Aathira Perinchery 
Kochi: More than 46 million healthcare professionals from around the world on November 1 endorsed a letter addressed to the president-designate of the 28th Conference of Parties (COP28), calling on leaders of all countries to commit to “accelerating the phase-out” of fossil fuels – in a just and equitable way – as “the decisive path to health for all”. The letter cites the impacts on human health due to the extreme weather caused by climate change and the millions of premature deaths that air pollution causes worldwide annually – both caused largely by fossil fuel combustion – as reasons for the phase-out.
At this year’s annual UN conference on climate change, leaders and governments will discuss several aspects of climate change such as the means to curb and deal with the impacts of ongoing global warming by methods including decreasing the use of polluting fossil fuels. It will be underway from November 30 to December 12 in Dubai, UAE.
Full and rapid phase-out of fossil fuels
This year, for the first time in the history of COPs, health is on the agenda. One day, December 3, will be dedicated to discussions on health alone.
More than 46 million healthcare professionals – including those affiliated with the World Medical Association, World Federation of Public Health Association and International Council of Nurses – have endorsed a letter addressed to president-designate Sultan Ahmed Al-Jaber, supporting this move to bring health “front and centre”.
However, keeping the global temperature increase within the 1.5°C target of the Paris Agreement will happen only if we rapidly phase out fossil fuels, the letter noted. Failure to do so can “lead to overwhelming health consequences”, it warned.
“We call on the COP28 Presidency and the leaders of all countries to commit to an accelerated, just and equitable phase-out of fossil fuels as the decisive path to health for all,” the letter, coordinated by international NGOs Health Care Without Harm and Global Climate and Health Alliance on behalf of the health community, read.
This is because combustion of fossil fuels adds to carbon emissions that accelerate global warming and cause climate change. The latter also manifests in extreme weather events such as intense heat waves that are a threat to the health of both human and non-human species. Fossil fuel use also releases pollutants into the air, and these are known to cause direct impacts on human health. One of the pollutants is particulate matter (PM, or solid inhalable particles ranging from fine diameters of 2.5 mm to larger ones of 10 mm) and these are known to cause public health issues ranging from respiratory illnesses to cancers. According to the World Health Organisation, air pollution – which fossil fuels and other pollutants contribute – causes 7 million premature deaths annually.
“A full and rapid phase-out of fossil fuels is the most significant way to provide the clean air, water, and environment that are foundational to good health,” the letter said, adding that solutions such as Carbon Capture and Storage – put forward by the oil industry – are “unreliable and inadequate”. Per the International Energy Agency, CCS techniques involve capturing carbon dioxide from fossil fuel-based sources like power generation or industrial facilities and burying them in “deep geological formations such as depleted oil and gas reservoirs or saline aquifers”.
The letter demands that energy transition be made just and equitable for all, and that unlocking finance will be crucial for this. It also highlighted that “fossil fuel interests have no place at climate negotiations”. In January this year, the UAE announced that Al-Jaber, the UAE’s minister of industry and advanced technology, would be president-designate. Al-Jaber, however, is also the serving CEO of the UAE-owned Abu Dhabi National Oil Company (ADNOC), as The Wire reported in January. Activists worldwide expressed concern at the move, calling the appointment “outrageously regressive” and “deeply problematic”, among others.
“As representatives of the global medical community, we fully support this letter,” said Dr Lujain Alqodmani, president of the World Medical Association, in a press release. “We are already seeing the impacts of the climate crisis on our health – heat stress, malnutrition, anxiety, vector-borne diseases, respiratory illnesses due to dirty air to name a few. Extreme weather events have another far reaching impact- hospitals and healthcare centres that are meant to provide cure and relief are often first in the line of fire, with access and infrastructure getting hit. Our dangerous addiction to fossil fuels will only aggravate this further. This is why we think that a rapid transition to clean and equitable forms of energy is a win-win on all fronts.”
Sultan Ahmed Al Jaber. Photo: X/@FC_actu
India, air pollution and child health
“It is a well-known fact that air pollution – whether indoor or outdoor – adversely affects children and we are seeing that in our practice now,” Dr Naveen Thacker, president of the International Pediatric Association and one of the signatories of the letter, told The Wire.
“Definitely as a pediatrician, I see an increase of cases in respiratory illnesses such as asthma,” he added. Thacker is also the director of Deep Children Hospital and Research Centre at Gandhigram, Kutch, Gujarat, and former president of the Asia Pacific Pediatric Association and former national president of the Indian Academy of Pediatrics.
A study in 2022 by a team of scientists from across the world, including IIT Delhi, found a “robust relationship” between ambient air pollution and infant mortality (death of children under five years of age) in India when they studied the data on particulate matter (PM2.5) from satellite imagery, and data from the Demographic and Health Survey of India of 2015-2016. They examined data pertaining to more than 2.5 lakh children across 640 districts in India. Preliminary descriptive analyses showed that children who died in the first year of their lives were less privileged than those who survived (based on factors such as lower wealth quintile and less maternal education).
North India stands out, because pollution levels are higher in the area, per a separate preliminary study in 2019. Researchers affiliated with the Indian Statistical Institute Delhi, Brookings India and IIT Delhi (using similar methods as in the 2022 study) found that air pollution negatively affects child health in India in their working paper. Exposure to air pollution during the first trimester of pregnancy decreases both height-for-age (a measure of stunting, when a child is too short for their age) and weight-for-age (a measure of being underweight) for children below five years of age. “The effect,” they wrote, “is prominent for poorer households, with Northern states being more vulnerable due to high pollution levels in the area.” Their study looked at not just child mortality, but also the growth indicators that play a role in child survival.
Increasing awareness of how to prevent or reduce exposure to air pollutants such as particulate matter is important, Thacker told The Wire. These include gauging air pollution levels to use masks to reduce exposure, or small steps that can be practised at home to decrease indoor air pollution. Controlling the number of fires that some areas such as north India tend to witness during the winter months is also important and people should be made aware that this is a problem, added Thacker.
Even as Thacker spoke to The Wire on the evening of November 1, particulate matter PM2.5 and PM10 dominated Delhi’s air, and the city’s Air Quality Index at 4 pm (averaged across the last 24 hours) was 364, in the “Very Poor” category. Per the Central Pollution Control Board, prolonged exposure to such air quality can cause respiratory illnesses. The national capital is notorious for poor and sometimes severe air quality during the winter months (November to January). While studies show that farm fires – stubble burning of crop residue in farms – across Delhi NCR, Punjab and Haryana are one of the major contributors to the worsening air quality in the city (and often aided by meteorological conditions such as low wind speed), particulate matter released by industries and vehicular emissions are also part of the picture here.
India has pledged to decrease carbon emissions as per its submissions to the United Nations as part of its Nationally Determined Contributions. However, the government has made it clear that a complete phase-out of fossil fuels is impossible since India’s historical contributions to climate change have been minimal (even though India is the second-highest carbon emitter currently). India has argued for a phase-down of fossil fuels instead, to ensure that the energy transition to cleaner and greener forms such as solar and wind will not impact the people depending on the fossil fuel industry in the country, or impede India’s economic ambitions. Just and equitable transitioning, therefore, is crucial for developing countries that depend heavily on fossil fuels for growth, experts have argued.
According to Thacker, India is making “great progress”, through its current pledges. “If we can commit more, it would be a good step,” he said. “It has to always be a balance though: we cannot commit without ensuring proper rehabilitation to people, and that the process be just and equitable,” he added.