It’s time to admit that our health and climate crises are one

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The writer served as the first national climate adviser to the White House and is a former administrator of the US Environmental Protection Agency

It is of course completely right that climate, economic and technical experts are included in every COP discussion, such as the one in the United Arab Emirates later this month. But only rarely do you see health leaders in the mix. In fact, for as long as I can remember, health has never been treated as a serious factor in the consideration of climate action or as a significant driver of climate investments, even though these challenges are inseparably linked and nothing is more important to us and our families than our wellbeing. 

Now is the time to change this. Today, people are dying not just as a result of greenhouse gases and the climate chaos those emissions create, but from the air pollutants that accompany our dependence on fossil fuels. These tag-along pollutants foul our air, causing cancer, heart disease, neurological diseases, asthma and so many other illnesses.

As a report from the State of Global Air Quality Funding 2023 makes clear: “Over 99 per cent of people around the world are breathing air that exceeds the WHO air quality guidelines, and air pollution causes 7mn premature deaths every year, including more than half a million children under five.”    

While I salute COP28’s leaders for using their resources to focus on health both before and during the event, this commitment simply isn’t enough. Two facts must also be visibly acknowledged. The first is that the only way to build sustainable economies is by making clean air a core consideration in every country’s climate strategy. The second is that our dependence on fossil fuels is the root cause of our global health and climate crisis — not to mention the greatest threat to our children’s future.

For these reasons, we cannot focus on adaptation and resilience while failing to address our historic and current reliance on fossil fuels. Ignoring the threat that they pose to our health — especially in poor countries — is like spending all our time and money designing strategies to fight second-hand smoke without focusing on stopping people from smoking in the first place.

Today, it’s important to incentivise clean energy as a way to beat out higher-priced fossil fuels and reduce air pollution. In the US, the Inflation Reduction Act has opened up opportunities by directly supporting states and cities, as well as the private sector, in transitioning towards clean energy. These investments, in addition to the funding contained in the Bipartisan Infrastructure Law, are transforming transportation and electricity generation: the two sectors that have the greatest impact on climate change and public health. The Breathe Cities initiative is breaking down barriers to clean air and tools such as Google’s Environmental Insights Explorer provide local emissions data and opportunities to design strategies that improve air quality and protect health. 

The US Environmental Protection Agency has also made progress in updating regulations to take into account new technologies, as well as the health and economic benefits that can be achieved when harmful pollutants are reduced. But it’s not enough to advance clean energy and update regulations — we have to reduce and in time eliminate fossil fuels.

While it makes sense to try to eliminate millions of premature deaths each year from air pollution, historically this battle has been chronically underfunded. Only 1 per cent of international development funding ($17.3bn) and 2 per cent of international public climate finance ($11.6bn) was expressly committed to targeting air pollution over the last six years for which full data is available.

Isn’t it time to use our many financial tools — such as green bonds, social bonds and results-based funding — to mobilise long-term private capital and a range of investments that count not just greenhouse gas reductions but lives saved? 

Moreover, as nations design their climate change mitigation strategies and consider the best way to invest in their future, now is the moment for them to include air pollution metrics.

We have access to cost-effective opportunities that can help us phase down global dependence on fossil fuels. This effort will take the engagement of local climate and health leaders, as well as disinvestments in technologies such as carbon capture and sequestration that are used to justify prolonging their use.

My hope is that we can find a way at this COP to live up to the Paris Agreement, by staying focused on ways we might invest in the clean energy transition, while taking steps to phase down fossil fuels. If we engage on all levels and include health experts to advance new metrics in the development and implementation of country strategies, we will succeed in creating the cleaner world we so desperately need.

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