“We know what we need to do to avoid severe climate change. We know how to get it done. We have the technology, and we can afford it. But we don’t have the political will.” That’s the message I remember most clearly from the BMJ’s conference on climate change, and sadly as a human being with all the evolutionary defects of our species I see our failure inside myself. This is not a comfortable state.

The speaker who gave the message may have exaggerated a little. It seems that if we want to keep global temperature rise to no more than 2°C then we need to see global carbon emissions fall within about three years. Ultimately we need to reduce carbon emissions from 768 units per unit of global gross domestic product to 8. (I may not have got this entirely right, but it doesn’t matter too much: the point is that we need a very substantial reduction, much larger than most of us begin to grasp.)

“Business as usual” will by the end of the century lead to a rise of 5°C, a figure that may well disrupt our fragile and highly interdependent ecosystem (our “life support system”) to such an extent that human life will not be possible. Even meeting all the current agreed targets on carbon reduction is estimated to produce a rise of 4.3°C, a figure that would see London, New York, Mumbai, Shanghai, and Hong Kong, all global financial centres, under water.

Unfortunately we cannot be sure that a rise of 2°C will see us safe. Indeed, we are seeing the effects of climate change already. Tens of thousands have already died from extreme weather events, drought, flooding, starvation, infectious disease, and war. The civil war in Darfur, drought in Somalia, and the melting of the Arctic are all consequences of climate change.

I’ve been attending conferences on the health effects of climate change for nearly 20 years, and until comparatively recently we talked mostly about infections like malaria, dengue fever, and schistosomiasis extending their range and high death rates during heat waves. Now we realise that much more death and suffering will come from hunger, drought, flooding, mass migration, and war. That’s why the conference was about health and security.

Although we few may have been discussing the health effects of climate change for 20 years, we heard from several speakers that it came as a revelation to many politicians that climate change had health effects. How, I wondered, could this possibly be?

When we were told that we know how to do what needs to be done that too may have been something of an exaggeration, but determined introduction of sustainable sources of power, drastic changes in transport (“Let’s ban cars from central London tomorrow,” said one enthusiast), transforming agriculture (an end to meat eating), and insulating and improving housing and other buildings would take us a long way. And Lord Stern in his report told us that we could afford it—or at least that we couldn’t afford not to do it.

But there is not the political will to make all this happen. Indeed, climate change is lower on the political agenda than it was a few years ago—not least because politicians are understandably preoccupied with the global financial crisis. What’s more, the main answer to our immediate crisis is economic growth, something that will hasten global warming unless we go for a very different form of growth.

The climate change deniers have also been very successful. Funded by groups like the oil, power, and car companies, they have, we were told, consciously copied the techniques of the tobacco industry. Their main weapon is doubt. As a tobacco memo from 1969 said: “Doubt is our product, since it is the best means of competing with the ‘body of fact.’” Ironically doubt is also central to science: “In God we trust, all others bring data.” The vast majority of scientists may agree that climate change is real, manmade, and will have catastrophic consequences without urgent action, but there will always be some reputable doubters. And there are many examples of where orthodox scientific opinion has been wrong, so doubt is a very powerful weapon to use against issues like climate change where most of the evidence depends on science. Further, the science of climate change is much more complicated than the science of the harmful effects of tobacco, and the climate change deniers were handed a gift by the poor behaviour of the East Anglia climate scientists. A respected journalist told us at the meeting that the media had lost interest in climate change after what happened in East Anglia.

Doubt is also powerful because the favourite method of discourse of the media and of other institutions (law, parliament) is debate—where two sides try to do each other down. It’s easy for the media to find two scientists taking opposite views on climate change–not least because the vested interests support scientists who deny climate change and employ public relations companies to push them to the media. The public then hears a debate where two scientists take opposing views and understandably decides that the science is unclear. The effect is so strong that most Republican candidates for the US presidency, people of high education with easy access to scientific advisers, don’t believe that climate change is manmade and will have catastrophic consequences if unchecked.

