On September 5th medical, nursing and public health journals across the world simultaneously published an editorial calling for world leaders to take emergency action to transform societies and limit climate change, restore biodiversity, and protect health. The editorial was published in over 220 leading journals, including The Lancet, the East African Medical Journal, the Chinese Science Bulletin, the New England Journal of Medicine, the International Nursing Review, the National Medical Journal of India, The British Medical Journal, the Revista de Saúde Pública (Brazil), and the Medical Journal of Australia. Never have so many journals combined to publish the same editorial.
The editorial was published in advance of the UN General Assembly, one of the last international meetings taking place before the (COP26) climate conference in Glasgow, UK in November. This is a crucial moment to urge all countries to deliver enhanced and ambitious climate plans to honour the goals of the Paris Agreement.
In a year of Covid-19 and crucial environmental conferences, the editorial warns that the greatest threat to global public health into the future is the continued failure of world leaders to take adequate action to keep the global temperature rise below 1.5°C and to restore nature.
The editorial in full:
Rises above 1·5°C increase the chance of reaching tipping points in natural systems that could lock the world into an acutely unstable state. This would critically impair our ability to mitigate harms and to prevent catastrophic, runaway environmental change.9, 10
Equity must be at the centre of the global response. Contributing a fair share to the global effort means that reduction commitments must account for the cumulative, historical contribution each country has made to emissions, as well as its current emissions and capacity to respond. Wealthier countries will have to cut emissions more quickly, making reductions by 2030 beyond those currently proposed 20, 21 and reaching net-zero emissions before 2050. Similar targets and emergency action are needed for biodiversity loss and the wider destruction of the natural world.
As health professionals, we must do all we can to aid the transition to a sustainable, fairer, resilient, and healthier world. Alongside acting to reduce the harm from the environmental crisis, we should proactively contribute to global prevention of further damage and action on the root causes of the crisis. We must hold global leaders to account and continue to educate others about the health risks of the crisis. We must join in the work to achieve environmentally sustainable health systems before 2040, recognising that this will mean changing clinical practice. Health institutions have already divested more than $42 billion of assets from fossil fuels; others should join them.4
1. World Medical Association; International Council of Nurses; ISDE International, et al
2. Intergovernmental Panel on Climate Change
3. Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services
4. Watts N; Amann M; Arnell N; et al.
Lancet.2021; 397: 129-170
5. Rocque RJ; Beaudoin C; Ndjaboue R; et al.
6. Haines A; Ebi K
N Engl J Med.2019; 380: 263-273
7. UN Environment Programme; International Livestock Research Institute
8. Intergovernmental Panel on Climate Change
9. Lenton ™; Rockström J; Gaffney O; et al.
Nature.2019; 575: 592-595
10. Wunderling N; Donges JF; Kurths J; Winkelmann R
Earth Syst Dynam.2021; 12: 601-619
11. High Ambition Coalition.
12. Global Climate and Health Alliance
13. Thunberg G; Neubauer L; Charlier A; et al.
14. Fajardy M; Köberle A; MacDowell N; Fantuzzi A
15. Anderson K; Peters G
Science.2016; 354: 182-183
16. Climate action tracker.
17. Secretariat of the Convention on Biological Diversity
18. Steffen W; Richardson K; Rockström J; et al.
19. UK Health Alliance
20. Climate Action Tracker
21. UN Environment Programme
22. Markandya A; Sampedro J; Smith SJ; et al.
Lancet Planet Health.2018; 2: e126-e133
23. Paremoer L; Nandi S; Serag H; Baum F
BMJ.2021; 372: n129
Publication History: Published: September 04, 2021
Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said:
“The risks posed by climate change could dwarf those of any single disease. The COVID-19 pandemic will end, but there is no vaccine for the climate crisis. The IPCC report shows that every fraction of a degree hotter endangers our health and future. Similarly, every action taken to limit emissions and warming brings us closer to a healthier and safer future.”
Professor Lukoye Atwoli, Editor-in-Chief of the East Africa Medical Journal, and one of the co-authors of the editorial, said:
“While low and middle income countries have historically contributed less to climate change, they bear an inordinate burden of the adverse effects, including on health. We therefore call for equitable contributions whereby the world’s wealthier countries do more to offset the impact of their actions on the climate, beginning now, and continuing into the future.”
Ambassador Aubrey Webson, Chair of the Alliance of Small Island States (AOSIS) and Ambassador, Antigua and Brabuda, and Permanent Representative to the United Nations, said:
“Our world is on the brink of climate chaos from the ravages of a warming world, and it will take extraordinary action to turn this around. Even at 1.5˚C of warming, nobody is more at risk than the Small Island States. This editorial reiterates the demand that governments need to be doing more on reducing emissions and to ensure that we all transition to a just, equitable and fairer world. Equitable funding must be at the core of our response so that vulnerable nations like the Small Islands can have a fighting chance. We need developed countries to keep their promise to provide US$ 100 billion in finance with a higher goal by 2025, and we also need to re-look the reality of what it will actually cost developing countries to implement the commitments we have undertaken in the Paris Agreement. This is not simply a matter of money. It is a matter of our actual survival.”
