ReviewThe Lancet Countdown: tracking progress on health and climate change
Introduction
WHO estimated that, in 2012, 12·6 million deaths (23% of all deaths worldwide) were attributable to modifiable environmental factors, many of which could be influenced by climate change or are related to the driving forces of climate change.1 The 2009 UCL–Lancet Commission: managing the health effects of climate change2 described the ways in which climate change acts as a force multiplier for threats to global health. This initiative has drawn on long-standing expertise and leadership in the health and climate field, including from institutions such as WHO and the Intergovernmental Panel on Climate Change (IPCC), and a previous call for the systematic monitoring of health outcomes related to climate change.3, 4
The 2015 Lancet Commission on Health and Climate Change: policy responses to protect public health5 built on these foundations and explored the health benefits of climate change mitigation and adaptation policies. As first described in the 2009 Lancet series, greenhouse gas mitigation across a range of sectors can result in considerable improvements in public health.6, 7, 8, 9, 10 Taken together, the potential to avoid substantial impacts of climate change and the potential co-benefits of climate change mitigation and adaptation led the 2015 Lancet Commission5 to conclude that “tackling climate change could be the greatest global health opportunity of the 21st century”.
The direct impacts of climate change result from rising temperatures, heatwaves, and increases in the frequency of complex extreme weather events such as windstorms, floods, and droughts.11 The health and social consequences of these events are far-reaching, ranging from reduced labour productivity and heat-related deaths, through to direct injury, the spread of infectious diseases, and mental health effects following widespread flooding. The effects of climate change will also be heterogeneously mediated across different environmental and social systems, resulting in changing patterns of the burden and distribution of infectious diseases, changes in food productivity, and potential effects on food and water shortages, population displacement, and conflict (figure 1).3 Climate change places undue burden on the countries least responsible and least able to respond, with low-income and middle-income countries experiencing multiple impacts simultaneously.12
The Rockefeller Foundation–Lancet Commission on planetary health13 described how sustained human health and development are dependent on flourishing natural systems. This Commission13 and others14 have drawn attention to the fact that human activities are breaching environmental limits across a range of areas, driving terrestrial and marine biodiversity loss, ocean acidification, depletion of freshwater, soil degradation, and other potentially irreversible processes.
At the international level, the Paris Agreement provides the framework for future international cooperation and national action on climate change. Modelling suggests that the full implementation of all mitigation actions pledged by national governments would limit average global warming to around 2·7°C by 2100—an improvement on the high-end 4·8°C or more scenario, but substantially higher than the agreed UN target of “well below 2·0°C”.15
Responsibility for implementation of the Paris Agreement now falls on national governments. The next 15 years, from 2016 to 2030, are a crucial window that will determine the trajectory of climate change and human development for the coming century. As part of this transition, countries will have to undergo a shift from understanding climate change solely as a threat, to embracing the response to climate change as an opportunity for human health and wellbeing. Tracking and communicating this transition will be the central focus of the Lancet Countdown.
Section snippets
Aims of the Lancet Countdown on health and climate change
The Lancet Countdown aims to track the impacts of climate change and the speed of the transition to a decarbonised global economy (a transition that is already underway); analyse and show the health benefits available; provide a global picture of successes and obstructions in this shift; draw out exemplary case studies for shared learning; and engage with policy makers and the broader health community to better communicate the opportunities available in responding to climate change both for
Indicators of progress: a call for input and engagement
The work of the Lancet Countdown is divided into five working groups, responsible for specific sets of indicators and their integration. Proposed indicator domains for these working groups are outlined in the panel and below. These indicators and indicator domains are presented for consultation with varying degrees of certainty, ranging from the presentation of a specific indicator through to the description of a broad domain within which several indicators might be present.
The ongoing framing
1: Health impacts of climate hazards
The health effects of climate change are projected to become increasingly severe in the future, and threaten to undermine the gains made in public health and development during the past half-century.3, 5 The effects of climate change are unevenly distributed within and between countries, with all risks having important social, economic, and geographical mediating factors.19 The first working group of the Lancet Countdown proposes seven indicator domains to be considered and then tracked.
