Ahead of COP27, Lancet details Climate change’s impact on health

The 2022 United Nations Climate Change Conference, designated as COP27, will be held from November 6 to 18 at Sharm El Sheikh in Egypt. Ahead of that, the noted British general medical journal Lancet has issued a document stating the multifarious and serious issues created by climate change and how the world has to walk the talk on mitigating its ill effects. 

Among ordinary folk, climate change triggers images of devastating floods, depressing droughts, cyclones, forest fires and other climactic natural disasters. But Lancet makes the point that climate change has deep and multifarious effects on people’s lives across the globe though not always instantly and dramatically.        
Here are some key points from 
the document:     

The year 2022 marks the 30th anniversary of the signing of the UN Framework Convention on Climate Change (UNFCC). But little meaningful action has followed its adoption. The carbon intensity of the global energy system has decreased by less than 1% since the UNFCCC was established. Global electricity generation is still dominated by fossil fuels, with renewable energy contributing only 8·2% to the global total.  

The current strategies of 15 of the largest oil and gas companies would lead to production exceeding levels needed to limit the global average surface temperature rise to 1·5°C by 37% in 2030, and 103% in 2040. Therefore, emissions from the oil and gas sector need to be reduced drastically to enable a healthy future.
The total global energy demand has risen by 59%. The resultant increase in energy-related emissions was a historical high in 2021. But current policies have put the world on track to a catastrophic 2·7°C increase by the end of the century. 

Even if countries implement the commitments that they gave in the Nationally Determined Contributions (NDCs), global emissions could be 13·7% above 2010 levels by 2030. This will be a far cry from the 43% decrease from current levels required to meet Paris Agreement goals.  

The global fossil fuel market is volatile, and during supply disruptions, millions across the world do not get access to the energy needed to keep their homes at healthy temperatures and preserve food and medicines. Even in normal times, 59% of healthcare facilities in low and middle-income countries do not have access to reliable electricity. 

The day when renewable sources will be a major player is still a far cry. In 2020, only 1·4% of electricity came from modern renewables (mostly from wind and solar power).  
In most under-developed countries, the main source of domestic energy is biomass, which is unhealthy. Biomass accounts for as much as 31% of the energy consumed in the domestic sector globally. In low-income countries, the dependence on biomass is as high as 96%. As is well known, biomass creates illnesses of various kinds, such as chronic bronchitis, respiratory issues, and lung infections. 

It is well known that climate change creates floods, droughts and heatwaves. Rapidly increasing temperatures exposed people to 3·7 billion more “heatwave days” in 2021 than between 1986 and 2005 annually. Heat-related deaths increased by 68% between 2000–04 and 2017–21. Of course, the death toll had been significantly increased by the COVID-19 pandemic. 

Heat exposure led to 470 billion “labor hours” lost globally in 2021. Potential income losses were equivalent to 0·72% of the global economic output. The figure went up to 5·6% of the GDP in low Human Development Index (HDI) countries. Extreme heat was associated with 98 million more people reporting moderate to severe food insecurity in 2020 than annually in 1981–2010 in the 103 countries analyzed.

The changing climate is affecting the spread of infectious diseases.  Coastal waters are becoming more suitable for the transmission of Vibrio pathogens which are bacteria that can cause foodborne infection. The number of months suitable for malaria transmission increased by 31·3% in the highland areas of the Americas and 13·8% in the highland areas of Africa from 1951–60 to 2012–21. The likelihood of dengue transmission rose by 12% in the same period. 

Between 2014–21 and 1982–89, because of changes in sea-salt concentrations and temperatures, coastlines suitable for Vibrio pathogens increased from 47·5% to 86·3% in the Baltic; from 30·0% to 57·1% in the US northeast; and from 1·2% to 5·7% in the Pacific Northwest. These are three regions where Vibriosis is regularly reported.

The ongoing seventh cholera pandemic, which started in the 1960s, is responsible for more than 2·8 million cholera cases and 95,000 deaths annually. Although inadequate sanitation is a leading cause, climate conditions are increasingly favoring the survival of Vibrio cholera in natural waters. 
Non-cholera Vibrio bacteria survive in brackish waters. These can cause gastroenteritis, if they enter the body though food. Potentially, lethal wound infections could take place if direct contact is made with contaminated water. 

Extreme weather caused damage to the tune of over US$ 253 billion in 2021, particularly burdening people in low HDI countries. Higher temperatures threatened crop yields directly, with the “growth seasons” of maize becoming shorter by nine days in 2020, and the growth seasons of winter wheat and spring wheat becoming shorter by six days as compared to the period 1981–2010. The threat to crop yields adds to food insecurity across the globe. 
Improvements in air quality would help to prevent 1·2 million deaths resulting from exposure to fossil fuel-derived ambient PM2·5. PM2.5 are tiny particles in the air that affect people’s health when their levels in the air are high. 
Red meat and milk contribute to 55% of global agriculture emissions. Per capita emissions from red meat and dairy consumption are very high in HDI countries. In 2019, 11·5 million deaths were attributable to imbalanced diets, with 17% associated with a high intake of red and processed meat and dairy products. 

Therefore, an accelerated transition to a balanced and more plant-based diets would not only help reduce agricultural sector emissions coming from red meat and milk production, but also prevent up to 11·5 million diet-related deaths annually. It will also substantially reduce the risk of zoonotic diseases. 

Increases in palm oil production account for some of the greatest changes since 2000. Emissions by the palm oil sector in Southeast Asia (mainly Indonesia) increased by over 600%.
But there is light at the end of the tunnel. Signs of change are emerging in the energy sector. Zero-carbon sources accounted for 80% of investment in electricity generation in 2021 Renewable energies have reached cost parity with fossil fuel energies. 

As some of the highest emitting countries attempt to cut their dependence on oil and gas in response to the war in Ukraine and soaring oil and gas prices, many countries are focusing on increasing renewable energy generation, raising hopes for a health-centered response to climate change challenges. 
There is an increase in awareness of the ill effects of climate change. But commitments made in terms of spending and execution should be translated into action urgently, so that hope turns into reality, the Lancet document said.