The Global Stocktake: a health check for the Paris Agreement
Authors: Anna Pérez Català, Arthur Wyns
Journal: The Lancet Planetary Health (2022)

The UN Climate Change Conference (COP26), which took place in Glasgow, UK in November, 2021, marked the beginning of an important two year process at the very heart of the Paris Agreement, known as the Global Stocktake (GST). In this Comment, we briefly introduce the GST, its purpose and features, and highlight why it is an important opportunity for the health community to accelerate global action and ambition on climate change. The GST can be understood as an assessment of the world's collective progress towards achieving the long-term goals of the Paris Agreement. The GST is an essential part of the Paris Agreement, covered under article 14, which prescribes the first stocktaking exercise to take place in 2023, and every five years thereafter. The rules governing the GST were agreed on as part of the Katowice Climate Package at COP24 in 2018, and were finalised in Glasgow at COP26.1United Nations Framework Convention on Climate ChangeDecision 19/CMA.1.https://unfccc.int/sites/default/files/resource/cma2018_3_add2_new_advance.pdf#page=53Date: 2018Date accessed: February 1, 2022Google Scholar, 2United Nations Framework Convention on Climate ChangeSources of input for the global stocktake under the Paris Agreement.https://unfccc.int/documents/309888Date accessed: February 1, 2022Google Scholar The stocktaking exercise will assess collective progress across three areas of action: mitigation; adaptation; and means of implementation and support, including finance. The exercise will also consider the social and economic consequences of response measures, and efforts to avert, minimise, and address loss and damage. The outcome of the GST will inform countries on how to update and enhance their actions and support, including through their Nationally Determined Contributions (NDCs), thereby providing the necessary information base to help increase countries’ climate ambitions and action over time. Put simply, if national climate plans are the beating heart of the Paris Agreement, then the GST is the agreement's regular health check. In addition to assessing progress, the GST provides a useful setting to explore how to close the ambition and action gap. Even though the GST will maintain a largely global focus, the provision of thematic analyses—eg, on transport, agriculture, or health—would allow for a more granular exercise that identifies constraints and levers within communities of practice and spheres of influence. This thematic approach could present a more composite, bottom-up picture of the actions needed, trigger stronger sectoral cooperation to remove barriers and promote collective progress, and produce more actionable information for policy makers and civil society. Assessing the achievement of health and other thematic, cross-sectoral priorities that are ingrained in the goals of the Paris Agreement—such as food security, human rights, health, and equity—would also ensure that the societal implications of current levels of climate action are well understood. Global progress on health and climate change should be an important source of information for the GST, and a key area in which to identify solutions, since health plays a substantial role across the GST's five main areas of focus. In terms of mitigation, the health care sector's climate footprint is equivalent to 4·4% of global net emissions.3Karliner J Slotterback S Boyd R Ashby B Steele K Wang J Health care's climate footprint: the health sector contribution and opportunities for action.Eur J Public Health. 2020; 30: ckaa165-ckaa843Google Scholar As for adaptation and resilience, health is one of the three sectors most often prioritised for adaptation in countries’ NDCs.4WHOWHO health and climate change survey report.https://www.who.int/publications/i/item/9789240038509Date: Nov 8, 2021Date accessed: February 1, 2022Google Scholar With regards to finance, health measures are severely underfunded, with just 0·5% of overall funding from multilateral climate finance allocated to projects that explicitly aim to protect or improve human health.5Climate Policy InitiativeGlobal Landscape of Climate Finance 2019.https://www.climatepolicyinitiative.org/wp-content/uploads/2019/11/2019-Global-Landscape-of-Climate-Finance.pdfDate: 2019Date accessed: February 1, 2022Google Scholar When it comes to response measures, the health and social co-benefits from mitigation and adaptation actions have the potential to far outweigh the costs of our necessary response to climate change, and need to be monitored and quantified.6WHOCOP24 special report: health and climate change.https://www.who.int/publications/i/item/cop24-special-report-health-climate-changeDate: Dec 3, 2018Date accessed: February 1, 2022Google Scholar The loss of life and wellbeing caused by global heating, and the damage to health infrastructure and services (a sector valued at 10% of global GDP before the COVID-19 pandemic7WHOGlobal spending on health: weathering the storm.https://www.who.int/publications/i/item/9789240017788Date: Dec 10, 2020Date accessed: February 1, 2022Google Scholar) deserve to be closely monitored, and can serve as a sobering indicator to contrast the striking insufficiency of current levels of climate action. The health community has an opportunity to strengthen the GST by identifying what hinders and drives climate action within their community of practice, and by identifying strategies to improve global sectoral cooperation to safeguard health from the climate crisis. Furthermore, existing initiatives such as the Independent Global Stocktake (iGST) and the Lancet Countdown can facilitate the participation of the global health community in the GST, and offer them opportunities to convene, analyse, and advocate for increased government action on climate and health. We declare no competing interests.