An open letter from the Pan-European Commission on Climate and Health

Climate inaction is already costing lives and livelihoods. The WHO European Region is warming at roughly twice the global average, with cascading impacts across health, infrastructure, and economies. Over the past two decades, heat-related mortality in Europe has risen by 33% – from 51 to 68 deaths per 100 000 people annually – particularly among older adults, with women affected more than men. Intensifying floods across Europe and central Asia are destroying infrastructure, disrupting livelihoods and essential services, and extreme weather events are becoming increasingly uninsurable.

Globally, the picture is alarming. In 2024 alone for example, heat exposure led to an estimated loss of 639 billion labour hours – equivalent to 307 million full-time jobs, or the entire workforce of France, Germany, Italy, Spain and the United States combined – resulting in potential income losses of US$1.09 trillion, roughly the size of Poland’s economy. These are not just statistics: they represent families unable to work, communities being disrupted, and loss of income leading to increasing poverty. The costs of inaction are already being paid in lives, livelihoods, and widening inequities within and between countries and generations. The growing health and economic toll of climate inaction – and the multiple benefits of action – demand a far more ambitious climate agenda.

The impacts on health systems are profound. Hospitals and clinics face surging demand from heatwaves, wildfires, floods, and from vector-borne and other infectious diseases, alongside cardiovascular, respiratory, and mental conditions. Climate change amplifies air pollution, already responsible for half a million premature deaths in the WHO European Region each year. Energy and water disruptions make it harder for health workers to deliver care, while the toll of extreme heat and other climate impacts on the health workforce adds an as-yet unpriced but potentially devastating cost.

Scientific evidence and political commitments are diverging. Global emissions reached a record high in 2024 – the hottest year since records began 175 years ago. Our climate is sending us an urgent message, but we are not listening.

At COP30’s Health Day, leaders must endorse the Belém Health Action Plan – a key global roadmap for climate-resilient, low-carbon health systems – with clear monitoring and equity commitments. By the next Global Stocktake in 2028, every country should show measurable progress.

Adaptation alone is not enough. Ending dependence on fossil fuels is essential to prevent five million premature deaths around the world annually from air pollution and reduce climate risks. The health sector itself contributes around 5% of regional greenhouse gas emissions – equivalent to the carbon footprint of the Netherlands. But all sectors – energy, transport, agriculture, urban development – must align to cut emissions, protect health and improve lives.

Amid rising threats, there is cause for hope. The EHP Partnership for Health Sector Climate Action, led by Ireland and 11 WHO European Region Member States, exemplifies regional leadership and solidarity. Recently, countries discussed how the health sector can drive the decarbonization of pharmaceutical use by switching to less environmentally harmful products, integrating environmental criteria into supply chains, and reducing waste in pharmacies and hospitals. Cities and regions are also powerful drivers of local climate action with global impact. Many are redesigning streets for walking, cycling, and clean public transport; governments are investing in healthy,

sustainable school meals; and businesses are shifting to clean energy. Transformation is not only possible – it’s already underway, bringing multiple societal benefits.

Climate and health action must now be scaled with urgency and solidarity. The costs of inaction are unaffordable. The benefits – for people, the planet, and future generations – are irrefutable.

Signed by:

H.E. Katrín Jakobsdóttir, former Prime Minister of Iceland, Chair of the Pan-European Commission on Climate and Health Professor Sir Andrew Haines, Chief Scientific Advisor Dr Majlinda Bregu, former Secretary General of the Regional Cooperation Council Professor Hans Bruyninckx, former Executive Director at the European Environment Agency Professor Sandrine Dixson-Declève, Honorary President, Club of Rome and Executive Chair, Earth4All Dr Omnia El Omrani, Climate Change and Health Policy Fellow, Imperial College London, United Kingdom Professor Enrico Giovannini, former Minister for Infrastructure and Sustainable Mobility, Italy Ms Khatuna Gogaladze, former Minister of Environment and Natural Resources Protection, Georgia Ms Connie Hedegaard, former European Union Commissioner for Climate Action Professor Ernst Kuipers, former Minister of Health, Welfare and Sport, Netherlands (Kingdom of the) Dr Karl Lauterbach, former Minister of Health, Germany Mr Sulton Rahimzoda, Chairman of the State Committee on Investment and State Property Management, Tajikistan Dr Hülya Şirin, Associate Professor, University of Health Sciences, Türkiye

The Pan-European Commission on Climate and Health is an independent advisory group, chaired by former Icelandic prime minister H.E. Katrín Jakobsdóttir, and supported by Chief Scientific Advisor, Sir Andrew Haines, Professor of Environmental Change and Public Health at the London School of Hygiene and Tropical Medicine. The Commission consists of 11 Commissioners, all of whom bring a unique and comprehensive understanding of the nexus between climate, health and policy-making from across the WHO European Region. It was established by the WHO Regional Office for Europe to identify pathways from evidence to action for protecting and promoting health in a changing climate. Through three expert hearings, on understanding the threats, unlocking opportunities for action, and governing transformation, the Commission has heard from health professionals, scientists, policy-makers, and communities across the Region. In their next consultations, they will hear directly from cities, regions, and health sector leaders who are already taking bold steps to protect health, cut emissions, and build resilience.

Further information about the members of the Pan-European Commission on Climate and Health is available here.

For media enquiries, kindly contact Bhanu Bhatnagar (bbhatnagar@who.int) or James Creswick (creswickj@who.int).