Climate breakdown, “the greatest threat to global health of the 21st century” is driven by the same political and economic systems that are exacerbating health inequities, so starkly amplified by covid-19. The UK Government’s recent announcements appear to acknowledge the imperative to tackle the “twin problems of social inequalities and climate change.” However promises of a “green industrial revolution”, or last week’s “ambitious” emissions reductions pledge, fail to acknowledge the true scale of the challenge, or of the UK’s historical responsibility. As the UK prepares to host the 26th Conference of Parties to the UN Framework Convention on Climate Change (COP26)—the first global reassessment of emissions reductions commitments since the signing of the Paris Agreement in 2015—it should show true ambition in adopting policies that prioritise the health and wellbeing of people and planet. Over 1000 UK health workers and students have recently presented three key demands, described below, to put health and climate justice at the heart of COP26. 

The need for a just and historically accurate nationally determined contribution

The stark injustice of climate breakdown is that the communities most vulnerable to its effects have contributed least to emissions. This places responsibility for mitigation on those who have benefited most from unsustainable exploitation of our common atmosphere. The UK’s present affluence is a direct consequence of its colonial and industrial legacy, making it the 6th greatest source of historical emissions since 1850—and historically the highest emitter per capita globally. 

A just commitment to emissions reductions should acknowledge three considerations: the need to limit warming to 1.5C above pre-industrial levels; the historical responsibility of different states for current global heating; and the consequent economic capacity to support emissions reductions. Taking these factors into account, the UK’s “fair share” of emissions reductions goes far beyond last week’s pledge of a 68% reduction (relative to 1990 levels) by 2030; fairly accounting for the UK’s climate debt would require a 200% reduction by that time. This would entail not only a zero-carbon domestic economy, but funding of low-carbon development in communities presently threatened by climate breakdown.  

The call to cancel all future fossil fuel extractive projects

Meeting this goal requires immediate and rapid decarbonisation. Yet the UK continues to invest heavily in fossil fuels. Subsidies to fossil fuel companies vastly outweigh those for renewables; new extractive projects like the Woodhouse Colliery in Cumbria continue to receive public support; and UK Export Finance continues to fund new fossil fuel extraction internationally, to the tune of £2 billion in 2018 (compared to just  £700,000 spent on renewable projects). 

This investment increases emissions, perpetuates reliance on fossil fuels, and can be detrimental to local populations.  Investing in these projects locks in carbon dependence and is incompatible with restricting global heating to 1.5˚C. Just continuing to exploit existing projects will take us beyond this limit. These investments also represent a missed opportunity to invest in renewables, rapidly becoming the cheapest energy sources for most of the world. Investing in a just transition to a low carbon economy could revitalise areas of the UK suffering unemployment due to the loss of heavy industry.

The demand for a fossil free COP26

The fossil fuel industry is disproportionately responsible for anthropogenic climate change, accounting for 71% of global greenhouse gas emissions in recent years. Business plans of the largest carbon majors predict increasing GHG emissions. Even “front runners” amongst the oil majors invest only 3% total capital expenditure on renewables, while advocating for mitigation policies that justify inaction and shifting costs of climate change onto the Global South and future generations.

Exploiting the same tactics as the tobacco industry, the fossil fuel industry has played a major role in funding denial of climate science and has used its considerable political influence to undermine national and international climate mitigation policy. Oil companies have sought to lobby and influence the UK government in the build up to, and at, COP26, and the first round of sponsorship for COP26 includes fossil fuel funders and carbon-intensive power companies.

Just as the WHO Framework Convention on Tobacco Control (FCTC) works to insulate all tobacco control policy from industry influence, reducing its social and political capital, so too should the health sector work to promote effective climate policy by insulating the COP26 from carbon-intensive industries.

A call to action

As part of the health community, we must do more than provide care. The climate crisis is already having devastating impacts on people’s health and the communities least responsible are suffering most. The proposals presented here outline some of the actions required for a just transition and rapid decarbonisation that safeguards the health of people and planet. The UK government should show ambition commensurate with its historical responsibility for climate breakdown, and centre health and climate justice at COP26. 

Alistair Wardrope, Academic Neurology Unit, University of Sheffield; Department of Clinical Neurology, Sheffield Teaching Hospitals NHS Foundation Trust. Alistair is a Medact member and receives funding from NIHR. 

Alison Chisholm, Nuffield Department of Primary Care Health Sciences, University of Oxford and member of Medact Climate and Health Research Group. @AlisonChisholm7  

Tess Elliott, GP partner in leeds. Member of Medact’s Climate & Health Research Group. 

Rhiannon Osborne, University of Cambridge School of Medicine. This author is also the Policy and Advocacy Director at Students for Global Health UK and an Independent Commissioner for the Cambridgeshire and Peterborough Independent Commission on Climate. @rhiannon_osborn

Bethan Page, Gloucestershire Hospitals NHS Foundation Trust. Bethan is a Public Health Specialty Registrar in the South West Training Programme and a member of Medact’s Climate & Health research group. Twitter handle: @bethan_page. 

Aditi Babel, Foundation Doctor at Leeds Teaching Hospital Trust, member of Medact’s Climate and Health Research Group

Ben Eder, Climate & Health Campaigner at Medact. @beneder