Bericht der Lancet Commission über die Auswirkungen des Klimawandels, 23.6.2015 (engl. Originalfassung)
The 2015 Lancet Commission on Health and Climate Change has been formed to map out the impacts of climate change, and the necessary policy responses, in order to ensure the highest attainable standards of health for populations worldwide. This Commission is multidisciplinary and international in nature, with strong collaboration between academic centres in Europe and China.
The central finding from the Commission's work is that tackling climate change could be the greatest global health opportunity of the 21st century. The key messages from the Commission are summarised below, accompanied by ten underlying recommendations to accelerate action in the next 5 years.
The effects of climate change are being felt today, and future projections represent an unacceptably high and potentially catastrophic risk to human health
The implications of climate change for a global population of 9 billion people threatens to undermine the last half century of gains in development and global health. The direct effects of climate change include increased heat stress, floods, drought, and increased frequency of intense storms, with the indirect threatening population health through adverse changes in air pollution, the spread of disease vectors, food insecurity and under-nutrition, displacement, and mental ill health.
Keeping the global average temperature rise to less than 2°C to avoid the risk of potentially catastrophic climate change impacts requires total anthropogenic carbon dioxide (CO2) emissions to be kept below 2900 billion tonnes (GtCO2) by the end of the century. As of 2011, total emissions since 1870 were a little over half of this, with current trends expected to exceed 2900 GtCO2 in the next 15–30 years. High-end emissions projection scenarios show global average warming of 2·6–4·8°C by the end of the century, with all their regional amplification and attendant impacts.
Tackling climate change could be the greatest global health opportunity of the 21st century
Given the potential of climate change to reverse the health gains from economic development, and the health co-benefits that accrue from actions for a sustainable economy, tackling climate change could be the greatest global health opportunity of this century. Many mitigation and adaptation responses to climate change are “no-regret” options, which lead to direct reductions in the burden of ill-health, enhance community resilience, alleviate poverty, and address global inequity. Benefits are realised by ensuring that countries are unconstrained by climate change, enabling them to achieve better health and wellbeing for their populations. These strategies will also reduce pressures on national health budgets, delivering potentially large cost savings, and enable investments in stronger, more resilient health systems.
The Commission recommends that over the next 5 years, governments:
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1 Invest in climate change and public health research, monitoring, and surveillance to ensure a better understanding of the adaptation needs and the potential health co-benefits of climate mitigation at the local and national level.
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2 Scale-up financing for climate resilient health systems world-wide. Donor countries have a responsibility to support measures which reduce the impacts of climate change on human wellbeing and support adaptation. This must enable the strengthening of health systems in low-income and middle-income countries, and reduce the environmental impact of health care.
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3 Protect cardiovascular and respiratory health by ensuring a rapid phase out of coal from the global energy mix. Many of the 2200 coal-fired plants currently proposed for construction globally will damage health unless replaced with cleaner energy alternatives. As part of the transition to renewable energy, there will be a cautious transitional role for natural gas. The phase out of coal is proposed as part of an early and decisive policy package which targets air pollution from the transport, agriculture, and energy sectors, and aims to reduce the health burden of particulate matter (especially PM2.5) and short-lived climate pollutants, thus yielding immediate gains for society.
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4 Encourage a transition to cities that support and promote lifestyles that are healthy for the individual and for the planet. Steps to achieve this include development of a highly energy efficient building stock; ease of low-cost active transportation; and increased access to green spaces. Such measures improve adaptive capacity, whilst also reducing urban pollution, greenhouse gas emissions, and rates of cardiovascular disease, cancer, obesity, diabetes, mental illness, and respiratory disease.
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6 Rapidly expand access to renewable energy in low-income and middle-income countries, thus providing reliable electricity for communities and health facilities; unlocking substantial economic gains; and promoting health equity. Indeed, a global development pathway that fails to achieve this expansion will come at a detriment to public health, and will not achieve long-term economic growth.
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7 Support accurate quantification of the avoided burden of disease, reduced health-care costs, and enhanced economic productivity associated with climate change mitigation. These will be most effective when combined with adequate local capacity and political support to develop low-carbon healthy energy choices.
The health community has a vital part to play in accelerating progress to tackle climate change
Health professionals have worked to protect against health threats, such as tobacco, HIV/AIDS, and polio, and have often confronted powerful entrenched interests in doing so. Likewise, they must be leaders in responding to the health threat of climate change. A public health perspective has the potential to unite all actors behind a common cause—the health and wellbeing of our families, communities, and countries. These concepts are far more tangible and visceral than tonnes of atmospheric CO2, and are understood and prioritised across all populations irrespective of culture or development status.
Reducing inequities within and between countries is crucial to promoting climate change resilience and improving global health. Neither can be delivered without accompanying sustainable development that addresses key health determinants: access to safe water and clean air, food security, strong and accessible health systems, and reductions in social and economic inequity. Any prioritisation in global health must therefore place sustainable development and climate change front and centre.
The Commission recommends that over the next 5 years, governments:
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8 Adopt mechanisms to facilitate collaboration between Ministries of Health and other government departments, empowering health professionals and ensuring that health and climate considerations are thoroughly integrated in government-wide strategies. A siloed approach to protecting human health from climate change will not work. This must acknowledge and seek to address the extent to which additional global environmental changes, such as deforestation, biodiversity loss, and ocean acidification, will impact on human health and decrease resilience to climate change.
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9 Agree and implement an international agreement that supports countries in transitioning to a low-carbon economy. Whilst the negotiations are very complex, their goals are very simple: agree on ambitious and enforceable global mitigation targets, on adaptation of finance to protect countries' rights to sustainable development, and on the policies and mechanisms that enable these measures. To this end, international responsibility for reducing greenhouse gas emissions is shared: interventions that reduce emissions and promote global public health must be prioritised irrespective of national boundaries.
Responding to climate change could be the greatest global health opportunity of the 21st century.
To help drive this transition, the 2015 Lancet Commission on Health and Climate Change will:
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10 Develop a new, independent Countdown to 2030: Global Health and Climate Action, to provide expertise in implementing policies that mitigate climate change and promote public health, and to monitor progress over the next 15 years. The Collaboration will be led by this Commission, reporting in The Lancet every 2 years, tracking, supporting, and communicating progress and success along a range of indicators in global health and climate change
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Achieving a decarbonised global economy and securing the public health benefits it offers is no longer primarily a technical or economic question—it is now a political one
Major technical advances have made buildings and vehicles more efficient and renewable energy sources far more cost effective. Globally, there is plentiful financial resource available, however much of it is still being directed towards the fossil-fuel industry. Bold political commitment can ensure that the technical expertise, technology, and finance to prevent further significant climate change is readily available, and is not a barrier to action.
The Commission recommends that over the next 5 years, governments:
Establish the framework for a strong, predictable, and international carbon pricing mechanism.