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Monday, December 5, 2011

Call to action in health

Captions: The ever-popular Martin Khor; No South African event is complete without traditional dancers; Kumi Naidoo moved the audience; Dr Hugh Mongomery and Minister Dr Aaron Motsoaledi

“I doubt there is a more important group at COP17 than you,” said Professor Hugh Montgomery (a founding member of the UK Climate and Health Council and director of the University College London’s Institute for Human Health and performance). “I doubt whether I will ever give a more important talk than this one.”

He was talking to a group of delegates, observers and visitors to the 17th Conference of the Parties running in Durban, South Africa, where governments and corporate interests are negotiating and advocating around climate change. The group comprised roleplayers in health-care worldwide, from nurses to student doctors to NGOs.

Why does he consider them so important? Healthcare professionals were referred to as a ‘sleeping giant’ during this day-long Climate and Health Summit: trusted by society as healthcare providers, they number millions around the globe and could be hugely influential, both in shifting public perceptions and swaying political interests.

The summit was held on 4 December, and organised by Health Care Without Harm, the Climate and Health Council, the World Federation of Public Health Associations, the Nelson R Mandela School of Medicine at University of KwaZulu-Natal and with help from the South African NGO groundwork, addressed.

Professor Montgomery followed South Africa’s Minister of Health Dr Aaron Motsoaledi as keynote speakers, and they as well as other speakers repeatedly spelled out a simple message, yet one that has never yet been so clearly articulated at climate change events: health is the core issue of climate change. Forget sea-level rise and tornadoes and melting ice, the images so over-used in this context: when it comes right down to it, the most important, tragic and costly impact will be on the health of humans (and of course, with them, all other animals and species).

By the end of the day, the group had racked up a first: a declaration from and call to action for all health professionals worldwide to use their considerable clout and societal leverage to fight climate change.

Here’s a few possible consequences for humans which are already being felt around the world, and nowhere more so than in the countries that are home to the world’s poorest:

* Deaths and increased illness from living and working in significantly higher temperatures

* Respiratory disease as a result of the fatal collision of pollutants and rising temperatures, which trigger chemical changes in the air we breathe

* Malnutrition and starvation as crops fail (or are destroyed by extreme weather events, from floods to landslide to cyclones to wildfires – remember Russia’s breadbasket in flames last year?)

* Under-nutrition as food prices rise around the world, and people are forced to make poorer food choices

* Rising incidence of allergens as allergenic plants produce pollen sooner and extend their pollen season as warm weather lasts longer

* Rises in water-borne diseases and those carried by insect vectors which are able to expand their range due to warmer conditions, as well as quicker breeding by diseases like malaria due to more favourable conditions

* More injuries and deaths due to conflicts provoked by migration in search of food or water

… and much more.

These are the risks we face – but there are also benefits, said Professor Montgomery. There is what he called the “convenient truth”: that tackling climate change seriously will entail making real changes to our lifestyles – and it so happens that those changes bring with them enormous public health benefits: reducing our use of cars would mean increasing exercise throughout society as people walk and cycle more; reducing our intake of meat, one of the most ‘expensive’ foods in terms of greenhouse gas production would bring down animal fat intake and improve cardiovascular health; reducing the particulate pollution in the air would mean vastly improved respiratory health across societies.

“Waiting for someone else to do what must be done does not show moral leadership,” Montgomery said. “The talk about delays of eight years is frankly nonsense. If we plan to write a prescription in eight years time, we might well find ourselves writing a death certificate instead.”

Executive director of the South Centre, Martin Khor, closed the plenary session with tough talk that also, in his inimitable style, had everyone laughing. He said we all need to change our way of life and our desires dramatically: “We used to have a shoe to wear; now we have a shoe to go running, a shoe to go jogging – but not running… we all have a little Imelda Marcos in us.” We are squandering resources on what we don’t need today – and in the process, we are ensuring there will be no resources for tomorrow, he said. “We have to change our perception of what life is.” It’s not the wasteful stuff we use that makes up life: “Life is the wealth we have inside of us.”

A highly informative afternoon of parallel sessions was closed by a pair of rousing speeches, one from the premier of the province of KwaZulu-Natal where COP17 is being held, Dr Zweli Mkhize (who said, “What is the problem at these climate change negotiations? It’s the politics of profit…”) Dr Mkhize called for health professionals to find a way to bring research and evidence-based information of changing patterns in health to support advocacy at this and future meetings of its kind.

Kumi Naidoo, our ‘homeboy’ from KwaZulu-Natal who now heads up Greenpeace, drew on his experiences as an activist in South Africa’s struggles to call for a commitment from health professionals and all of civil society to fight climate change. He told the group of a friend of his, Lenny Naidoo (no relation), who was also an anti-apartheid activist, and who asked him once, back in those days, what was the greatest thing he could do for the struggle. Kumi replied, “To give my life for it.”

“You mean to die for it?”


“Wrong answer. The greatest thing you could do is to give the rest of your life for it,” said Lenny. (Ironically, some years later, while in exile, Kumi heard that his friend had been brutally killed by security forces.)

Naidoo asked that we all do exactly that: show our conviction and commitment by giving the rest of our lives to it.

The group made a fine start with a heartfelt and ringing reading of the declaration it had drawn up, followed by a Call to Action:

Given the gravity and urgency of the situation—and the opportunity to promote public health by addressing climate change--we call on our colleagues in public health organizations, health professional associations, hospitals, health systems and ministries of health around the world to endorse this Call to Action and take concerted action.

Having convened at the first Global Climate and Health Summit in Durban, South Africa, we hereby commit to:

1. Provide Leadership: As representatives of our organizations, we will drive the agenda for climate and health, promoting this Call to Action throughout the world.

2. Engage and Inform: We will engage and inform our constituencies of millions of doctors, nurses, public health workers, hospitals, health systems and health policy makers about the health risks from climate change, and the health benefits of climate action. As health professionals, we will also serve as messengers to our patients, our communities and our governments about the major health impacts of climate change and the steps they can take to reverse their impact.

3. Mitigate: We will lead by example and reduce the carbon footprint of our own institutions, practice and activities. We will strive to make our hospitals greener and healthier by reducing waste, investing in energy efficiency and clean energy sources, while promoting sustainable transport and resource consumption. By doing so, we commit to demonstrating how our societies can move toward carbon neutrality.

4. Adapt: We will strive to make our health systems more resilient and capable of withstanding and responding to the human toll of natural disasters and the shifting burden of disease.

5. Advocate Locally and Nationally: We will work within our countries to advocate for emissions reductions and/or low-carbon development strategies that promote both a healthy climate and public health. We will call for solutions that reduce the local health impacts of fossil fuels; solutions that foster clean energy and social justice; solutions that save lives and money while protecting public health from climate change.

6. Advocate Globally: We will advocate for a fair and binding global agreement, as articulated in the Durban Declaration on Climate and Health, that:

* Places the protection of human health as a primary objective of any agreement.

* Establishes an ambitious fair shares framework to reduce global emissions (based on the principles of Equity and Common but Differentiated Responsibilities and Respective Capabilities) in order to avoid a global public health disaster.

* Fosters both energy efficiency and clean, renewable energy that protects public health by reducing both local and global pollution.

* Provides the immediate necessary resources to operationalize the Green Fund, and in the longer term, appropriate mitigation and adaptation funding required to address the health impacts of climate change, assuring all countries’ Rights to Sustainable Development and their ability to pursue a low carbon development pathway.

The matter is urgent. The health of the world’s population is at risk. The time for action is now.

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