Hospital.Help

Berlin/Bakue Almost a week ago, the World Climate Conference ended with a sobering result for many. Alina Seebacher from Doctors Without Borders reports what decisions were made at the so-called COP29 (Conference of Parties). German medical journal. As an expert on the topic of climate crisis and food security, she followed the conference.

In an interview, Seebacher explains what she is pinning her hopes on and what projects there are to curb climate change-related diseases.

Five questions for Alina Seebacher, Doctors Without Borders

How do you assess the outcome of the World Climate Conference and the promised climate financing?
The result of COP29 is disappointing. Countries in the global south, especially small island states, are already suffering massively from the climate crisis: its consequences are causing damage and losses, overloading health systems, leading to illness and displacement, and costing human lives. 1.3 trillion US dollars were requested so that the countries most affected by the climate crisis can implement urgently needed adaptation and climate protection measures. However, the states were only able to agree on an annual amount of 300 billion US dollars for the new climate financing target. Instead of a clear commitment, it remains a non-binding appeal to mobilize the required trillions by 2035.

Beyond the quantum of climate financing, there is also the question of fair access. Because at the moment not enough money is reaching where it is most urgently needed – we also see this in many of the humanitarian contexts in which we work. In fragile and conflict-affected states, three times as many people are affected by extreme weather events every year than in other regions.

However, people in extremely fragile countries receive around 80 times less climate financing. According to an analysis by the United Nations Development Program (UNDP), annual climate finance between 2014 and 2021 was just $2.1 in extremely fragile states. That compares to $161.7 in non-fragile countries.

Beyond the controversial question of who should provide the financing, i.e. so-called industrialized countries or emerging countries such as China and the Gulf States, the discussion about alternative sources of financing is becoming increasingly important. In addition to private investments and multilateral banks, the key words here are also taxes, for example on aviation and fossil fuels, or a potential tax on the rich, as was currently discussed at the G20 summit.

The Brazilian government, as the future COP30 presidency, will play a key role in mobilizing the needed $1.3 trillion. This is the only way we can adequately help people who are already paying with their health to adapt and protect themselves.

Last year there was a health day at the COP for the first time. What has happened since then?
The climate crisis and human health are inextricably linked. At last year’s COP in Dubai, this topic connection was the focus for the first time; there was the first Health Day and a declaration on climate and health, signed by 150 countries.

The momentum initiated by COP28 continued over the past year, with the issue of climate and health also playing a central role in other global forums, such as the World Health Assembly and the G20 Summit. This momentum must now be used to drive ambitious action at COP30 in Brazil next year, where health will once again be a more central theme. Contributions from the medical-scientific community are also essential for this, for example in the area of ​​research into climate-related health effects and in the assessment of climate and health risks, especially in humanitarian contexts.

Are there any important decisions regarding health this year?
The topic of health in the context of the climate crisis continued in Baku, although not with the same intensity. Topics such as respiratory diseases, sexual and reproductive health, mental health and the creation of climate-resilient health systems were addressed, and the Health Day and the Health Pavilion were also part of the program this year. Key moments were a special report from the World Health Organization (WHO) on climate change and health and the founding of the Baku COP Presidencies Continuity Coalition for Climate and Health.

This coalition of presidencies from COP26 to COP30 and the WHO is intended to strengthen the continuity of climate and health initiatives, implement previous commitments and advance financing. However, it became clear in Baku: lengthy negotiations over the financing target blocked progress in other areas. These would have been essential, especially when it came to reducing emissions. With the current national climate protection plans, or NDCs for short, the world is heading towards a warming of 2.6 to 3.1 degrees Celsius, a scenario with catastrophic health consequences for billions of people.

The hope now lies in the new NDCs, which must be submitted in 2025. But given the weak climate financing target, which is intended to provide funds for so-called developing countries, it will be difficult for poorer countries in particular to strive for ambitious national climate goals. The formulation of the new NDCs also offers an important opportunity to anchor health goals more firmly. So far these have mostly been superficial. There is a need to catch up, for example by setting air pollution control targets, priorities for health adaptation, and the development of concrete investment and implementation strategies.

How does Doctors Without Borders experience climate change? What new challenges are there?
The climate crisis presents our work with a double challenge: On the one hand, health and humanitarian needs are increasing dramatically, extreme weather events are becoming more frequent, weakened health systems are being further strained and existing crises are becoming more severe. The effects are particularly serious in so-called climate hotspots, i.e. in countries such as Niger, Bangladesh or South Sudan, and affect the lives and health of millions of people. Specifically, the climate crisis often means more malnutrition, malaria, dengue, cholera, floods, droughts, hurricanes or displacement for these people.

On the other hand, the implementation of humanitarian aid is made more difficult. Destroyed infrastructure and interrupted transport routes cut off many people’s access to medical care. And our employees also face greater challenges in reaching communities that urgently need support.

This situation will get worse: around 70 percent of deaths worldwide can already be attributed to climate-related diseases. According to WHO forecasts, up to 250,000 additional people could die each year between 2030 and 2050 as a result of climate change. Emergency aid organizations alone cannot meet this increasing need. This makes it all the more important to fight for every tenth of a degree of avoided global warming and to promote effective adaptation measures.

How do you meet these challenges?
MSF works on three levels: adaptation, mitigation and advocacy. Adaptation includes improving our understanding of climate impacts on health and strengthening our data and analysis, for example using seasonal weather forecasts or models to predict malaria peaks. This enables us to act faster and more targeted.

A good example is our project in Honduras: Here we are working in cooperation with the Ministry of Health and local universities on an innovative pilot project that is intended to contain dengue fever and other arboviruses. By releasing mosquitoes that have previously been infected with the Wolbachia bacterium, which is harmless to humans, we aim to minimize the likelihood of dengue transmission. Initial figures show that dengue cases in the region have fallen significantly. We expect final results in the next few months.

In the area of ​​reduction, we focus on our own ecological footprint with the aim of halving it by 2030 compared to 2019 through sustainable practices in the areas of energy, transport and procurement. From solar-powered medical facilities to reusable materials to optimizations in logistics.

As a medical emergency aid organization, in our political work we draw attention to the health and humanitarian consequences of the climate crisis that we are experiencing in our operations and demand the necessary political decisions that really correspond to the challenges: for example from the international community of states and the German federal government, that they better protect particularly vulnerable societies and provide them with appropriate support in adapting to and coping with climate damage. © mim/aerzteblatt.de