Millions more people could die unnecessarily unless the World Health Organization formally declares the climate crisis a global public health emergency, leading international experts have warned. The independent Pan-European Commission on Climate and Health, convened by WHO/Europe, has concluded that the scale of the threat to human health is so severe that only the highest level of international alert – a Public Health Emergency of International Concern (PHEIC) – can trigger the coordinated response required.
A public health emergency of international concern
The commission’s report, which will be presented to European ministers on Sunday ahead of the WHO’s world health assembly starting Monday, argues that the international spread of vector-borne diseases such as dengue and chikungunya, together with the health impacts of extreme weather, global heating, food insecurity and air pollution, make a PHEIC declaration necessary. PHEICs are the WHO’s most serious level of health alert; previous declarations have covered infectious diseases including Covid-19 and Mpox. Although such a declaration would not on its own reverse climate change, the commission says it would galvanise the kind of collective international action that has so far failed to materialise.
“The climate crisis may not be a pandemic, but it’s still a public health emergency that threatens humanity’s very health and survival,” said Katrín Jakobsdóttir, former prime minister of Iceland, who chaired the commission. “And if we don’t act more quickly and comprehensively, many millions more people could die or face life-changing illness.”
Sir Andrew Haines, professor of environmental change and public health at the London School of Hygiene & Tropical Medicine and the commission’s chief scientific adviser, said: “WHO has already recognised that climate change is a major threat to global health. What we’re asking for is a step further.”
The 11-strong commission, which includes former health and climate ministers, described climate change as “an immediate and long-term threat to health, economic, food, water, environmental, personal, community and national security”. Over 200 health journal editors globally had already called on the WHO to declare a climate and nature emergency in October 2023, arguing the crisis met the conditions of being serious, affecting multiple countries and requiring immediate international action.
The toll on human health
The health consequences of a warming world are already severe and accelerating. The WHO conservatively projects approximately 250,000 additional deaths each year between 2030 and 2050 from undernutrition, malaria, diarrhoea and heat stress alone. Among people over 65, heat-related deaths have risen by 70% over two decades. In the European region, more than 100,000 people died from heat-related causes in 2022 and 2023 combined.
Climate change is driving humanitarian emergencies – heatwaves, wildfires, floods and storms – that are increasing in frequency and intensity. Air pollution from fossil fuel combustion is linked to an estimated 7 million premature deaths globally each year. Sir Andrew Haines warned: “If we carry on emitting at current rates, that will accelerate the risks to health for both current and future generations including: more people suffering and dying from excess heat, floods and infectious diseases, air pollution from wildfires, more preterm births and more food insecurity.”
Vector-borne diseases are spreading into new areas as temperatures and precipitation patterns shift. Warmer environments are allowing mosquitoes and ticks to thrive in countries previously unaffected, raising the threat of illnesses such as dengue and chikungunya. Changes in land use have also increased contact between species, facilitating the emergence of new pathogens and pandemic risks.
Food security is deteriorating. Climate change affects food availability, quality and diversity, and in 2020 an additional 98 million people experienced food insecurity compared with the 1981–2010 average. The mental health burden is also growing: climate change induces both immediate conditions such as anxiety and post-traumatic stress, and longer-term disorders linked to displacement and disrupted social cohesion. Young people in particular are experiencing rising anxiety about the existential threat.
These impacts fall disproportionately on the most vulnerable, including women, children, ethnic minorities, the poor, migrants, the elderly and those with pre-existing health conditions. Low-income countries and small island developing states, which have contributed the least to emissions, endure the harshest consequences. Johan Rockström, director of the Potsdam Institute for Climate Impact Research, said: “The current state of the planet, where we are breaching multiple planetary boundaries, and which manifests itself as public health threats impacting millions of people across the world, provides ample scientific evidence that climate change should be declared a public health emergency of international concern.”
Calls for urgent policy change
The commission’s report urges governments to stop subsidising fossil fuels, which it says are directly responsible for 600,000 premature deaths a year in Europe alone. The region spends approximately €444bn (£387bn) annually on subsidies for oil and gas production. In 12 European countries, fossil fuel subsidies exceeded 10% of national health expenditure in 2023, and in four they exceeded the entire health budget. “This is not a sustainable energy policy. It’s really more of a public health failure,” Jakobsdóttir said. “European governments are subsidising the very industries responsible for their own citizens’ premature deaths.”
She warned that new subsidies and redrilling in the wake of the Iran crisis would be “catastrophic for health”. Globally, fossil fuel subsidies reached an estimated US$7 trillion in 2022, equivalent to 7.1% of global GDP. An IMF study found that for every $1 transferred to the poorest 20% via gasoline subsidies, it costs $33, with 97% of the benefits going to the richest four-fifths of the population. Eliminating implicit subsidies could increase global economic welfare by 3.9%, generate an additional $2.5 trillion in government revenue annually, cut global CO₂ emissions by 32%, and prevent over 1.5 million deaths each year from fossil fuel-driven air pollution.
The commission also called for measures to tackle disinformation, greater use of national climate-health impact assessments, and formal recognition that climate change constitutes a mental health crisis. Jakobsdóttir said: “The way to challenge climate scepticism and misinformation is simple: make it personal. Climate change is not happening somewhere else, to someone else, in the future. It is shortening lives in European cities right now. It is filling hospitals. It is driving anxiety and stress and other mental health issues. And the policies that would fix it – clean air, active travel, insulated homes, sustainable food – are exactly the policies that make people healthier and happier today. When the health argument and the climate argument are the same argument, it becomes very hard to oppose.”
Healthcare systems themselves need to become far more resilient, the report said. Sir Andrew Haines pointed out that many hospitals are built on floodplains and are not energy efficient. “Even in the UK, which is a temperate country, we know that many hospitals struggle when it comes to extreme heat. Many of the buildings were designed before climate change.” The healthcare sector accounts for 5% of global emissions and must prioritise adaptation, the commission concluded. Dr Hans Kluge, the WHO’s regional director for Europe, said: “The conflicts in Ukraine and the Middle East have clearly shown what fossil fuel dependency really means – not just higher bills, but strained or broken health systems, disrupted food and fuel supplies and societies under pressure. The case for acting on climate now is not just environmental. It is a security argument, a health argument and an economic argument, all at once. And it is a moral imperative.”
Kluge added: “The decisions taken by governments today will determine the disease burden carried by people who are currently in primary school. I commit to ensuring that climate change is treated as the health emergency it is across the 53 member states of the WHO European region.”
