Scientific reports that have been published in recent weeks summarize the alarming situation we are currently in – and I am not referring to the ongoing COVID-19 pandemic, which undoubtedly continues to bring disease and suffering to the world. The United Nations Intergovernmental Panel on Climate Change (UN IPCC) announced in its Sixth Assessment Report that there is no region of the world that is anymore immune to the negative impacts of climate change. UN Secretary General Antonio Guterres called this report a “code red” for humanity – which was later reinforced by the 2021 report of the Lancet Countdown on Health and Climate Change. The WHO also published its own COP26 Health Report, which presented ten policy recommendations for protecting health from the climate crisis. Meanwhile, a new report from the World Bank also presented ways on how the ongoing pandemic response can be made ‘climate-smart.’

There is no doubt that the COVID-19 crisis has overwhelmed national health systems and derailed global health agendas. But the global health sector cannot continue operating business as usual – as if the climate is stable. Worse, the dire situation of the world’s health will be further exacerbated if the climate emergency ensues. We will not only witness future COVID-19 waves, but also tsunamis of climate-induced health challenges if we delay climate action today. We can only hope for ambitious commitments to come out of the COP26 negotiations, but we the health sector cannot rely on lip service and hollow pledges – COVID-19 has shown us what happens next. Hence, the global health sector – as the guardian of the health of the human civilization – must now step up and do its part. Here are five asks for my colleagues in the health professions.

First, every health professional must embrace climate change as a personal and professional issue – affecting practice, patients, and communities. Climate change is a pressing concern not just for ecologists and economists, but for all of us in the health professions. We must with intention acknowledge it as a central part of our healing mission. For centuries, medical professionals have recited the Hippocratic Oath, but unfortunately, we have forgotten that Hippocrates, the Father of Western Medicine, also instructed medical students to study the seasons, the conditions of water, the speed of the wind – and their effects on human health. A good place to start is reciting and internalizing the new Planetary Health Pledge that integrates the care of the planet with that of human patients.

Second, every health profession school must ensure that the curriculum covers the climate crisis, its impacts on health, and the actions that can be done by the health sector to tackle this emergency. Such climate-oriented curriculum will produce the next generation of health professionals who are equipped to deal with climate-sensitive diseases, incorporate environmental sustainability into their practice, and lead low-carbon and climate-resilient healthcare organizations such as hospitals and health ministries. To date, only 15% of the world’s medical schools have incorporated climate change and health into the curriculum. The same situation can be expected from nursing, pharmacy, dentistry, and public health schools. Thankfully, there are platforms where health profession schools can acquire resources and learn techniques on how to teach climate change to health students such as the , Planetary Health Alliance, and International One Health for One Planet (1HOPE) Initiative.

Third, every hospital and healthcare facility must have conducted climate and health assessments and designed climate and health plans and strategies. Hospitals and other healthcare facilities must be the last buildings standing when climate disasters strike, but also must stop emitting avoidable carbon and being accomplice to the climate crime. In order for hospitals to fulfill this dual responsibility to be both climate-resilient and environmentally sustainable, the first step is to conduct facility-wide baseline assessments covering both climate adaptation and mitigation. For instance, does the hospital have back-up energy supply in case of storm-induced electricity disruption, but does it obtain its electricity from renewable sources? Are extra medical supplies available for climate disasters, but are they also procured from pharmaceutical companies that abide by green principles? To advance these actions, hospitals must establish multidisciplinary task forces, create a new unit, and even appoint a chief sustainability and resilience officer. Some key resources for assessment tools and strategies include the Global Green and Healthy Hospitals network and the newly-published WHO guidance for climate resilient and environmentally sustainable health care facilities. More than 50 healthcare institutions around the world have joined the United Nation’s , committing to reaching net zero emission by 2050 and reporting annually on progress towards these goals.

Fourth, every professional society and health advocacy organization must speak up for climate action and incorporate climate change into their mission.Every organ system of the human body will be influenced by climate change – and so every clinical specialty must also deal with it with urgency. Professional societies governing different disciplines as well as disease-focused organizations must mobilize their members to integrate climate considerations into education, research, advocacy, and practice. WONCA, the international society of family physicians, published a declaration calling on the world’s family doctors to act on planetary health, and more recently launched an online course for primary care physicians. For the first time, the International AIDS Society hosted a plenary session on HIV-AIDS in the era of climate change during its 2021 scientific conference. The G4 Alliance also began discussions on how to incorporate climate change into the global agenda around SOTA (Surgical, Obstetric, Trauma and Anesthesia) care. The NCD Alliance also recognized the different shared opportunities for action between noncommunicable disease prevention and tackling climate change.

Finally, every local, regional, and national health system must have implemented climate and health assessments and developed plans to enhance system resilience and reduce healthcare’s carbon footprint.  Going beyond hospitals and healthcare facilities, entire health systems must both mitigate and adapt to climate change at the same time. Thankfully, national governments are now starting to appreciate the importance of conducting vulnerability and adaptation assessments and developing health and climate change plans.In a recently published WHO survey, about 67% of countries reported having conducted assessments, and 77% of countries have developed or are currently developing a national plan. Several guides already exist for governments to adopt for policy and implementation – such as WHO’s climate-resilient health systems framework and World Bank’s climate-smart healthcare framework. As part of the COP26 Health Program, nearly two dozen countries ranging from Argentina and Kenya to Nepal and Sierra Leone have submitted national commitments to achieve climate-resilient and low-carbon health systems over the coming years.

With slow vaccine rollouts and new variants of concern arising, the end of the COVID-19 challenge remains far out of sight. For sure, it is hard to keep on responding to this pandemic while fulfilling other clinical and public health duties and also performing actions to reduce emissions and enhance resilience. But we cannot wait until COVID-19 is over, because by that time, the impacts of climate change especially on human health would be irreversible. Time is running out – we must act now.

This article was published in the blog Speaking of Medicine.