Indeed, most “scientists,” most of who are not climate scientists and have not examined the raw data themselves may doubt the serious consequences of climate change. I, of course, have not examined the raw data myself. Nor have I read any original papers on climate change. Rather I have listened to dozens of scientists and respected the opinions of the Intergovernmental Panel on Climate Change, the Royal Society, and the National Academy of Sciences. It is in some sense “unscientific” of me to accept the opinions of these authorities without doubting what they say and examining the evidence for myself. 

The other strategies of the tobacco lobby were to talk repeatedly of tax increases, something that most people dislike. In the context of climate change this strategy emerges as talk not only about tax increases but also about how action on climate change and economic progress are opposites, between which a choice must be made. Unsurprisingly most people and politicians opt for economic development.

The end result of all this obfuscation is that most people don’t believe that climate change is real and almost nobody grasps the urgency and the seriousness of the problem. It thus becomes impossible for a politician in a democracy to insist on the drastic actions that are needed.
 There was much talk at the meeting of the need to “find a story” that would convince the public of the gravity of our predicament and the need to have it “professionally told.” Somebody suggested that the right story was “the oldest story of all,” the expulsion of Adam and Eve from the Garden of Eden. Somebody else pointed out that the oldest story of all was actually that of Gilgamesh, who boldly slayed a monster and was well rewarded. There seemed to be agreement that a story that would mobilize the public would need a happy ending—that a story of simply avoiding an extremely unhappy ending (like the extinction of humanity) would not suffice. Ultimately the view was that many stories not just one were needed, but nobody at that conference knew what the stories were.

 We groped our way to the awful conclusion that human beings are insufficiently evolved to cope with this impending disaster that will cause mayhem for most of us not tomorrow but some 20 to 30 years from now—when many of us at that meeting will be dead.

Our resistance to making the changes we need to make lies within ourselves, within our own human failings. Exhibit A is myself. In 1980 I heard green economists argue that unfettered growth could lead only to disaster in a finite world. I joined the Ecology Party and collected wastepaper in Wandsworth, but I quit when I couldn’t see clearly enough the connection between what I was doing and a better world. In 1993 I wrote in the BMJ: “We must rethink how we transport ourselves, what we eat…how many children we have, and how we live.”  In another editorial in the BMJ I wrote in 1994: “Action is needed because of the high probability of serious harm to health…[we must] live less environmentally damaging lives.” Since then I’ve been to dozens of meetings on climate change, but what I have actually done—apart from spin thousands of words on the topic.

The sad answer is—go on, say it—“nothing.” In the two weeks before the meeting I’d flown to Barcelona to give two talks and to Bangladesh for the day (really) for an important meeting. Since the BMJ meeting I’ve been in Madrid, and tomorrow I fly to Washington. “My reasons” are that “I can’t do global health and spend all my time in a basement in Clapham” and “the planes will go whether I’m on them or not.” This last excuse may be particularly important because it illustrates our difficulties in acting both alone and together. I’m yet another human lemming.

I have a gas guzzling car, an old Saab, that I haven’t changed because it’s too much hassle and too boring—I’d rather spend my time writing about the horrors of climate change. I console myself that I hardly ever drive. Nor have I changed my 25 year old boiler. I did have our five story house looked over to see how it could be made greener, but I didn’t ever get round to making the changes.

Perhaps I’m the most pathetic and hypocritical person on the planet, but I doubt it. Human beings are full of defects. I think of the experiments that show that most people will torture others to get them to do what their masters want them to do and that if a woman is attacked in a crowded place most people will do nothing.

Darwin’s theory of evolution was so uncomfortable to the Victorians not only because it made God and an afterlife much less probable but also because it made clear that humans would become extinct just like all other species. That time may be close.

Much has already been written and published about the BMJ meeting, including a piece by Fiona Godlee and a blog by Julian Sheather. You can also capture much of the conference by accessing the hashtag #healthandsecurity on Twitter. I’ve posted some 30 Tweets. My piece is wholly superfluous, but I needed to write it as a penitent needs to confess.

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.