Call For Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health: Wealthy nations must do much more, much faster 

Lukoye Atwoli1, Abdullah H. Baqui2, Thomas Benfield3, Raffaella Bosurgi4, Fiona Godlee5, Stephen Hancocks6, Richard Horton7, Laurie Laybourn-Langton8, Carlos Augusto Monteiro9, Ian Norman10, Kirsten Patrick11, Nigel Praities12, Marcel GM Olde Rikkert13, Eric J. Rubin14, Peush Sahni15, Richard Smith16, Nick Talley17, Sue Turale18, Damián Vázquez19

1. East African Medical Journal 2. Journal of Health, Population and Nutrition 3. Danish Medical Journal 4. PLOS Medicine 5. The British medical journal 6. British Dental Journal 7. The Lancet 8. UK Health Alliance on Climate Change 9. Revista de Saúde Pública 10. International Journal of Nursing Studies 11. Canadian Medical Association Journal 12. Pharmaceutical Journal 13. Dutch Journal of Medicine 14. The New England Journal of Medicine 15. National Medical Journal of India 16. UK Health Alliance on Climate Change 17. Medical Journal of Australia 18. International Nursing Review 19. Pan American Journal of Public Health.                

Correspondence to: Laurie Laybourn-Langton, UK Health Alliance on Climate Change,

Received: 15 Aug 2021; Revised: 31 Aug 2021; Accepted: 1 Sept 2021; Available online: 6 Sept 2021
Ann Afr Surg. 2021; 18(4): 194-197 
© 2021 Author. This work is licensed under the Creative Commons Attribution 4.0 International License 


The UN General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and the climate conference (COP26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature, and protect health.
Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades. (1) The science is unequivocal; a global increase of 1.5°C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse (2, 3). Despite the world’s necessary preoccupation with covid-19, we cannot wait for the pandemic to pass to rapidly reduce emissions.
Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognizing that only fundamental and equitable changes to societies will reverse our current trajectory.                        

The risks to health of increases above 1.5°C are now well established (2). Indeed, no temperature rise is “safe.” In the past 20 years, heat related mortality among people aged over 65 has increased by more than 50% (4). Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality (5, 6). Harms disproportionately affect the most vulnerable, including among children, older populations, ethnic minorities, poorer communities, and those with underlying health problems (2, 4).
Global heating is also contributing to the decline in global yield potential for major crops, falling by 1.8-5.6% since 1981; this, together with the effects of extreme weather and soil depletion, is hampering efforts to reduce undernutrition (4). Thriving ecosystems are essential to human health, and the widespread destruction of nature, including habitats and species, is eroding water and food security and increasing the chance of pandemics (3 7 8).
The consequences of the environmental crisis fall disproportionately on those countries and communities that have contributed least to the problem and are least able to mitigate the harms. Yet no country, no matter how wealthy, can shield itself from these impacts. Allowing the consequences to fall disproportionately on the most vulnerable will breed more conflict, food insecurity, forced displacement, and zoonotic disease—with severe implications for all countries and communities. As with the covid-19 pandemic, we are globally as strong as our weakest member.
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).

Global targets are not enough

Encouragingly, many governments, financial institutions, and businesses are setting targets to reach net-zero emissions, including targets for 2030. The cost of renewable energy is dropping rapidly. Many countries are aiming to protect at least 30% of the world’s land and oceans by 2030 (11).
These promises are not enough. Targets are easy to set and hard to achieve. They are yet to be matched with credible short- and longer-term plans to accelerate cleaner technologies and transform societies. Emissions reduction plans do not adequately incorporate health considerations (12). Concern is growing that temperature rises above 1.5°C are beginning to be seen as inevitable, or even acceptable, to powerful members of the global community (13). Relatedly, current strategies for reducing emissions to net zero by the middle of the century implausibly assume that the world will acquire great capabilities to remove greenhouse gases from the atmosphere (14, 15).
This insufficient action means that temperature increases are likely to be well in excess of 2°C, (16) a catastrophic outcome for health and environmental stability. Critically, the destruction of nature does not have parity of esteem with the climate element of the crisis, and every single global target to restore biodiversity loss by 2020 was missed (17). This is an overall environmental crisis (18).
Health professionals are united with environmental scientists, businesses, and many others in rejecting that this outcome is inevitable. More can and must be done now—in Glasgow and Kunming—and in the immediate years that follow. We join health professionals worldwide who have already supported calls for rapid action (19, 1).
Equity must be at the centre of the global response