Doctors and climate change
Authors: Mike Gill, Fiona Godlee, Richard Horton, Robin Stott
Journal: BMJ (2007)

One of the two duties of a doctor laid down by the General Medical Council of the United Kingdom is “to protect and promote the health of . . . the public.”1 Should this duty extend to working to prevent climate change? We believe it should.

Climate change leads to the extinction of species. During the past 500 million years—a mere 10th of the world's history—five major and many minor events have caused extinctions. The last major event eliminated the dinosaurs 65 million years ago. An extraterrestrial object 10 km in diameter slammed into what is now the Yucatan peninsula, Mexico. It caused firestorms, a tsunami 1 km high, planet wide darkness for months, and an extended period of carbon dioxide induced global warming. Within a few months of the event, the 150 million year reign of the dinosaurs was over, and the space for mammalian evolution was created.2

The present climate related extinction event, so far a minor one, is caused by humans. Excessive amounts of carbon dioxide are being poured into the atmosphere as a result of human activity, even though we know what the consequences will be. These consequences are starkly spelt out in the latest Intergovernmental Panel on Climate Change and Stern reports.3 4

Alterations in food production, with expected decreases in areas already under stress; rises in sea levels; the spread of vector borne disease; and water shortages are already aggravating health problems, particularly in poor countries. The impact of climate change will get much worse, and predictions of a hundred million climate refugees is no longer fanciful.

Health professionals must show leadership in tackling the potentially catastrophic effects of climate change. The Climate and Health Council was set up at the instigation of concerned doctors,5 6 and it has evolved over the past year into a focus for international action. Membership of the council is open to individuals and organisations. Many people have already signed the declaration (www.climateandhealth.org), and readers are invited to add their signatures.

The council sets out five ways in which health professionals should act. Firstly, we should inform our professional colleagues and the wider community about the health consequences of climate change, and the major health benefits that will result from tackling it, including a reduction in the prevalence of obesity in rich countries.7 8 9 Secondly, we should set an example by reducing our personal carbon footprints and ensuring that the organisations we work for do likewise. Thirdly, we should advocate. The international community recognises that a post Kyoto global framework is an essential part of any solution. Our advocacy must insist that this framework promotes health. To this end, the framework must constrain carbon dioxide emissions so that atmospheric levels do not exceed 450 parts per million, the level at which the odds for avoiding dangerous climate change are better than 50:50. The framework must also be the basis for ensuring a transfer of resources to give time to those countries that are undergoing, or have yet to undergo, the social and economic transition that fossil fuel has enabled in the rich Western world. The framework based market of contraction and convergence achieves both these aims, and is the most feasible option at present.10 Health professionals should make a concerted effort to contribute to the post Kyoto framework, and to lobby at the United Nations' conferences on climate change in Bali in December and then in Copenhagen in November 2009.

Fourthly, health professionals should seek innovative approaches to using our many networks, such as specialty associations, to facilitate the necessary changes to recruit as many organisations, institutions, and individuals as possible.

Climate change challenges the health of everybody, but particularly of people with the fewest resources. It is the major challenge of the 21st century. Unless we cap carbon emissions in ways that ensure transfer of resources to the poorer nations, we may all go the way of the dinosaurs, and the going will not be comfortable. The Climate and Health Council will be as strong as its collective membership. By adding your voice to the council and taking the necessary actions, you can help to ensure that health professionals are, in the best of our traditions, part of the solution.