Editors called on governments to take emergency action to tackle the “catastrophic harm to health” from climate change.

A joint editorial said that while recent targets to reduce emissions and conserve biodiversity are welcome, they are not enough and need to be matched with credible short and longer term plans.

The editorial was published simultaneously on 6 September in 233 international titles including The British Medical Journal, The Lancet, the New England Journal of Medicine, the East African Medical Journal, the Chinese Science Bulletin, The National Medical Journal of India, and the Medical Journal of Australia.

It was published just prior to the United Nations General Assembly and the United Nations Climate Change Conference (COP26) in Glasgow.

Here is an abridged version of the editorial:

We – the editors of health journals worldwide – call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature, and protect health.

Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs that health professionals have been bringing attention to for decades.

The science is unequivocal: a global increase of 1.5°C above the pre-industrial average and the continued loss of biodiversity, risk catastrophic harm to health that will be impossible to reverse.

Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions.

Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.

The risks to health of increases above 1.5°C are now well established. Indeed, no temperature rise is “safe”. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50 per cent.

Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.

Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities, and those with underlying health problems.

Thriving ecosystems are essential to human health, and the widespread destruction of nature, including habitats and species, is eroding water and food security and increasing the chance of pandemics.

No country, no matter how wealthy, can shield itself from these impacts.

Allowing the consequences to fall disproportionately on the most vulnerable will breed more conflict, food insecurity, forced displacement, and zoonotic disease – with severe implications for all countries and communities. As with the COVID-19 pandemic, we are globally as strong as our weakest member.

Global targets are not enough

Targets to reach net-zero emissions are easy to set and hard to achieve. They are yet to be matched with credible short and longer term plans to accelerate cleaner technologies and transform societies.

Emissions reduction plans do not adequately incorporate health considerations.

Concern is growing that temperature rises above 1.5°C are beginning to be seen as inevitable, or even acceptable, to powerful members of the global community. Relatedly, current strategies for reducing emissions to net zero by the middle of the century implausibly assume that the world will acquire great capabilities to remove greenhouse gases from the atmosphere.

This insufficient action means that temperature increases are likely to be well in excess of 2°C, a catastrophic outcome for health and environmental stability. This is an overall environmental crisis.

Health professionals are united with environmental scientists, businesses, and many others in rejecting that this outcome is inevitable. We join health professionals worldwide who have already supported calls for rapid action.

Equity must be at the centre of the global response. Contributing a fair share to the global effort means that reduction commitments must account for the cumulative, historical contribution each country has made to emissions, as well as its current emissions and capacity to respond.

Wealthier countries will have to cut emissions more quickly, making reductions by 2030 beyond those currently proposed and reaching net-zero emissions before 2050. Similar targets and emergency action are needed for biodiversity loss and the wider destruction of the natural world.

To achieve these targets, governments must make fundamental changes to how our societies and economies are organised and how we live.

Many governments met the threat of the COVID-19 pandemic with unprecedented funding. The environmental crisis demands a similar emergency response. Huge investment will be needed, beyond what is being considered or delivered anywhere in the world. But such investments will produce huge positive health and economic outcomes.

These include high-quality jobs, reduced air pollution, increased physical activity, and improved housing and diet. Better air quality alone would realise health benefits that easily offset the global costs of emissions reductions.

Cooperation hinges on wealthy nations doing more

In particular, countries that have disproportionately created the environmental crisis must do more to support low- and middle-income countries to build cleaner, healthier and more resilient societies. Funding must be equally split between mitigation and adaptation, including improving the resilience of health systems.

As health professionals, we must do all we can to aid the transition to a more sustainable, fairer, more resilient and healthier world.

We must hold global leaders to account and continue to educate others about the health risks of the crisis. We must join in the work to achieve environmentally sustainable health systems before 2040, recognising that this will mean changing clinical practice.

The greatest threat to global public health is the continued failure of world leaders to keep the global temperature rise below 1.5°C and to restore nature.

Urgent, society-wide changes must be made and will lead to a fairer and healthier world.

We, as editors of health journals, call for governments and other leaders to act, marking 2021 as
the year that the world finally changes course.

Read the full editorial