Disease outbreaks and climate-related emergencies that fuel an ever-growing hunger crisis in the Horn of Africa. Torrential monsoon rains in Pakistan that left millions at risk of drowning and malnutrition, and one-third of the country flooded. Increased carbon emissions and rising antimicrobial resistance that tag alongside a global food crisis – all made worse by Russia’s invasion of Ukraine.
These are some of today's health crises behind the urgent call for action among global health leaders at the 27th United Nations Climate Change Conference, or COP27, the two-week summit underway in Egypt's resort city of Sharm el-Sheikh.
"The climate crisis is a health crisis," said the World Health Oranization's Director-General Tedros Adhanom Ghebreyesus.
Environmental risk factors cause nearly a quarter of all deaths worldwide and the death toll is highest in lower- and middle-income countries, WHO estimated. Between 2030 and 2050, it said, climate change is expected to cause a quarter million more deaths a year from malnutrition, malaria, diarrhea and heat stress.
Direct health costs are expected to rise by up to US$4 billion a year by 2030, compounded by climate displacement that could affect 1.2 billion people by 2050; the first effects already are hitting people in poorer areas of Africa, the Americas and Asia-Pacific.
Yet rich nations still have not made good on their 2009 pledges to give US$100 billion a year to help developing nations deal with climate change.
Annual clean energy investment must increase to US$4 trillion by 2030, more than triple the current level of spending, to achieve net zero emissions, according to the International Energy Agency's latest World Energy Outlook. And of the US$632 billion a year the world has been spending to mitigate impacts of climate change, only about 7% goes to adaptation, World Resources Institute reported.
Paying for all of this will require a transformation of the international financing system that includes $100 billion in emergency liquidity from the International Monetary Fund and US$1 trillion in multilateral lending by the World Bank, according to the Bridgetown Agenda proposed by Barbados' government.
IMF recommended carbon taxes to limit global warming and urged policymakers to raise prices from today's global average of US$6 a ton of CO2 to US$75 by 2030.
Climate-health crises surge in the Horn of Africa
As COP27 unfolds in a seaside resort along the northern Red Sea regularly used to host conferences among world leaders, the Horn of Africa region along the southern boundary of the Red Sea is severely impacted by increasing disease outbreaks and climate emergencies linked to drought, floods and dire hunger.
“As a continent we are the least responsible for global warming, but among the first to experience its tragic impact,” said WHO's Regional Director for Africa Dr. Matshidiso Moeti.
The seven countries in the Horn of Africa – Djibouti, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda – recorded 39 disease outbreaks and climate-related health emergencies in the first 10 months of 2022, a WHO analysis found.
With two months left to go, that is the already the highest annual figure since 2000. Outbreaks of anthrax, measles, cholera, yellow fever, chikungunya, meningitis, and other infectious diseases made up more than 80% of the acute public health events; drought, flooding and other disasters accounted for 18%.
A recent outbreak of Ebola disease has led to 43 confirmed deaths and 21 probable deaths in Uganda where there have been 130 confirmed cases and 21 probable cases, WHO's chief, Tedros, told reporters.
In the past four years, Moeti noted, the number of people in the Horn of Africa suffering acute hunger more than doubled. WHO said it needs US$124 million through the end of the year to keep people alive, but its appeal is only 34% funded.
"We must put a stop to this exponential rise in misery," said Moeti. "Between malnutrition and death there is often disease. The dire conditions in the greater Horn of Africa are a perfect storm for outbreaks, which unless we act quickly will flare up with increasing intensity."
Young African climate activists shut out of COP27
The world was headed for 4.5° Celsius of warming by the end of this century, compared to pre-industrial levels going back to the year 1750. But since the adoption of the 2015 Paris Agreement at a U.N. climate summit, enough action has been taken to lower the global forecast to 2.6° C.
That is still well above the Paris treaty limit of 2°, which would require a 27% reduction in carbon emissions by the end of this decade. It is even further from the preferred ceiling of no more than 1.5°, which would require a 43% emissions cut – since the planet has already warmed by 1.2°.
With more than 40,000 people registered at COP27, pressure is growing on world leaders to lock in climate finance, emissions-cutting and climate adaptation and mitigation measures to combat a spiral of global health-climate emergencies.
The prospect of leaders hearing from African voices and others championing regional-specific issues at the summit was dim, however. Many young activists across the continent, especially those impacted acutely by disease outbreaks and climate emergencies, were unable to secure a spot at COP27, said Global Citizen.
Among those who were denied the accreditation required to attend, it said, were activists from the U.N. summit's host country, Egypt, along with countries such as Benin, Burundi, Chad, Congo, Mali, Morocco, Somalia, South Africa and Tanzania.
"I would like to be at the COP to make polluting countries pay for loss and damage now and for the destruction of the planet, it's very urgent," said Remy Zahiga, a geologist and co-founder of CongoEnviroVoice. "As African activists, we should unite our voices to demand for climate justice for our continent and respective communities."
Russia’s war on Ukraine undermines climate efforts
Since Russia's invasion of Ukraine on Feb. 24, the war has led to widespread concerns that the spike in energy and foods costs and other global impacts will severely dampen if not block the world's progress on tackling global warming.
Russia's use of military hardware for dozens of attacks on oil and gas facilities in Ukraine and retaliatory attacks on Russia's turf have caused "huge quantities of emissions" that include the release of soot particulates, methane and C02 into the atmosphere, online journal International Politics and Society reported.
Countries in the Horn of Africa are especially feeling the resounding impact of Russian President Vladimir Putin’s war on their own food crisis, as Russia and Ukraine have provided global food staples including 40% of Africa’s wheat supply.
