Archive for Urbanisation and Health

Calling for a stronger climate and health nexus within the UNFCCC

From 1-11th June I was part of the International Federation of Medical Students Association’s (IFMSA) delegation at the UNFCCC intersessional’s in Bonn. The IFMSA has been engaging diligently in the UNFCCC process for over 5 years working to reinforce the climate and health nexus within the negotiating text. Our efforts have been greatly appreciated by delegates and the global climate policy community, as there is a relatively small health community engaging with the UNFCCC, despite the recognition that climate change is the “greatest threat to global health of the 21st century” (1). Last December, our work was rewarded in the Lima Call for Action where health was placed firmly in the preamble of the text (2). We entered these intersessionals with positive spirits, due to recent successes of the World Health Assembly, which took place in Geneva the previous week. This resulted in a resolution on the public health dangers of air pollution and the need to phase out fossil fuels in order to both tackle ill-health from pollution and reap co-health benefits of climate change mitigation (3). However, as we head towards COP21 in Paris, which aims to produce a legally binding global agreement, there is concern that the need to dramatically shorten the text will force certain issues into the side-lines. Our aim from now until Paris is to use the contacts we have made at these intersessionals and previous COPs to coordinate a larger coalition of countries that will provide a strong position on health in the new global agreement.

This was my first experience as a delegate at the UNFCCC, and despite not having particularly high expectations, I must admit that the pace of the talks was even slower than I had expected. Negotiations hardly got further than discussing commas and brackets and how these could be used to shorten the text from its former 96 pages to something more manageable. However, after day 6 they had only managed to cut this down to 86 pages, and nothing of the substance of the text had even begun to be discussed. This was frustrating for many of the organisations who had come to lobby delegates on a breadth of issues which need to be included within the text such as human rights, intergenerational equity, gender and health. Being part of the youth constituency, I found there were many barriers to prevent our voices being fully considered. From informing us of interventions less than hour before, not providing adequate translation services, giving us interventions only at the end of sessions and forcing our creative actions to be within strict rules and regulations; our opportunity to represent young people, who are going to be most impacted by the decisions, was severely restricted. The lack of representation of the Global South also made me question the legitimacy of the process. How are we supposed to go about constructing effective policy solutions when those suffering the most from climate change are not represented? Of course, this is not an issue unique to climate change policy, but to witness this stark injustice in reality was a powerful reminder of the need for change.

After spending the past year being involved with local and national action on climate change and health, the pace and level of engagement at these high level negotiations was at best disheartening. It is clear we cannot wait upon the UN to ensure effective solutions to the impending and already tangible impacts of climate change. Whilst the IFMSA and others will continue to be at the forefront of ensuring a legally binding and successful agreement that will protect and promote global health, we rely upon a forward thinking global health community to implement solutions in their own communities. This needs to go beyond acknowledging the intersections between ecology and health towards being part of the structural change needed to ensure a sustainable and healthy future.

This is a critical year for climate action and the implications of inaction on our health and our future is unprecedented. I hope to continue to work within the UNFCCC, but also to bridge the gap between this process and community action which is a key part to building climate resilience. Through attending several side events during the conference I also found that public health provided an important and coherent narrative in which to address a wide range of climate change issues from food and water scarcity, air pollution, occupational and community health surround fossil fuel extraction, transitions towards sustainable active transport and rising infectious diseases in crops, livestock and people. It was clear that health is a powerful tool to provide an anchor of agreement in the UNFCCC, as well as provide a lens to engage a breadth of people with climate change. I look forward to tracking the progress of the UNFCCC and hope that an agreement in Paris will be reached that will mobilise the diverse and collaborative movement needed to save human and ecological life on this planet.


Costello (2009) Managing the health effects of climate change. The Lancet [pdf]

Lima Call for Action:

World Health Organisation (2015) World Health Assembly closes, passing resolutions on air pollution and epilepsy [online] Available at:

ADP2.9: Last Updates from the IFMSA Delegation

ADP2.9: Updates from the ADP 2.9 United Nations Climate Change Conference

ADP2.9 – Meet the IFMSA Delegation!


Eleanor Dow – Medical student at the University of Edinburgh and coordinator of Healthy Planet UK, a network of students raising awareness of the links between climate change and health.


The Year of Environment and Health

“A point has been reached in history when we must shape our actions throughout the world with a more prudent care for their environmental consequences. Through ignorance or indifference we can do massive and irreversible harm to the earthly environment on which our life and well being depend. Conversely, through fuller knowledge and wiser action, we can achieve for ourselves and our posterity a better life in an environment more in keeping with human needs and hopes …” Stockholm, 1972

All living things depend on their environment for energy and for the basic requirements that sustain life – air, water, food and habitat. This simple dynamic is not in dispute. However there is a growing body of evidence that suggests the relationship between environment and human health is in fact a reciprocal one, each having complex effects on the other. According to the UN Environment Programme, every human being has the right to a safe, healthy and ecologically-balanced environment…….but what exactly are these complex relationships, and how can we ensure that human rights to a safe and healthy environment are delivered, even under conditions of rapid global environmental change?

