Missing in climate action: concrete health activities in nationally determined contributions
Authors: Sarah Dickin, Adis Dzebo
Journal: The Lancet Planetary Health (2018)

As part of the Paris Agreement, participating countries outlined ambitious steps to address climate change mitigation and adaptation in the form of nationally determined contributions (NDCs). The NDCs reflect countries' ambitions to reduce emissions and adapt to climate impacts, taking into consideration their national circumstances and capabilities. Health is one of the top five sectors described as vulnerable in the NDCs,1Pauw WP Cassanmagnano D Mbeva K et al.NDC explorer.https://klimalog.die-gdi.de/ndc/Date: 2016Google Scholar as the damaging effect climate change is having on health worldwide has been increasingly recognised.2Watts N Adger WN Agnolucci P et al.Health and climate change: policy responses to protect public health.Lancet. 2015; 386: 1861-1914Summary Full Text Full Text PDF PubMed Scopus (1034) Google Scholar Meanwhile, health is also prominent as one of the 17 Sustainable Development Goals (SDGs) that comprise the 2030 Agenda, and there is a growing emphasis on identification of coherent approaches to implement both agendas.3Dzebo A Brandi C Janetschek H et al.Exploring connections between the Paris Agreement and the 2030 Agenda for Sustainable Development.https://www.sei-international.org/mediamanager/documents/Publications/SEI-PB-2017-NDC-SDG-Connections.pdfDate: 2017Google Scholar Although the health sector seems on the surface to be well integrated into countries' NDCs, concrete steps are missing. An interactive online tool analysing the connections between NDCs and the SDGs4Brandi C Dzebo A Janetschek H Lambert C Savvidou G NDC-SDG connections.https://klimalog.die-gdi.de/ndc-sdgDate: 2017Google Scholar highlights the fact that only 245 (3%) of all NDC activities mention health (SDG3), indicating a lower priority than for other sectors. The NDC–SDG Connections tool is based on a comprehensive global analysis of all NDCs, breaking them down into so-called activities—ie, statements identifying a strand of future activity. The focus of climate actions related to SDG3 is mainly connected to target 3.3 (dealing with communicable diseases) and target 3.9 (addressing deaths and illnesses from air pollution and other sources of contamination). Beyond SDG3, many others climate actions, such as transition from coal energy, will have impacts on health but these are not captured in this tool. The Lancet Countdown5Watts N Adger WN Ayeb-Karlsson S et al.The Lancet Countdown: tracking progress on health and climate change.Lancet. 2017; 389: 1151-1164Summary Full Text Full Text PDF PubMed Scopus (246) Google Scholar aims to track progress on climate change and health, and includes an indicator on adaptation plans (target 2.1), but could more explicitly track health activities within the NDCs. The NDCs are critical tools as they are the primary means for governments to indicate to the international community the specific steps they will take to tackle climate change within their countries. More concrete actions relating to health must be included as countries strengthen or add to their next iteration of NDCs by 2020. There are also opportunities to work with closely linked sectors such as sanitation (SDG6.2) and nutrition (SDG2.2), as well as gender equality (SDG5), and reduced inequalities (SDG10), which have the potential to play important roles in dealing with health-related climate impacts, but are underrepresented in NDC activities. Finally, NDC commitments are just the first step, and achieving them requires global partnerships and financial support to ensure their implementation. We declare no competing interests.