COP30, HEALTH INCREASINGLY AT THE CENTER OF NEGOTIATIONS
Bringing the voice of the health community to the climate COPs: why it matters and how to do it (even to the rhythm of music, if needed)
- In recent years, health has become an increasingly prominent topic in climate negotiations, and the voice of those working in this field has grown stronger and more influential.
- It is essential to integrate health into countries’ climate planning (NDCs, NAPs) and to monitor it through relevant indicators, such as those proposed within the Global Goal on Adaptation.
- The health co-benefits of mitigation measures are clear, and these must be paired with targeted adaptation efforts and actions to reduce social and health inequalities.
That public health must be taken into account when discussing climate change has long been clear, as also stated in Article 4.1(f) of the UNFCCC, which calls for climate action within social, economic, and environmental policies in order to ‘minimize adverse effects on the economy, public health, and the quality of the environment.’
However, in the early stages of climate negotiations, health remained on the margins of the discussion and only in recent years has it begun to enter the negotiating discourse. As a technical body of the United Nations, the World Health Organization (WHO) has provided support and tools to bring the voice of health professionals to the climate COPs and to convey their messages and evidence, which are highly relevant to the discussions and decisions taken at the negotiating tables.
Health at the COPs: a recap
In 2021, COP26 was the first to establish a significantly stronger focus on health-related issues. Driven by the health community—which highlighted priorities and recommendations in a report (The Health Argument for Climate Action) and in a letter signed by 46 million health professionals (Healthy Climate Prescription)—the UK Presidency launched the ‘COP26 Health Programme’, featuring initiatives dedicated to the climate change–health nexus.
The initiative also included a call for countries to commit to making their health systems more resilient and low carbon. During COP26, 50 countries joined the programme—including several European nations, though not Italy—pledging, through their ministries of health, to achieve resilience (all 50) and low emissions (45 of the 50). A third, more ambitious objective—achieving net-zero emissions in the health sector by 2050—was endorsed by far fewer countries (only 14 at COP26).
In June 2022, the World Health Organization launched the ATACH network (Alliance for Transformative Action on Climate Change and Health), a support tool for achieving the goals of COP26. To date, more than 100 countries (Italy not yet included) and over 80 non-governmental partners have joined the network.
Also in 2022, at COP27 in Sharm el-Sheikh, in addition to the contributions and updates presented at the WHO Health Pavilion, the Egyptian Presidency launched the I-CAN initiative (Initiative on Climate Action and Nutrition), developed in collaboration with the WHO and also intended to be advanced through the ATACH network.
Even greater political prominence was given to health at COP28, held in Dubai in 2023, which hosted the first Health Day and a ministerial event organized by the Presidency of the United Arab Emirates to formulate a political document on the link between climate and health. This resulted in a declaration (Health and Climate Change Declaration), signed by more than 140 countries, including the European Union, emphasizing the urgency of integrated actions to address the health impacts of climate change. Shortly after this COP, a consortium of multilateral banks, funding agencies, and philanthropic organizations published a guide to strengthen financing dedicated to climate-related health issues (Guiding Principles on Financing Climate and Health Solutions), in light of the limited budget allocated until then (0.5% of multilateral climate finance).
To reaffirm the commitments made, in May 2024 a new resolution on climate change and health (Climate Change and Health) was adopted at the 77th World Health Assembly (discussed here). At the same session, the Global Health Strategy and Fourteenth General Programme of Work 2025–2028 was approved, identifying climate change as one of six strategic objectives that need to be addressed as a priority.
At COP29 in Baku—alongside the now-established Health Pavilion and Health Day that accompany the negotiations—the WHO presented a new special report to reaffirm the importance of health as a motivating factor for climate action (COP29 Special Report on Climate Change and Health). The 2024 COP also led to the formation of the Continuity Coalition for Climate and Health, composed of the most recent COP presidencies (United Kingdom, Egypt, United Arab Emirates, Azerbaijan, Brazil), to ensure the inclusion of health on the COP agenda and consistency in the commitments made.
In May 2025, at the 78th World Health Assembly, the Global Action Plan on Climate Change and Health 2025–2028 was adopted, outlining interventions to address the health crisis linked to climate change. Key points include adaptation, mitigation within and beyond the health sector, climate surveillance, protection of vulnerable populations, and the integration of health into climate policies and climate-finance mechanisms.
All these developments set the stage for this COP30, where the Brazilian Presidency launched the Belém Health Action Plan (we discussed it here), made central during the conference’s Health Day through dedicated events, with the support of the WHO and the ATACH network, and with an initial commitment of funding from philanthropic organizations.
What do all these reports, declarations, and action plans tell us?
They tell us that health workers want to do their part in climate action and to be heard at the COP, not only because they are increasingly overwhelmed by growing health needs and challenges, but also because they believe that health is one of the most critical and compelling motivations we have to persuade our governments to act and bring about change. Because what’s at stake are human lives, rights, and the well-being of entire populations—and these cannot be ignored.
Health as Both a Measure and a Goal of Climate Action
As a goal of climate action, health must be integrated into negotiation decisions as an element to be monitored, measured, and protected. This has gradually given rise to a number of important developments over the years.
