COP26 diary: the health clans gather

Saturday 6 November

Today is the day when the health clans gather to review progress (or the lack of it), plan, recharge our batteries, meet old friends, and make new ones. The meeting is held at Glasgow Caledonian University, and we don't have to show that we have a negative lateral flow test from that day, but we do need to show a vaccine passport and wear a mask except when eating, drinking, or speaking to an audience. The programme is packed and runs from 9 to after 5.

The mood is upbeat not because the planetary crisis is being fixed, although there do seem to be more commitments, but because health is getting closer to the heart of COP after years of being on the outside. The World Health Organisation (WHO) pavilion inside the Blue Zone is the most obvious manifestation of health having a greater presence.

The weather is filthy, but out on the streets some 100 000 people are marching calling for urgent action on climate change. They are joined by people in dozens of cities across the world. I can't be the only one who wonders if we might do better to be joining the march rather than holding our meeting. The simple answer, I suppose, is that we need multiple interventions by many different players.

During our meeting one person observes that the people in the march, mostly young people, are getting angrier. She worries where this might lead and asks a medical student what the best response might be. The student answers “meaningful participation,” but reflects that participation is often not offered and is often tokenistic rather than meaningful. There are not many young people and no children at COP26.

After being welcomed by the director general of WHO and the head of the university, the leader of Glasgow City Council tells us how Glasgow's post-industrial transition was neither fair nor healthy but how its post-carbon transition must be. Mary Robinson, the former president of Ireland and United Nations high commissioner for human rights, joined the meeting live but online and emphasised how climate change was increasing economic, gender, racial, and intergenerational injustice.

Andy Haines, Britain's and one of the world's leading academics on climate change and health, summarised new evidence in just a few slides, emphasising both how essential research will be in responding to climate change (not least being the question of how to get a health system all the way to net zero), but also how research funding has been sparse. With many climate-related issues we are, he said, “flying blind.” (Julia Gillard, the former Australian prime minister who is now chair of the Wellcome Trust, spoke later and said how Wellcome is committed to action on climate change, including funding research.)

New methods allow us to be confident that 70% of extreme weather events are directly attributable to climate change. The melting of the permafrost may release Methuselah organisms, long frozen bacteria and viruses that could cause new infections or even further pandemics. New evidence shows the benefits to mental health from people taking action and building community resilience.

Research on adaptation to the effects of climate change has lagged even behind that on mitigation, said Haines, but the National Academy of Sciences in the US and the Aga Khan Foundation are now calling attention to the need.

Haines's main message, which recurred throughout the meeting, is the need for health professionals to get out of their comfort zones and work with unfamiliar partners. The minister of transport, he said, is probably more of a health minister than the health minister, who is mostly concerned with health services, which account for only a small fraction of health. (I thought of the medical students buttonholing the negotiators at COP.)

Diarmid Campbell-Lendrum, who heads climate change at WHO and cycled with the healthy prescription letter from Geneva to London for it to be carried onto Glasgow, presented some of the main messages from WHO’s COP26 Special Report on Climate Change and Health1: every nationally declared contribution [to countering climate change] should include something on health; health (unlike almost everything else) is non-negotiable (this one, I must confess, strikes me as slightly silly); build health resilience to climate risks; we need a healthy recovery from the covid pandemic; we need an energy system that protects and improves public health; respect nature as the foundation of our health; build healthy and resilient food systems; stop subsidising pollution; mobilise the health community for climate action.

One of the highlights of the day was an address by Rosamund Adoo-Kissi-Debrah, the mother of Ella Adoo-Kissi-Debrah, who died of air pollution but whose death certificate included these words, unlike the seven million others, many of them children, who die every year from air pollution. Adoo-Kissi-Debrah led a group of mothers to meet with Alok Sharma, the COP26 president, arguing for clean air for all. There is still time, she said, to include safer limits on air pollution in the Environment Bill going through Parliament, and she praised her lawyer who had put together data on her daughter's asthma attacks and levels of air pollution in a way that convinced the coroner to put air pollution on Ella's death certificate. Her warm and upbeat talk received a standing ovation.

Another highlight was Nick Watts, the chief sustainability officer of the NHS, arguing that all programmes of decarbonising must be built around data, annual targets, and tough accountability. Words, he said, may be too slippery, giving people the opportunity to sound as if they are doing a great deal while doing nothing—the “greenwashing” that Greta Thunberg and others marching in the streets object to.

The final highlight before I left the meeting was Rhiannon Osborne, a Cambridge medical student, arguing passionately and convincingly that the whole economic system is based on racism, colonialism, exploitation, and extracting from and destroying nature for profit. Health professionals need to recognise the deep roots of the problem and respond radically. She was loudly applauded, and afterwards a knight of the realm told me he thought she was right.

I've written about how I have what I've named the Dorian Gray Syndrome, whereby I think that I'm the youngest person in the room when I'm often the oldest.2 Osborne cured me of that syndrome, and I thought back on my days as a communist as I travelled back through the gloom along the Firth of Clyde.