Much of our society’s development has depended upon technological advancements in our environment; improvements in agriculture, sanitation, water treatment, and hygiene have had revolutionary effects on health, well being and longevity. While our environment and the natural resources within in it sustain human life, it can also be the limiting factor in improving health, as well as being a primary source of disease and infection. Lack of basic necessities are a significant cause of human mortality. Approximately 1.1 billion people currently lack access to safe drinking water, and 2.6 billion do not have proper sanitation1, so while advancements in managing the productivity of our environment has resulted in access to surplus quantities of food, water and services, for many, this development has not occurred equally across the world.

Our environment can also be a major source of infection. It is estimated that almost one quarter of global disease and 23% of all deaths can be attributed to environmental factors2.  Pollution and other environmental hazards such as food contaminants, over-exposure to sunlight, algal blooms, flooding and drought increase the risk of a myriad of health concerns that include cancer, heart disease, asthma and respiratory diseases, anxiety, stress and depression as well as many other illnesses.   Environmental factors influence 85 out of the 102 categories of diseases and injuries listed in the World Health Report and in 2012, 7 million deaths worldwide were attributed to exposure to air pollution – now the world’s largest single environmental health risk3.   However social and political aspects that affect our environment such as housing conditions, access to education, access to green space and poverty are major influencing factors in the relationship between health, well-being and environment.

On the other hand, policies and processes that are undertaken with the aim of promoting health and well-being can have significantly detrimental effects on ecosystems as well as our human environments. For example, food production requires unsustainably large volumes of fresh water and causes environmental damage from pesticides and fertilizers, soil erosion, animal wastes and carbon emissions from food manufacture and transportation. Disease prevention can also drastically alter environments. For example, malaria was eradicated in many developed nations in the 1950s by draining wetlands and spraying DDT to kill mosquitoes. The destruction of these ecosystems to control malaria, and the addition of persistent and toxic chemicals into the soils and watercourses has had long-term detrimental impacts on these ecosystems at a regional scale. Wide-spread disease prevention on a global scale creates additional consequences for the environment as the subsequent increase in longevity and reduction in human mortality creates further pressures from overpopulation, increased use of fossil fuels, increased land-clearing, water use and agriculture, as well as generating high volumes of pollution and waste. Recently, a socio-economic approach to evaluating the benefits and services provided by ecosystems has provided insight into the threats and challenges that may lie ahead.

The ecosystems services approach provides a framework for decision making, and for valuing the ‘products, functions and services’ ecosystems provide, to ensure that society can maintain a healthy and resilient natural environment, now, and for future generations. For example, The UK National Ecosystem Assessment indicates that the United Kingdom relies on it’s ecosystems for a range of services that include climate regulation, waste removal, pest control, flood protection, food supply, potable water, natural medicine, aesthetics, recreation and tourism, among many others. However, this innovative approach recognises and strives to promote the philosophy that our environment provides much more than material benefits. It states clearly that ecosystems contribute to national security, resilience, social justice, health and well-being, and freedom of choice and action4. Therefore, the degradation of our environment, and the ecosystems it supports can have seriously harmful and far-reaching impacts on society, its governance and the economy.   Primary impacts of ecosystem degradation relate specifically to human well-being: ‘significant and detrimental human health impacts can occur if ecosystem services are no longer adequate to meet social needsWorld Health Organisation Secondary impacts that may result from a decline in ecosystem function can affect jobs, income, local migration and, on occasion, may even cause political unrest and conflict. The Economics of Ecosystems and Biodiversity report estimates that globally, the degradation of our planet’s ecosystems is costing us €50 billion each year.   This figure does not take into account the resultant impacts on national security and social justice, which have wide-ranging impacts on well-being, and the availability and access to food, water and healthcare provisions. Of great concern is the way that the complex relationship between health and environment is evolving due to a culmination of global-scale changes including rapid changes in climate, flooding, drought and fluctuations in temperature, not to mention population growth and urbanisation.

The World Health Organisation Global Forum on Urbanisation and Health in 2010 highlighted that for the first time in history more people live in urban settings than rural, and that conditions in cities will be among the most important health issues of the 21st century5. Greater urbanisation puts ever increasing pressure on services such as housing and health. Understanding the surrounding environment, the impact that an ever increasing population has on it and how we can develop and increase services with the least impact is key. The use of our natural environment has provided human civilisation with many benefits, but the costs to our ecosystems have been severe and extensive.   As our population continues to grow and our demands for food, fresh water, healthcare, fuel and building materials soar, we must ask ourselves what price we are prepared to pay. What legacy do we want to leave for future generations? Both the Convention on Biological Diversity and the World Health Organisation have made clear that unless we come to understand the relationship between environment and health and address they way we use and manage our environment, then we will substantially diminish the benefits and well-being that future generations can acquire from ecosystems, and severely compromise their ability to meet their basic human rights to a safe and healthy environment.

The Year of Environment and Health is a collaboration between the University of Edinburgh’s Global Health Academy and its Global Environment and Society Academy. It endeavors to examine the key issues in the relationship between Environment and Health through the lens of Global Change.

Join us in a series of public lectures exploring some of the themes discussed above:-

  • Urbanisation and Health
  • Pollution and Health
  • Ecosystem Services and Health
  • Extreme Weather and Health


  2. WHO
  3. WHO
  4. Convention on Biological Diversity
  5. WHO Global Forum on Urbanisation & Health 2010

Catherine Morgan (Global Environment & Society Academy); Lisa Wood (Global Health Academy), University of Edinburgh.