A first-ever WHO initiative to join global negotiations on a plastics treaty, as well as the first WHO decision on climate and health since 2008, are set to come before the World Health Assembly in May, following a strong show of member state support for both measures on the closing day of this week’s Executive Board meeting in Geneva. 

The draft decision on climate change and health, led by eight member states, including Peru, Kenya, the United Arab Emirates and the United Kingdom, reflects the wealth of new evidence on the linkages between climate and health that have come to light over the past 16 years. The draft includes an estimated 5% contribution of the health sector to climate emissions, although that data also remains bracketed leaving in question if it will be included in the final draft. 

With regards to a treaty on plastics pollution, currently being negotiated under the leadership of the UN Environment Programme (UNEP), WHO told EB members that it wants to address health aspects of that long-neglected agenda in the context of the plastic treaty negotiations.  

It proposes that the agency provide formal health-related inputs into the new treaty instrument, including about particularly hazardous plastics or polymers that should be phased out, as well as playing an active role in a UN science-policy panel on plastics pollution. 

Both the climate and the plastics initiatives appeared to garner wide support from the 34-member Executive Board, as well as member states observing the proceedings from across the Americas, Europe, Asia and Africa.

“We support the WHO to take a more active role in global chemicals management to protect human health,” including inputs to the plastics treaty now being negotiated on “the importance of the issue of plastic pollution, chemicals and microplastics and potential harmful implications” to health,” said  Switzerland, speaking on behalf of nine member states, including Canada, Colombia, Costa Rica, Excuador, El Salvador, Mexico,Panama and Norway. 

One member state, Russia, however, voiced strong objections to the twin initiatives. Climate change is already a part of WHO’s programmes; addressing the health issues related to plastics pollution goes beyond WHO’s mandate, Russia’s representative to the EB said. 

Civil society complains about lack of reference to fossil fuels  

At the same time, a range of non-state actors rapped the WHO member states for failing to even refer to “fossil fuels” as a driver of climate change in the draft climate and health decision, with one NGO suggesting that WHO should treat fossil fuels like tobacco.

“We urge member states to take a stand against the fossil fuel industry and its influence as done with the tobacco industry,” said one NGO, Public Services International. The agency’s remarks were echoed by at least three other civil society groups but by few member states.

The NCD Alliance asked member states to incorporate language in the draft decision “calling for reductions in fossil fuel use as the most significant driver of climate change and air pollution.” 

Responding to those remarks, WHO Director General Dr Tedros Adhanom Ghebreyesus, described fossil fuel phase out as “crucial.”  But he stopped short of explicitly asking that such a reference be included in the draft decision being negotiated.  

“What was agreed during the COP28, the phase out of fossil fuels is very, very crucial,” Tedros said. “And that’s not without reason, because fossil fuels contribute more than 70% of greenhouse gas emissions – fossil fuels, meaning oil, natural gas and coal. 

“So that’s where the focus should be in order to get the 1.5 degrees centigrade [ceiling of global warming]. That was already agreed. So thank you so much for underlining the importance of focusing on fossil fuels, and as many of you have rightly said, there is a good reason to do that.” 

With respect to tobacco and fossil fuels, the Maldives highlighted the inter-linkages between the issues in more than just rhetoric. 

“The huge amount of plastic waste produced by the tobacco industry, some of which are disposed with their deadly chemical content, must be addressed in this treaty in a way that does not allow the tobacco industry to greenwash their tactics.” stated the Maldives delegate, commending WHO for its “comprehensive and … focused approach in supporting vulnerable nations” on both climate and plastics pollution. 

Tame, but still urging a more proactive stance  

Indeed, the new WHA initiatives create a much broader scope for action on interlinked climate and plastic pollution issues, even if the framing and terms used reflect delicate balance of member state interests and the organization’s inherent political conservative. 

Some 20% of fossil fuels production eventually winds up as plastics products, highlighting the synergies that exist between unsustainable energy production and unsustainable  consumption and disposal of plastics products.  

WHO’s 2008 resolution on climate and health focused only on a very brief, discrete set of issues related largely to health “vulnerability” to climate change and “adaptation” measures the health sector could promote. The new draft decision carves out new territory, even if hesitantly, urging health actors and health systems to play a more proactive role in the climate policy arena. 

That includes not only active initiatives to reduce health sector emissions, but public awareness-raising about the “interdependence between climate change and health,” as well as intersectoral  “engagement in the development of climate and health policies, fostering recognition of health co-benefits and sustainable behaviour…” that address “ the root causes of climate change.” 

Finally, the draft document calls upon WHO to clean up its own house by “firmly integrating climate across the technical work of the WHO at all three levels” and develop a “Roadmap to Net Zero by 2030 for the WHO Secretariat, in line with the UN Global Roadmap.” That will be a big lift for an agency whose pre-pandemic carbon footprint was one of the largest in the UN family – from air travel to routine procurement of heavy-duty diesel vehicles for regional and country offices. 

“We’re not talking about the future. It’s about now,”  declared Tedros with respect to the initiatives, saying that, “both mitigation and adaptation is key.”

He said: “We need to push while saying that, by the way, the health sector also contributes 5% [of GHGs]. And that’s why we should start from the health sector as well.”

Greening health systems 

Indeed, the boldest feature of the draft WHA decision is the explicit request to WHO to support member states’ development of “decarbonization” of “health systems, facilities and supply chains.” 

That “request” also refers in detail to the long chain of climate impacts associated with the enormous quantities of water, energy, food, medical equipment, drugs and chemicals that modern health facilities consume, and the waste and emissions they produce.  

The draft promotes further development of an “Alliance for Transformative Action on Climate and Health (ATACH),” a new WHO-led platform on development of sustainable health systems.

ATACH, launched in June 2022, has gained further traction since WHO helped lead the first-ever Health Day in December 2023 at the UN Climate Conference in Dubai. Some 75 countries are now committed to creating “low-carbon health systems” and 29 countries even setting net zero targets for sometime between 2030 and 2050.   

But limiting GHG emissions of health systems should only be promoted “when doing so does not compromise health care provision and quality, in line with relevant WHO guidance,” the draft decision recommends. 

The draft text also remains full of brackets, suggesting continued member state disagreements on the fine points of language linking climate action to factors like “healthy environments … more sustainable life choices” and “air quality,” and even to longstanding legal agreements like the United Nations Framework Agreement on Climate Change and the 2015 Paris Climate Agreement.  

More attention to noncommunicable diseases 

Norway, the US, and a number of non-state actors also underlined the importance of climate impacts on non-communicable disease, particularly with regards to extreme heat, with the NCD Alliance calling on member states to include reference to NCDs, as well as to fossil fuels, in the new WHA climate decision. 

We hear you Norway 👏
"People living with #NCDs have increased risks of mortality due to heat & other climate-related extreme events," @NorwayInGeneva at #EB154.
👏Also, highlighted the need for synergies between environment, economy & health, and multi-sectoral collaboration. pic.twitter.com/r74Q5FV7Lx

— NCD Alliance (@ncdalliance) January 27, 2024

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