New alliance of Royal Colleges to tackle climate change 

Written by Simon Lenton

 

I am drafting this article on 13 August which by some strange coincidence is "Earth Overshoot Day"; the day in 2015 when the human race outstripped its annual biological footprint and enters ecological debt. Every year since the mid-1970s this day gets earlier in the year and by the end of this year the projection is that the world will consume more than 1.6 planets worth of natural resources. What will be the impact for children and health services in the future and how should we respond?

Virtually all human activity consumes resources (energy, minerals, food etc) in the process of creating goods or providing services, which simultaneously also creates undesirable social and environmental consequences. Climate change now constitutes the biggest threat to human health in the lifetime of children being born today.

Carbon dioxide production from carbon derived energy sources is by far the largest contributor to the problem and after years of denial, climate change is now accepted as a real phenomenon as exemplified by the statements from the following authorities:

“warming of the climate system is unequivocal, as is now evident from observation of increases in global average air and ocean temperatures, widespread melting of snow and ice and rising global average sea level” (Intergovernmental Panel on Climate Change)

“current global trends in energy supply and consumption are blatantly unsustainable-environmentally, economically and socially” (International Energy Agency)

“Health impacts will be disproportionately greater in vulnerable populations including the very young, the elderly and the medically infirm” (World Health Organisation)

The debate has now switched to how large will be the impact and what the solutions might be. All of the predictions suggest at least a 2°C rise in global temperatures is inevitable, with a 4° C rise having severe, sustained and irreversible consequences. The economic impacts of global climate change have been extensively studied and the Stern Report (2006) concludes that "major action early far outweighs the consequences of inaction". Interestingly he describes climate change as the "greatest and widest-ranging market failure ever seen" which presents a unique challenge since the neo-libertarians believe a free market is the solution to most world problems! 

This vicious cycle has to be reversed if people and the planet are going to happily coexist in the future. Medicine must be more than saving lives when illness or injury presents. The first rule is to “do no harm” and this applies equally to whole health systems as it does to individuals. Public health medicine is all about making the right investment decisions to protect against hazards and to promote well-being. 

The health impacts of climate change have not received the same attention as the economic impacts. Fortunately the Lancet Commission on Managing the Health Effects of Climate Change has recently been published ahead of the United Nations Climate Change Conference being held in Paris December 2015, with the objective to highlight the health impacts of climate change. These include both direct and indirect effects coupled with greater inequalities.

Direct effects

1. exposure to the sun's radiation-sunburn, melanoma, heatstroke

2. extreme weather events-drowning, injuries, diarrhoea and dehydration

3. changing disease distribution-especially vector borne diseases

4. changing air pollutants-respiratory disease

Indirect effects

1. food-reduced crop production

2. sea level rise-migration from flooded areas

3. changing rain precipitation-causing drought, leading to migration

4. political-greater inequalities, food and water shortages-civil unrest

Increased inequalities

The impacts of global climate change will not be experienced equally. The greatest burden will be on those who have contributed least to carbon emissions meaning the resource poor countries. Climate change effects will also be felt by our grandchildren thereby creating intergenerational inequity.

Action

Motivating individuals to take a long-term perspective when making everyday decisions is difficult in a society that is increasingly consumerist and short-term in its thinking.  However most paediatricians, especially those with children, desire a better future for their children and an improved quality of life for themselves.  Harnessing this universal human concern and creating a practical agenda for sustainable development at a local level is potentially feasible and largely unexplored. 

There are major health benefits for adopting sustainable low carbon living strategies into our personal lives in terms of reducing diabesity, risk of cardiac conditions and respiratory illness. Now is the time for paediatricians to promote “today’s decisions for tomorrow's children” for themselves, their families they serve and the organisations in which they work.

  • Increased walking and cycling.
  • More vegetarian meals.
  • Improved insulation at home.
  • Decrease in central heating temperatures.
  • Monitor energy use at home.
  • Fly less frequently.

Likewise health systems must adapt. The long-term intentions of health systems are to improve health, reduce inequalities and promote sustainability but in practice current methods of service delivery substantially contribute to climate change. The time has come to consider how health services can become part of the solution rather than part of the problem. 

  • Reduce patient journeys through improved integrated care.
  • Heat recycling in hospitals.
  • Green new building designs.
  • Combined heat and power generation.
  • Car-sharing, walk and cycle to work schemes.
  • Local procurement and reducing food miles.
  • Improved recycling, less packaging, more reusable products.
  • Monitoring energy use, comparative measures between health sectors.

New Alliance of Royal Colleges 

To increase public awareness and to engage with government, many Royal Colleges are coming together to enable their collective memberships to better understand sustainable development in order to tackle climate change. Health professionals retain a high degree of public trust and it is hoped that the NHS will lead through example in reducing its carbon footprint.

This alliance is beginning to take shape to:

1. become the UK authoritative body in relation to the health risks posed by climate change,

2. develop clearly defined policy expectations of government prior to the Paris summit,

3. focus on interventions to improve the quality of life of patients and NHS staff 

4. reduce the carbon footprint of the NHS (circa 10% of UK carbon emissions)

Specific programs could include:

1. disinvestment in the fossil fuel business, reinvestment in renewables

2. improve air quality,

3. reduce waste and the use of natural resources used in healthcare,

4. promote active lifestyles.

The Alliance is due to formally launch early 2016, but will be actively contributing to discussions at the Sustainable Innovation Forum (SIF15) within the annual Conference of Parties (COP) in Paris in December see http://www.cop21paris.org/

References

Global Footprint Network http://www.overshootday.org/

Haines A, Kovats RS, Campbell-Lendrum D, Corvalan C. Climate change and human health: impacts, vulnerability, and mitigation. Lancet. 2006 Jun 24;367(9528):2101-9

Lancet commission

Lancet and University College London Institute for Global Health Commission. Managing the health effects of climate change. The Lancet Vol 373 May 16, 2009 1693

World Health Organization. Climate Change and Human Health - Risks and Responses. Summary. Geneva: WHO, 2003. 

Patz JA, Campbell-Lendrum D, Holloway T, Foley JA. Impact of regional climate change on human health. Nature. 2005 Nov 17;438(7066):310-7

Simon Lenton

Consultant Paediatrician in Community Child Health, Bath (retired)

BACAPH co-chair

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