems strengthening, multi-sectoral action, evidence, advocacy, and the commitment to integrate climate change considerations across the WHO’s work. We strongly support the plan’s alignment with the UNFCCC and Paris Agreement. However, the principle of CBDR-RC in light of different national circumstances is relevant and applicable to UNFCCC and Paris agreement only, rather than to the global action plan or the work of WHO. So we would like to record that we disassociate from paragraph 1 of the guiding frameworks and principles of the plan”.

Categorically making it clear that they do not consider CBDR-RC as applicable to One Health approach, Germany said that it is against the postponement of the draft global action plan on climate change and health, and supported immediate adoption and implementation. It stated: “... However we cannot accept references to principles that are not relevant to the one health approach and could undermine its effectiveness. Therefore, Germany would like to disassociate with paragraph 1 on page 3 of the action plan. We do not consider Article 2, Paragraph 2 of the Paris Agreement which covers CBDR in the light of the different national circumstances to be applicable to the action plan or to the work of WHO…”

Japan argued that it will be difficult for Japan to fully endorse the Global Action Plan. This is because the first paragraph states, as noted above, that climate finance is not adequate. According to Japan, whether climate finance is adequate or not is a question to examine in the UNFCCC and not a subject matter for discussion in WHO.

Developing countries expressed disappointment with the arguments from these developed countries. Many of them questioned their double standards. “They want to adopt it now, but they themselves cannot adhere to its principles,” said a Member State delegate from the East Mediterranean Region.

Countries like India, Malaysia, Namibia, Bangladesh, however, opposed this view reiterating multiple times the importance of CBDR-RC. Countries like Brazil and South Africa, while not explicitly referring to CBDR-RC, specifically called for climate justice.

India said that while it remains steadfast in addressing the health impact of climate change, “any global plan must align with existing international agreements under the UNFCCC and Paris agreement. Central to this is the principle of CBDR-RC which safeguards equity and global climate action”.

Welcoming the Action Plan Bangladesh explained, “As one of the most climate vulnerable countries, Bangladesh prioritizes CBDR-RC as the bedrock principle in all climate actions. In the Plan, such a priority is missing.  Climate vulnerability and health impacts are not uniform across countries. Hence, countries most exposed to sea-level rise, flooding, heatwaves, and climate-sensitive diseases bear a disproportionate burden”.

Further Bangladesh urged the WHO “to develop objective criteria to assess climate vulnerability and related health risks, and to identify the countries most at risk” and proposed that the “targeted technical and financial assistance should be streamlined towards those countries to ensure equity- and justice-based resource allocation”.

Namibia stated that “the African Region is disproportionately impacted by climate change although the region contributes minimally to global emissions. It bears the greatest burden of climate change”. It appreciated the inclusion of the CBDR-RC principle (which was done post EB156 after the insistence of developing countries) in the draft global action plan and argued that operationalizing the principle of CBDR-RC is crucial for equitable responsibilities and action for developing countries. Namibia further called upon WHO to strengthen financial assistance based on the principle.

Malaysia, reiterating the need for the Global Action Plan to include clearer guidance on mechanisms for implementation, capacity building, and sustainable financing, stated that “a robust monitoring framework with clear indicators according to common but differentiated responsibilities and timelines will be required to measure progress”.

Calling for adoption by consensus, Indonesia also stated that “the action plan could have been better with a stronger emphasis on CBDR”.  It argued that countries must be empowered to align climate health goals in line with their national context, priorities and development needs.

Pakistan stated that there are divergences on the Action Plan, despite the work of the Secretariat to finalize the plan, and these divergences justify the postponement of the adoption of the Action Plan. Pakistan said the plan needs to be adopted by consensus because WHO should speak with one voice in matters of such import. 

Inadequate work after EB156

The 156th Session of Executive Board  (EB156) in February 2025 had mandated the WHO Secretariat to facilitate informal consultations on the draft action plan in an inclusive and transparent manner to enable the decision to adopt the global action plan on climate and health at this year’s WHA78. 

During EB156, developing countries found several problems in the draft action plan, including a missing reference to the CBDR principle and practical reflection of the said principle in action points. They thus requested changes to the action plan during EB156, and the EB Decision to conduct further consultations was taken up after the insistence of developing countries.

However, an examination of the WHO Calendar showed only one consultation facilitated officially by the WHO Secretariat post-EB156. According to several Member States, the process was also not inclusive and transparent. The final document placed by the WHO Secretariat for the consideration of the WHA78 was also uploaded just two days ahead of the beginning of the Health Assembly in May. 

“This denied meaningful opportunities for us to examine the draft action plan and validate whether our inputs and insights shared in the consultative meeting were captured appropriately by the Secretariat,” said a developing country negotiator at the beginning of the WHA78 session.

Another delegate remarked, “WHO likely knew consensus was impossible without CBDR-RC for developing countries – and with CBDR-RC for some developed ones. They may have delayed release to avoid early backlash”.

However, expressing discontent with the process, the Member States of EMR region proposed a conference paper (A78/B/CONF./3 Rev.1) that called for the postponement of the decision to adopt the action plan to the 79th WHA session. This conference paper amended the draft decision contained in the EB decision 156(40).

Egypt speaking on behalf of EMRO region countries, the Russian Federation and Algeria highlighted three concerns as reasons why they called for postponing the adoption of the action plan.

First, it stated that despite the EB Decision 150(40), informal consultations that are transparent and inclusive were not convened due to the hectic work schedule of WHO post-EB156.

Second, it stated that there needs to be a meaningful reflection of the CBDR-RC principle.

The EMR region explained that this principle, enshrined in the UNFCCC and Paris Agreement, recognizes that while all countries must act on climate change, they do so from differing starting points in terms of capacity, historical contribution and vulnerability. The EMR region contended that CBDR-RC operationalization is important for the Action Plan in order to ensure global expectations remain fair and realistic. 