Dr Fiona Godlee, Editor-in-Chief of The BMJ, and one of the co-authors of the editorial, said:
“Health professionals have been on the frontline of the Covid-19 crisis. And they are united in warning that going above 1.5C and allowing the continued destruction of nature will bring the next, far deadlier crisis. Wealthier nations must act faster and do more to support those countries already suffering under higher temperatures. 2021 has to be the year the world changes course – our health depends on it.”
Dr Richard Horton, Editor-in-Chief of The Lancet, said:
“Urgently addressing the climate crisis is one of the greatest opportunities we have for advancing the wellbeing of people worldwide. The health community must do more to raise its critical voice in holding political leaders accountable for their actions to keep global temperature rises below 1.5°C.”
HE Sheikh Hasina, Prime Minister of Bangladesh and Chair of the Climate Vulnerable Forum, said:
“Every country must pursue an ambitious target to curb Greenhouse gas emissions to keep the global temperature-rise below 1.5ºC. Developed nations should facilitate the green recovery of the CVF-V20 countries. Dedicated support is required for reducing the cost of capital and encouraging private sector participation. Strict implementation of the Paris Agreement is the only way to check global emissions and thereby global warming. The time to take action to save the planet is not tomorrow, but today.”
Eric J. Rubin, M.D., Ph.D., Editor-in-Chief of The New England Journal of Medicine, and one of the co-authors of the editorial, said:
“The environment and health are inextricably intertwined. The changing climate is endangering us in many ways, including its critical impacts on health and health care delivery. As medical and public health practitioners, we have an obligation not only to anticipate new health care needs but also to be active participants in limiting the causes of the climate crisis.”
Dr Peush Sahni, Editor-in-Chief of the National Medical Journal of India, and one of the co-authors of the editorial, said:
“The recent examples of extreme weather all over the globe have brought into focus the reality that climate change is. We must act now lest it is too late. We owe it to the future generations.”
Dr Richard Smith, Chair of the UK Health Alliance on Climate Change, and one of the co-authors of the editorial, said:
“Health professionals have long been concerned about the harm to health from climate change, but our voices have not been heard clearly in the global debate. This unprecedented joint publication shows our global concern and how we want to be part of acting on climate change.”
The editorial has been coordinated by the UK Health Alliance on Climate Change (UKHACC), a coalition of leading UK health bodies including The Royal Colleges of Physicians, GPs and Surgeons, the Royal College of Nursing, the British Medical Association, the British Medical Journal, and The Lancet. Together UKHACC advocates on behalf of health professionals for responses to climate change which simultaneously protect and promote public health.
This editorial was co-authored by 19 people, listed below, including the editors in chief of 17 health journals based around the world. It is supported – and will be published – by an international group of over 220 health journals. A full list of journals who are publishing is available at the end of this press release. It can also be found at: https://www.bmj.com/content/full-list-authors-and-signatories-climate-emergency-editorial-september-2021
The editorial co-authors are as follows (a full list of their declarations are available in the editorial):
Lukoye Atwoli, editor in chief, East African Medical Journal
Abdullah H. Baqui, editor in chief, Journal of Health, Population and Nutrition
Thomas Benfield, editor in chief, Danish Medical Journal
Raffaella Bosurgi, editor in chief, PLOS Medicine
Fiona Godlee, editor in chief, The BMJ (British Medical Journal)
Stephen Hancocks, editor in chief, British Dental Journal
Richard Horton, editor in chief, The Lancet
Laurie Laybourn-Langton, senior adviser, UK Health Alliance on Climate Change
Carlos Augusto Monteiro, editor in chief, Revista de Saúde Pública (Brazil)
Ian Norman, editor in chief, International Journal of Nursing Studies
Kirsten Patrick, interim editor in chief, CMAJ (Canadian Medical Association Journal)
Nigel Praities, executive editor, Pharmaceutical Journal
Marcel GM Olde Rikkert, editor in chief, Dutch Journal of Medicine
Eric J. Rubin, editor in chief, NEJM (New England Journal of Medicine)
Peush Sahni, editor in chief, National Medical Journal of India
Richard Smith, chair, UK Health Alliance on Climate Change
Nicholas J. Talley, editor in chief, Medical Journal of Australia
Sue Turale, editor in chief, International Nursing Review
Damián Vázquez, editor in chief, Pan American Journal of Public Health