While fossil fuels were not mentioned in the signed declaration, a new report says that climate change threatens to destabilise health systems as hospitals around the world face risk of shutdowns due to extreme weather events. Photo: Trinity Care Foundation/Flickr

Climate and health declaration signed by 123 countries at COP28 

While the declaration skips mentioning fossil fuels, another report finds that 1 in 12 hospitals around the world faces shutdown risk due to extreme weather triggered by fossil-fuel-induced climate change

At the ongoing COP28 in Dubai, the summit’s presidency announced a ‘COP28 UAE Declaration on Climate and Health’, which has been signed by more than 120 countries (excluding India). The declaration was announced a day ahead of the first Health Day at COP. “The impacts of climate change are already at our door. They have become one of the greatest threats to human health in the 21st century. Governments have now rightly recognized health as a crucial element of climate action. The Declaration sends a strong signal that we must reduce global emissions and work together to strengthen our health systems,” said COP28 President Dr Sultan Al Jaber. 

Some of the objectives of the declaration include improving and adapting current health systems to build more resilience to climate-related health risks. It also aims to strengthen “cross-sectoral collaboration to reduce emissions and maximize the health benefits of climate action, and increasing finance for climate and health solutions,” the press release stated. 

Health Day Opening Session during the UN Climate Change Conference COP28. Photo: COP28 / Mahmoud Khaled/UNFCCC/Flickr

The declaration, however, was criticised for its glaring omissions. Jess Beagley, Policy Lead, Global Climate and Health Alliance said, “There is no mention of human rights anywhere in the declaration, despite the fact that the human right to health is embedded in the Paris Agreement and the UNFCCC documentation since. There is no mention of fossil fuels in the declaration despite the fact that they are the leading driver of climate change and therefore of its health impacts, and also the leading drivers of air pollution. There is a recent paper published in the British medical journal suggesting that there are 5 million deaths annually from fossil fuel-driven air pollution. There is no mention of the existing commitments of the 79 countries to low-carbon resilient sustainable healthcare systems and the finance language doesn’t go far enough in terms of calling for new and additional finance.”

While fossil fuels were not mentioned in the signed declaration, a new report says that climate change threatens to destabilise health systems as hospitals around the world face risk of shutdowns due to extreme weather events

Risk of hospital shutdowns 

One in 12 hospitals around the world could face partial or total shutdown from climate change extreme weather events if countries fail to curb fossil fuel emissions, according to a new report by Cross Dependency Analysis (XDI). 

The 2023 XDI Global Hospital Infrastructure Physical Climate Risk Report analysed how continued emissions will affect the vulnerability of over 2,00,000 hospitals around the world to six climate change hazards: coastal inundation, riverine flooding, surface water flooding, forest fire, extreme wind and cyclone wind. The analysis focused on physical damage to building structures, and calculated how different emission scenarios can reduce risk

The report said that without a rapid phase out of fossil fuels, up to 1 in 12 hospitals worldwide will be at high risk of total or partial shutdown from extreme weather events by the end of the century— a total of 16,245 hospitals. This is almost twice as many hospitals as are currently at high risk. A residential or commercial building with this level of risk would be considered uninsurable.

All of these 16,245 hospitals will require adaptation, where practical. Even with this enormous investment, the report added, relocation will be the only option for many. Of the 16,245 hospitals identified as high risk by 2100, 71% (11,512) of them are in low and middle income countries.

The report said that limiting global warming to 1.8°C with a rapid phase out of fossil fuels would halve the damage risk to hospital infrastructure compared to a high emissions scenario. If emissions are high, the report warned, the risk of damage to hospitals around the world from extreme weather will increase more than four-fold (311%) by the end of the century. In a low emissions scenario, this increase in risk is reduced to just 106%.

Increase in the risk of damage to hospital infrastructure over time under different emissions scenario. Source: XDI report

India: 1 in every 10 hospitals to be affected

In India, the report found, the proportion of hospitals at high risk of being shut down by extreme weather events would be 5.7% by 2050, and would affect almost 1 in 10 (9.6%) hospitals by the end of the century if emissions are high.  India would be the country with, by far, the most hospitals at risk of damage from extreme weather events by 2100, with 5,120 hospitals at high risk. The number of hospitals analysed in India stood at 53,473, the highest among the 50 countries included in the study. 

In terms of the number of hospitals at risk by 2100, the top five countries are India, followed by China, Japan, South Korea and Indonesia. However, in terms of percentage of hospitals at risk, the Central African Republic stood the most vulnerable, followed by the Philippines, Nepal, Vietnam, Indonesia, and COP28 host UAE.

Higher risk in South Asia, coastal areas

According to the report, South East Asia has the highest percentage of hospitals at high risk of damage from extreme weather events in the world. With high emissions, almost 1 in 5 hospitals (18.4%) in South East Asia will be at high risk of total or partial shutdown by the end of the century.

South Asia has the highest number of hospitals at risk, reflecting the high population. By 2050, a third of all the most high risk hospitals (3,357) in the world will be in South Asia if emissions are high. By 2100 this could increase to 5,894, the report added.

Hospitals located on coastlines and near rivers are most at risk. Today, riverine and surface water flooding dominates the risk of damage to hospitals. Towards the end of the century, coastal inundation rapidly increases (exacerbated by sea-level rise) and becomes the most significant hazard after riverine flooding by 2100. 

Experts said that such impacts would be “nothing less than catastrophic”.  Eloise Todd, executive director, Pandemic Action Network, said, “We know that increased temperatures means more pandemic threats, this study shows that climate change will put entire health systems at risk of climate breakdown just as they will be put under more pressure. It’s time to stop the burning of fossil fuels and invest in climate- and pandemic-resilient health systems—the two can and must go hand in hand.”

The report said that communities hit by hurricanes, severe storms, flooding, forest fires and other disasters could be cut off from emergency hospital care right when they need it most, with low and middle income countries most at risk.

“Climate change is increasingly impacting the health of people around the world. What happens when severe weather results in hospital shutdowns as well? Our analysis shows that without a rapid phase out of fossil fuels, the risks to global health will be exacerbated further, as thousands of hospitals become unable to deliver services during crises,” said Dr Karl Mallon, director of Science and Technology, XDI.