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The imperative for global leaders to confront the climate crisis is underscored by the undeniable and escalating impact of climate change on physical and mental health. Despite compelling evidence indicating an imminent catastrophe, leaders assembled at the United Nations Climate Change Conference remain unwilling to acknowledge the critical necessity of phasing out fossil fuels.

The ongoing reliance on fossil fuels not only jeopardizes our health but also propels global temperatures to unprecedented levels. Recent climate-related events, including extreme weather, food insecurity, water scarcity, and heightened air pollution, directly result from greenhouse gas emissions. These consequences, experienced globally, may only foreshadow more severe catastrophes.

The Lancet Countdown report on climate change and health reveals a stark reality. The rising frequency of heatwaves and droughts has exposed 127 million more people to significant food insecurity in 2021 compared to the period between 1981 and 2010. Concurrently, 1.9 million lives are claimed annually due to outdoor air pollution from the combustion of fossil fuels, while infectious diseases like dengue expand to new regions.

Despite 27 years of climate-change negotiations, world leaders remain resistant to recognizing the urgency of phasing out fossil fuels. The draft statement on climate change and health for the upcoming United Nations Climate Change Conference (COP28) in Dubai omits any reference to this critical issue, signaling a concerning disregard for overwhelming evidence.

As countries and companies backtrack on climate commitments, global emissions surge, putting us on a trajectory toward a nearly 3°C temperature increase by 2100, well above the 1.5°C target set by the Paris agreement. The potential repercussions are catastrophic, with a 370% increase in annual heat-related deaths projected by mid-century, disproportionately affecting vulnerable groups like the elderly and children.

The climate crisis extends beyond direct effects on health, undermining societal well-being and the conditions necessary for a healthy population. Extreme heatwaves in 2022 resulted in a global loss of 490 billion working hours. Even if efforts limit global warming to just below 2°C, heat-related labor loss is expected to increase by 50%.

Notably, these effects are unevenly distributed, with regions contributing the least to climate change bearing the brunt of climate-related health risks. Africa, South and Central America, Asia, and small island developing states face disproportionate challenges.

The current pace of global emissions reduction efforts falls short of the Paris agreement’s targets. Energy-based emissions hit a record high in 2022, with renewables accounting for only 9.5% of global electricity. A substantial portion of households worldwide still relies on dirty fuels. In the most climate-vulnerable countries, families depend on polluting fuels for 92% of their domestic energy, exposing residents to toxic indoor air.

Addressing this crisis incrementally is insufficient. Urgently shifting away from fossil fuels is imperative to solving the climate-fueled health crisis. Governments can focus on climate policies that enhance public health and well-being, preventing premature deaths, building resilience, and strengthening economies.

Eleven concrete measures across five priority areas are outlined in our report. Phasing out fossil fuels through a just energy transition is paramount, mitigating health effects and expanding access to clean energy, especially in underserved regions. Simultaneously, adaptation efforts must be accelerated to protect communities already facing health consequences, with collaboration between the health sector, environmental organizations, and meteorological services.

Eliminating subsidies, lending, and investment in fossil fuels creates space for climate financing and supports adaptation in vulnerable countries. The health sector, responsible for 4.6% of global greenhouse gas emissions, can play a direct role in global decarbonization by implementing public-health measures, advocating healthier diets, encouraging active lifestyles, and regulating polluting industries.

COP28 represents a pivotal test of leaders’ commitment to addressing this crisis. A genuine focus on health could drive a swift shift away from fossil fuels and facilitate adaptation. Failure to do so risks a conference that pays lip service to health concerns, perpetuating inaction, and allowing climate-related deaths to increase while a livable future drifts further from reach.