First, health can be integrated into Nationally Determined Contributions (NDCs), the climate targets set by countries. According to a 2023 WHO analysis, 91% of NDCs reference health in their text—an improvement compared with the previous 2019 analysis. However, only two-thirds of NDCs (63%) include health-specific adaptation actions or plans. Fewer than one in three (30%) mention the health co-benefits associated with mitigation measures, and only one in ten (10%) aims to quantify or monitor them. Some NDCs (11%) include mitigation targets specific to the health sector. In addition, nearly one-third (29%) allocate climate finance to health-related actions or plans, but only one in ten (11%) includes unconditional financing mechanisms, meaning funding drawn from domestic public budgets rather than relying on multilateral sources.
A comprehensive assessment of the NDC 3.0s is still missing.
The Global Climate and Health Alliance attempted to address this with its analysis of the Healthy NDCs 3.0, which evaluated the NDCs submitted before the official February 2025 deadline, thus covering only a limited number of countries (11 in total). It found that most of the NDC 3.0s analyzed acknowledge the link between climate change and health, but in many cases they lack specific health-related targets, as well as the metrics and monitoring systems needed to track progress, and dedicated financial commitments remain insufficient.
National Adaptation Plans (NAPs) also represent an important space for identifying and implementing health-related adaptation measures. The WHO, in fact, encourages the inclusion of a dedicated health chapter within NAPs or the development of a standalone ‘Health NAP’. Analyzing 59 NAPs (submitted to the UNFCCC before October 2024) and a sample of 27 Health NAPs, the WHO found that all national adaptation plans reference a range of health risks linked to climate change; however, the risks cited are not consistently matched by concrete measures to address them. To address these shortcomings, the WHO provides specific recommendations to strengthen NAPs, so that they include not only an inventory of health vulnerabilities and risks, but also targeted actions to tackle them, estimates of the costs and resources required, strategies to mobilize these resources, and programs for monitoring and periodic reassessment. All of this should be carried out through clear and accountable governance by each country’s Ministry of Health, using scientific evidence to develop and update health planning, engaging the health sector in both the formulation and implementation of these plans, and promoting coordination across all sectors that affect health, such as the food and agriculture, energy, water, built environment, and sanitation sectors.
Progress in developing ‘Health NAPs’ is monitored for ATACH partner countries, alongside other relevant indicators. Of the 88 countries included in the monitoring so far, approximately two-thirds have completed or at least initiated the development of a ‘Health NAP’, while more than 70% have conducted a vulnerability and adaptation (V&A) assessment—also recommended by the WHO to identify health-related challenges for countries and their health systems in relation to climate change, and to implement targeted adaptation actions. Just over one-third of ATACH member countries have measured greenhouse gas emissions originating from the health sector.
Within the context of adaptation, health is one of the target areas for the indicators proposed in the Global Goal on Adaptation (GGA), currently under negotiation at COP30. (we discussed it here). The proposed health indicators were selected from an initial list of 900 indicators, then narrowed down to 62, and finally reduced to the current set of 10. These are specialized metrics, chosen based on scientific evidence and relevance criteria, which consider some of the impacts of climate change on health, the availability of essential health services—including mental and psychosocial health services—and the implementation of adaptation measures in the health sector (V&A assessments, early warning systems, and training of health professionals). Other indicators included in the GGA under different thematic areas are also relevant to health, for example those related to water, food, agriculture, sanitation, surveillance and early warning systems, and climate finance.
The WHO has also announced the publication of a survey, which in early 2026 will present data from over 150 countries on adaptation measures planned or already underway in the health sector. This will provide an even more comprehensive picture of the global progress on climate adaptation in relation to health.
It bears repeating, as highlighted at this COP, that mitigation actions bring significant health co-benefits, which are also associated with socio-economic advantages, such as savings in healthcare costs and gains in productivity. The Lancet Pathfinder Commission, through an extensive review of both scientific and grey literature, identified substantial co-benefits linked to mitigation interventions. Among these, significant examples include the reduction of air pollution through the transition to renewable energy sources, the adoption of healthy and sustainable diets, and the promotion of active mobility and public transport. According to a WHO report, the implementation of just five interventions—covering both adaptation and mitigation—could save 2 million lives each year. These interventions are the establishment of health early warning systems for extreme heat events; the transition to decentralized electricity sources in primary care facilities; the adoption of water, sanitation, and hygiene measures for climate adaptation; the use of clean household energy sources; and the implementation of stricter fossil fuel pricing policies alongside the phase-out of fossil fuels.
To maximize health co-benefits, systemic approaches are needed to engage sectors beyond health, integrate targeted mitigation and adaptation actions, and address inequalities—exacerbated by the climate crisis—in people’s and communities’ vulnerability as well as their access to essential health services and support.
If all these reports, statements, and action plans are not enough to move things forward or convince governments to change course, the health community steps in directly. This is what Canadian doctors from the Canadian Association of Physicians for the Environment (CAPE) did. Through a grassroots initiative, they campaigned until achieving a full phase-out of coal in several Canadian provinces, resulting in impressive health co-benefits for the population. The same Canadian doctors also made their voices heard at COP30 in Belém, taking action in a performance where they danced and rapped: “Are we all just fools? Make some noise if you think we should stop fossil fuels. Put ‘em up if you’re ready to jam, ‘cause the lungs of the world are in our hands!”.
Article by Lucia Giannini, Coordinator of the Climate and Health Section at Italian Climate Network.
Cover image: photo by UN Climate Change – Diego Herculano