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National Institute of Environmental Health Sciences

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Lancet Countdown Tracks International Progress on Health and Climate Change

By Wendy Anson

Launched last November, the Lancet Countdown: Tracking Progress on Health and Climate Change outlines a path to possibly “the greatest global health opportunity of the 21st century.” The Lancet Countdown builds on the work of the 2015 Lancet Commission on Health and Climate Change by tracking progress on international action on climate change and health through the year 2030. Five working groups made up of 48 experts and 16 academic partner institutions from around the world will report annually in The Lancet about indicators that signal significant movement on climate change, and therefore, on human health.

The World Health Organization (WHO) has calculated that 12.6 million deaths in 2012 (23% of all deaths worldwide) were caused by modifiable environmental factors such as increasing greenhouse gases, depletion of fresh water, and ocean acidification, all linked to human activities. The Lancet Countdown tracks progress in five categories: the health impacts of climate hazards, health resilience and adaptation, health co-benefits of climate change mitigation, economics and finance, and political engagement.

“Regardless of politics, everyone can agree that the evidence over the last decades shows that environmental threats are alarming,” said Nick Watts, M.D., executive director of the Lancet Countdown. “It’s possible that the last 50 years of gain can be compromised, affecting all of the environmental and social determinants of health.”

Air Pollution Is World’s Largest Environmental Health Risk

Approximately 18,000 people die daily from exposure to ambient and household air pollution, the world’s largest single environmental health risk. Globally, 80% of those living in urban areas are exposed to air pollution levels that exceed WHO guidelines. For urban populations in low- and middle-income countries (LMIC), the sum rises to 98%. Energy sector production and usage is the largest source of air pollution, with coal-fired energy generation contributing the most (50%) to ambient air pollution, and therefore to adverse impacts on health. Country-by-country data and forecasts surrounding coal use are currently produced by the International Energy Agency. The Lancet Countdown will use this data to provide estimates of coal-related air pollution in specific geographical locations as well as globally.

The Lancet Countdown aims to compute mean concentrations of harmful particulates via the WHO Global Urban Ambient Air Pollution Database in order to arrive at key urban air pollution indicators.

Developed vs. Developing Country Impacts

Some analyses, including those by the IPCC and WHO, claim that climate change puts a high burden on the countries least responsible and least able to answer the challenges, with low and middle income countries (LMIC) suffering multiple simultaneous climate change impacts. Watts explained that climate change hazards are not emerging in LMIC alone, but currently manifest in a domino effect in more developed nations. Heat, poor air quality, and forest fires resulting from the 2010 Russian heatwave led to approximately 11,000 “excess deaths” in that country (the 2015 Lancet Commission defines a heatwave as more than three consecutive days in which the minimum temperature exceeds the 99th percentile relative to summers ranging from 1986 to 2005). The Lancet Countdown will use the population-related metrics developed by the 2015 Lancet Commission to calculate the mean increase in temperature experienced by people worldwide. It will also help shed light on the relative burdens of climate change impacts in countries around the world.

NIEHS in the Climate Change Health Arena

“Checking in with experts like NIEHS’ John Balbus has provided indicators with the most added value,” said Watts. The NIEHS is no stranger to strategic work with indicators and public health in the global arena.

NIEHS partnered with WHO for a May 2012 conference in Geneva, Switzerland, on sustainable development, defined as development that meets the needs of the present without compromising the ability of future generations to meet their own needs.

The meeting focused on developing health indicators for the Sustainable Development Goals. Experts also discussed building capacity for tracking progress in environmental health in LMIC.

Healthy Planet, Healthy Populations

Watts, hristiana Figueres, and Richard Horton
Watts (right) poses with Christiana Figueres (Center) former Executive Secretary of the UNFCCC and Richard Horton (Left) Editor–in-Chief of the Lancet at the Countdown Launch.

“It’s clear that sustainable development is more important than ever, given the changing environment’s deleterious effects on our health,” said John Balbus, M.D., senior advisor for public health at NIEHS and director of the WHO Collaborating Centre for Environmental Health Sciences. “So development without the depletion or degradation of natural resources also becomes an indicator of human health. Activities making the planet healthier go hand in hand with making our planet’s people healthier.”

NIEHS has partnered with WHO and others to translate the science as well as build constructive coalitions around climate change and health. The institute partnered with WHO for two global summits on climate change and health in 2015 and 2016. The two organizations have also collaborated on events at the United Nations Framework Convention on Climate Change Conference of Parties (COP) meetings, including “Health Adaptation in the U.S. and Around the World” at COP19 in Warsaw, Poland, in 2013.

Nationally, a U.S. Global Change Research Program working group led by Balbus, Juli Trtanj of the National Oceanic and Atmospheric Administration, and George Luber, Ph.D., of the Centers for Disease Control and Prevention, coordinated a report updating the scientific evidence for climate change health impacts in the United States.

One of the largest perceived threats to climate change mitigation is a lack of public understanding of the issues and the science. “There’s not one silver bullet; but on the other hand there are huge opportunities when we see that people from health, business, and faith are beginning to communicate. ‘There’s no business on a dead planet’,” said Watts.

Researchers have found that the framing of climate change as a public health issue enhances engagement. The Lancet Countdown intends to analyze social media to identify how and why public engagement with and knowledge about climate change develops and evolves.

“What we are talking about is really not a climate change story, but a public health story,” said Watts. “Common sense dictates public health interventions. Why wouldn’t you want to clean up your air; it’s a double win. Technology and economics experts alike are testifying that we have the technology in hand, and that the cost of inaction is far higher than the cost of action.”