Third, it noted that the financial implication of the proposed plan is estimated at more than USD 167 million and stated that “in context of the WHO’s current financial constraints and Member State limited fiscal space, we urge caution in proceeding without a clear understanding of the plan’s funding sources, sustainability and delivery mechanisms”.  

Countries like Germany, the UK, Norway, France, Netherlands, Australia and Canada strongly opposed this proposal by Egypt, Russia and Algeria and pushed for the adoption of the Action Plan. As some of these countries were disassociating themselves from the key principle of CBDR-RC that guides the implementation of the Action Plan, several Member States and Non-State Actors observing the discussion were left perplexed.

Countries like Venezuela, Lebanon, Pakistan, Iran and others took the floor to support calls for postponing the adoption of the Action Plan.

Russia criticised the plan and work of the WHO in this regard and alleged that the plan would only need more paperwork and nothing more.

Cross regional support for immediate adoption of the Action Plan

Meanwhile, Peru on behalf of a coalition of Member States (Albania Andorra, Australia, Bahamas, Bolivia, Brazil, Canada, Central African Republic, Chile, Colombia, Dominican Republic, Ecuador, El Salvador, the 27 Member States of the European Union, Finland, Georgia, Guatemala, Guyana, Haiti, Honduras, Kenya, Lebanon, Mexico, Monaco, Montenegro, New Zealand, Norway, Panama, Peru, the UK, and Uruguay and a few others) argued against the postponing of the adoption of the Action Plan. They stressed the need to adopt the document at the WHA78 session itself.

Peru stated that the group of Member States are pleased that the WHO Resolution on Climate Change and Health was adopted by consensus last year that recognizes the “critical urgency” of the matter and “collective determination to move towards implementation as fast as possible”. It appreciated the WHO Secretariat for the “thorough work” done through 4 informal consultations throughout last year and feedback rounds in Geneva and regions. It further argued that the critical urgency has not gone away, but has only become more pressing, with global temperature surpassing the 1.5-degree Celsius threshold for the first time in 2024.

Peru also reiterated that the Action Plan is non-binding and is already part of the 14th general programme of work, with no additional expenses needed from WHO or Member States, and representing less than 2 percent of the WHO’s overall budget.

Small Island States from Western Pacific, South-East Asia, and the Americas as well as several African countries called for the adoption of the Global Action Plan.

Some developing countries expressed concern that their proposals for the Action Plan, both pre- and post-EB156, were not fully reflected in the final plan. Yet many acknowledged improvements. As one delegate stated: “We agreed to adoption because CBDR-RC is included, and the need for increased climate finance is also recognized”.

Informal Drafting Group on the Draft Decision

As it became clear that there were two diametrically opposite views regarding the adoption of the Action Plan, the co-chair of Committee B, Mrs. Katarzyna Drążek-Laskowska from Poland, suspended the session on 26 May and proposed to organize an informal drafting group to consider the various draft decisions under consideration on the issue.

Certain countries like Malaysia and Bangladesh also proposed a phased approach. For instance, Malaysia stated during Committee B: “While we welcome the adoption of the action plan, we recommend for the Secretariat to review and update the action plan in the near future to incorporate the diverse views of the Member States”.

According to sources, Kuwait, on behalf of the EMRO region, proposed a compromise to prevent delays in implementation while keeping the plan open to revision by WHA79. The proposal sought to "take note" of the current draft and requested the Director-General to report on the plan’s progress as a "living document" at WHA79 via the 158th Executive Board session.

The “living document” phrasing aimed to enable flexibility but was opposed by countries like Peru and Monaco. After over two hours of talks, the group failed to reach consensus.

A delegate from a developing country remarked: “There’s deep mistrust. Developed countries demand adoption yet reject the core principle of climate action – CBDR-RC. It’s hard to give full consent in such conditions”.

Decision adopted after several rounds of voting

As informal drafting groups failed to reach consensus on 26 and 27 May, the Chair of Committee B decided to proceed with voting on the draft decision as contained in document EB156(40) and the draft decision as amended by the EMR Member States contained in the document A78/B/CONF./3 Rev.1.

The amendments from EMR Member States propose that the adoption of the Global Action Plan be postponed with a view to conduct further consultations and revising the plan. As there was no Member State calling for a vote, and no consensus in sight, the Chair on her own discretion, decided to put the draft decisions to vote.

She first put forward the draft decision as amended by the EMR Member States. This draft decision was then rejected by 86 votes to 23, with 11 abstentions.

Cuba said that the Global Action Plan should have been adopted by consensus. Cuba voted constructively but reiterated the importance of CBDR and decisions made by UNFCCC Parties.

Israel said also it opposed the EMRO region’s amendments; however it registered its consensus with the argument the process was not inclusive enough. 

Further when the draft decision as contained in the document EB156(40) was about to be put to the vote, Russia insisted to consider its proposed amendments to the draft decision. The amendments were shown on screen, but some Member States opposed considering the amendments. The Russian amendments also were rejected from consideration by 61 votes to 47, with 13 abstentions.

Once again when the draft decision as contained in EB156(40) was up for adoption, Egypt and Kuwait objected to adoption by consensus and questioned whether the WHO Secretariat was satisfied by the mandate given by the Executive Board to conduct “inclusive and informal negotiations”.

Meanwhile, Peru had moved a motion to close the debate and directly proceed to voting. This motion to close the debate was approved by 94 votes to 20, with 10 abstentions. Since the debate was closed by the motion from Peru, the Secretariat did not need to answer the questions raised by Egypt and Kuwait.

Following from this, the draft decision was put to a vote and adopted.+