Pressing health issues such as the spread of antimicrobial resistance also plague Ukraine and could spread internationally with continued global warming. Antimicrobial resistance was directly responsible for 1.27 million deaths and linked to another 4.95 million deaths globally in 2019, according to a recent study.
Conflict zones like Ukraine’s are a breeding ground for multi-drug antimocrobial resistance due to "compromised public health and health care infrastructure, the use of explosives, and large-scale displacement," said Dr. Muhammad Asaduzzaman, a research fellow at University of Oslo's Centre for Global Health.
“The environments in conflict zones are heavily contaminated with explosive metabolites such as polycyclic aromatic hydrocarbons (PAHs) and heavy metals, which are drained into groundwater sources and mixed with soil, inducing multidrug bacterial resistance,” he wrote.
Adding climate change to the mix only exacerbates the incidence of antimicrobial resistance, as scientists' recent findings suggest that rising temperatures and high population densities correlate with more resistant bacteria.
Crisis of survival following floods in Pakistan
Other pressing climate-related health issues include the rise of waterborne diseases and malnutrition in Pakistan from monsoon flooding that has left one-third of the country underwater.
The catastrophic floods have already claimed 1,700 lives and injured 12,900 others, destroying 806,000 homes and damaging 1.3 million others, the U.N. Office for the Coordination of Humanitarian Affairs reported as of late October.
Malaria cases are increasing due to stagnant water, OCHA said, and the incidence of diarrhea is at least five times higher than usual, especially in Balochistan and Sindh provinces, where more than 1-in-9 children under the age of five that were admitted to health facilities suffered from severe acute malnutrition.
Stagnating water provides breeding sites for mosquitos, causing malaria outbreaks in nearly a quarter of Pakistan's more than 130 districts. Many families have no alternative but to drink water contaminated with waterborne diseases – turning their ordeal into a crisis of survival against severe acute malnutrition, diarrhea, malaria, dengue fever, typhoid, acute respiratory infections, and painful skin conditions. Six million people no longer have access to safe drinking water.
Some experts say the worst of the casualties from Pakistan's flooding and Africa's climate emergencies could have been avoided had countries worked harder to mitigate their carbon emissions and improve their adaptation strategies.
As a result, COP27 is "unlike any previous U.N. climate summit as we have crossed the threshold of suffering all over the world [due to] the impacts attributable to emissions of greenhouse gases since the Industrial Revolution over a century ago," said Saleemul Huq, a botanist who directs Bangladesh's International Centre for Climate Change and Development. "Hence we have entered a new era of 'loss and damage' from human-induced climate change."
The best outcome for COP27, he contended, would be an agreement to establish a global finance facility for loss and damage – rich nations paying for others with fewer resources to deal with the growing harm from climate change – then return to the next U.N. climate summit in 2023 and hammer out the details.
The platform for the summits is the U.N. Framework Convention on Climate Change, an international treaty launched at the landmark 1992 Earth Summit in Rio de Janeiro that galvanized the environmental movement. The treaty entered into force in 1994 and now includes 197 nations and territories.
"The way new institutions are established and implemented in the UNFCCC process always takes several COPs," said Huq, "but unless there is a decision to kickstart the process, nothing will happen."
All eyes on Sharm el-Sheikh
U.N. Climate Change Executive Secretary Simon Stiell opened the summit with a call to keep fulfill its main objective: hold warming below 1.5°. by halving greenhouse gas emissions by 2030 and reaching net zero emissions by 2050.
"A new era begins, and we begin to do things differently. We will be holding people to account, be they presidents, prime ministers, or CEOs," he said. "Because our policies, our businesses, our infrastructure, our actions, be they personal or public must be aligned with the Paris agreement and with the Convention."
Last year's summit clinched a "watered down" consensus agreement on a climate deal after an exhausting two weeks of talks in Glasgow, Scotland that bogged down in disputes over aid for the most vulnerable nations, phasing out coal and setting rules for global carbon markets.
Unless the international community spends the money and takes system-wide action to fulfill its 2015 Paris Agreement pledges, experts say, climate change will escalate more and leave the world vulnerable to concurrent health threats.
“It is critical that world leaders reach agreement on stemming the rise in temperatures at the COP27, which is very appropriately taking place in Africa,” said WHO's Moeti.
Global health leaders and climate experts sounded the alarm on the need for nations to keep the planet from overheating too much in an avalanche of reports leading up to the U.N. climate summit, including the Lancet Countdown and the U.N. Environment Program's Emissions Gap Report 2022, all of which are bleak.
As these major crises unfold around the world, the Lancet report said, climate change escalates unabated with worsening impacts "increasingly affecting the foundations of human health and well-being, exacerbating the vulnerability of the world's populations to concurrent health threats."
“This report tells us in cold scientific terms what nature has been telling us, all year, through deadly floods, storms and raging fires: we have to stop filling our atmosphere with greenhouse gases, and stop doing it fast,” said UNEP's Executive Director Inger Andersen.
“We had our chance to make incremental changes, but that time is over," she said. "Only a root-and-branch transformation of our economies and societies can save us from accelerating climate disaster."
UNEP's report shows the world is failing to protect people from "here-and-now" climate impacts, said U.N. Secretary-General António Guterres, who lamented that those on the front lines of the climate crisis are at the back of the line for support.
"The last eight years have been the warmest on record, making every heatwave more intense and life-threatening, especially for vulnerable populations," Guterres said as COP27 opened in Egypt.
"People and communities everywhere must be protected from the immediate and ever-growing risks of the climate emergency, " he said. "We must answer the planet’s distress signal with action – ambitious, credible climate action. COP27 must be the place and now must be the time."
