COP28 and Global Health

COP28 and Global Health

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INSIGHTi

COP28 and Global Health
December 8, 2023
In 1995, delegates from Parties and observer States to the 1992 United Nations Framework Convention
on Climate Change met in Berlin, Germany, for the first Conference of the Parties (COP) to identify and
assess climate measures under the agreement. Subsequent COP meetings have reassessed progress and
priorities annually. At the 28th COP, which opened on December 2, 2023, the COP28 Presidency and the
World Health Organization (WHO) announced the COP28 UAE Declaration on Climate and Health (the
Declaration). Signed by over 120 countries, including the United States, the Declaration marks the first
time governments explicitly acknowledged climate-health issues. COP28 included the first ever Health
Day and marked the first time that Health Ministers officially convened at the UN climate conference
alongside their peers from Environment Ministries. Congress has expressed significant interest in
strengthening global health systems to better detect, prepare for, and respond to epidemics. Several
Members of Congress are participating in COP28, and Congress may be interested in what types of
commitments, if any, U.S. delegates make toward addressing these concerns.
The relationship between climate change and global health is increasingly evident in research. According
to WHO, climate change is directly affecting health (e.g., injury or death from heatwaves and other severe
weather events) and indirectly contributing to increases in deaths and illness from noncommunicable
diseases (including asthma, heart and lung disease, and malnutrition) and the spread of infectious diseases
(including cholera, malaria, and dengue). The Intergovernmental Panel on Climate Change estimates that
almost 4 billion people currently live in areas highly susceptible to climate change, increasing their
vulnerability to food and water scarcity, as well as the aforementioned health conditions. Recent studies
estimate that infants and adults older than 65 years are now exposed to twice as many days of life-
threatening heat as they would have experienced in 1986-2005, and heat-related deaths of people older
than 65 years have increased by 85% compared with 1990-2000. A study published in 2022 found that air
pollution had caused 9 million deaths in 2015, and the World Food Program posited that 1.7 billion people
had been affected by extreme weather and climate-related disasters between 2012 and 2022. Further,
global land area affected by extreme drought increased from 18% in 1951-60 to 47% in 2013-22,
threatening water security, sanitation, and food production. The National Institutes of Health has noted
that “although climate change will likely increase positive health outcomes in some regions, the overall
balance will be detrimental for health and well-being, especially in low-and lower-middle income
countries that experience higher burdens of climate-sensitive health outcomes.” Figure 1, created by the
U.S. Centers for Disease Control (CDC), illustrates direct and indirect impacts of climate change on
human health.
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Figure 1. Climate-Health Impacts

Source: CDC, Climate Effects on Health, accessed on December 4, 2023.
Global Funding for Climate-Health
Some countries have identified health as a “high-priority sector vulnerable to climate change” in their
National Adaptation Plans. A 2021 WHO survey noted that 70% of surveyed countries identified
insufficient financing as a barrier to implementation of climate-health elements of NAPs. The United
Nations estimates that by 2050 approximately $26.8–29.4 billion annually will be spent on climate
change adaptation activities related to health; the World Bank estimates that sub-Saharan Africa will incur
80% of related global health costs. According to WHO, 0.5% of multilateral climate funding is currently
allocated to health specific projects. On December 2, 2023, international and civil society organizations,
including multilateral development banks, the Green Climate Fund, the Global Fund to fight AIDS, TB
and Malaria, and WHO published nine guiding principles for mobilizing financing for climate and health
solutions.
U.S. Funding and Responses for Climate-Health
Congress might be interested in the outcomes of COP28 related to health systems. Since the emergence of
COVID-19, Congress has dedicated increased attention and appropriations to strengthening the capacity
of health systems in low- and middle-income countries to detect, control, and respond to infectious
disease threats through “global health security” (GHS) programs managed by the U.S. Agency for
International Development (USAID) and CDC. Key areas of focus of such GHS programs include
strengthening national laboratory and surveillance systems and improving risk communication.

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U.S. bilateral health programs address several conditions that experts predict may be worsened by climate
change, including malaria, neglected tropical diseases, and infectious disease outbreaks. Global health
programs in other areas might also be affected by climate change. As examples, populations facing food
insecurity following drought and flooding may need nutritional support. Following severe weather events,
pregnant women may struggle to find places to safely deliver their babies. Other conditions that are
expected to worsen from severe weather events, such as water-borne diseases like diarrhea and cholera,
may be ameliorated by USAID-supported programs outside of the global health account, such as water
and sanitation programs.
In the Global Health Programs section of the FY2024 State, Foreign Operations Congressional Budget
Justification, the Administration identified climate-related catastrophes as threats to global health
programs but did not include any discussion on how climate-health issues would be addressed. In
December 2023, the Global Health Security and Diplomacy (GHSD) Bureau at the U.S. Department of
State released the Climate-Health Leading by Example Action Report outlining the bureau’s climate-
health response. The report highlighted activities supported, such as improving information sharing for
climate-sensitive diseases, but did not specify through which agencies or allocations the activities were
funded. Congress might consider whether or not to leverage its oversight authority to gain greater
specificity on how U.S. bilateral global health programs are being affected by and used to address
climate-health challenges, including seeking an updated National Biodefense Strategy and
Implementation Plan from the Administration with greater specificity on climate-health strategies.

Author Information

Tiaji Salaam-Blyther
Catherine L. Able-Thomas
Specialist in Global Health
Research Assistant

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