2: Health resilience and adaptation
Adaptation interventions designed to minimise the health impacts of climate change are already required. The second working group of the Lancet Countdown will therefore focus on the design and deployment of adaptation and resilience interventions. It will particularly draw on data collected for the WHO climate and health country profiles, including responses to surveys from national ministries of health.19
3: Health co-benefits of climate change mitigation
The existence of ancillary health benefits (co-benefits) of climate change mitigation policies provides a powerful incentive to accelerate policy change, as these benefits are experienced in the near term, whereas the benefits of climate change mitigation are largely observed in the long term. As noted, however, such benefits are not automatic, and care is needed to avoid unintended adverse consequences for health. To assess progress in climate change mitigation and the potential resultant
4: Economics and finance
Article 2 of the Paris Agreement establishes the importance of ensuring financial flows consistent with a pathway towards a low-carbon economy. The Lancet Countdown's fourth working group will focus on the ways in which flows of finance and economic incentives are developing to accelerate progress on health and climate change. Indicators for this working group will fall into three broad themes: investment in a low-carbon economy; valuing the health co-benefits of climate change mitigation; and
5: Political and broader engagement
The fifth working group will focus on the broader context within which progress on health and climate change is being made. These indicator domains will track the implementation of political commitments within the UNFCCC, alongside analysis of scientific and public engagement with health and climate change, which provide both background and context for policy implementation.
Conclusion
The Lancet Countdown is an international, multidisciplinary research collaboration dedicated to tracking progress on health and climate change from 2016 to 2030. It will be governed by a board comprising the research leads for each working group, and coordinated by a smaller executive team responsible for supporting the working groups to deliver and communicate the academic content. Over the coming months, the Countdown will work to establish an international advisory board, to provide
References (86)
- et al.
Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission
Lancet
(2009) - et al.
Global health watch: monitoring impacts of environmental change
Lancet
(1993) - et al.
Health and climate change: policy responses to protect public health
Lancet
(2015) - et al.
Public health benefits of strategies to reduce greenhouse-gas emissions: food and agriculture
Lancet
(2009) - et al.
Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport
Lancet
(2009) - et al.
Public health benefits of strategies to reduce greenhouse-gas emissions: household energy
Lancet
(2009) - et al.
Public health benefits of strategies to reduce greenhouse-gas emissions: low-carbon electricity generation
Lancet
(2009) - et al.
Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers
Lancet
(2009) - et al.
Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health
Lancet
(2015) - et al.
The determinants of vulnerability and adaptive capacity at the national level and the implications for adaptation
Global Environmental Change
(2005)
Energy, energy efficiency, and the built environment
Lancet
The expanding horizon of renewable energy in sub-Saharan Africa: leading research in the social sciences
Energy Res Soc Sci
Incorporating travel behaviour and travel time into TIMES energy system models
Applied Energy
Air quality and public health impacts of UK airports. Part II: impacts and policy assessment
Atmospheric Environment
Air quality and public health impacts of UK airports. Part I: emissions
Atmospheric Environment
Air pollution and early deaths in the United States. Part I: quantifying the impact of major sectors in 2005
Atmospheric Environment
First 20 years of DNDC (DeNitrification DeComposition): model evolution
Ecological Modelling
Environmental tax reform and the double dividend: a meta-analytical performance assessment
Ecological Economics
Barriers perceived to engaging with climate change among the UK public and their policy implications
Global Environmental Change
Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks
Human health: impacts, adaptation and co-benefits
Summary for policymakers
Climate change and global health: quantifying a growing ethical crisis
EcoHealth
Planetary boundaries: exploring the safe operating space for humanity
Ecology and Society
Energy and climate change: world energy outlook special briefing for COP21
OECD core set of indicators for environmental performance reviews
A review of frameworks for developing environmental health indicators for climate change and health
Int J Environ Res Public Health
Climate and health country profiles—a global overview
Transforming our world: the 2030 agenda for sustainable development. A/RES/70/1
Sustainable healthy urban environments
Indicators to monitor global targets of the Sendai Framework for disaster risk reduction 2015–2030: a technical review
Heat-related respiratory hospital admissions in Europe in a changing climate: a health impact assessment
BMJ Open
Heat, human performance, and occupational health: a key issue for the assessment of global climate change impacts
Annu Rev Public Health
Climate change, heat and cold waves as risk factors of increased mortality in Russia
Ecoforum
EURO-CORDEX: new high-resolution climate change projections for European impact research
Reg Environ Change
Reductions in labour capacity from heat stress under climate warming
Nature Climate Change
When is a drought a drought?
Nature
Understanding the drought phenomenon: the role of definitions
Water International
Increasing drought under global warming in observations and models
Nature Climate Change
Development: slow down population growth
Nature
Climate change and infectious diseases
Climate change and infectious diseases: from evidence to a predictive framework
Science
Temperature and population density determine reservoir regions of seasonal persistence in highland malaria
Proc R Soc Lond B Biol Sci
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