The paper summarizes 40 indicators of progress in the response to climate change. One finding the group found particularly striking is that an additional 125 million vulnerable people in the world were exposed to extreme and lethal heat between 2000 and 2016 due to the increasing frequency and intensity of heatwaves. This has led to a 5.3% reduction in global outdoor labor productivity and a 9.4% increase in vectoral capacity for the transmission of dengue fever. In addition to the effects of heat stress and heat stroke, extreme heat can worsen existing health issues such as cardiovascular and renal disease.

Despite the disappointing progress outlined in the paper, there are also reasons for optimism and “we are excited about some solutions that are starting to materialize,” said Dr Watts. The report also provides progress updates on some of the 10 policy recommendations made in 2015 highlighted below.

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  • Recommendation 1: Invest in climate change and public health research. The number of published papers on the link between health and climate change has increased 3-fold since 2007.
  • Recommendation 2: Scale-up financing for climate-resilient health systems. Spending on health-related climate change adaptation comprised 4.63% the world’s total adaptation spending.
  • Recommendation 3: Phase out coal-fired power. More renewable energy capacity than fossil fuel capacity was added to the mix of global energy in 2015. While the world’s energy supply from coal peaked in 2013, it has been plummeting ever since and planned capacity for new coal power plants dropped by half between 2016 and 2017 alone. Just this month, it was announced that 15 countries had joined the Powering Past Coal Alliance, which seeks to phase out the use of coal for power generation by 2030.3
  • Recommendation 4: Encourage a city-level low-carbon transition to reduce urban pollution. Although it was anticipated that electric vehicles would reach cost parity with non-electric vehicles by 2030, this is now expected to occur by 2018.
  • Recommendation 6: Rapidly expand access to renewable energy and related economic gains. With the increase in renewable energy over other sources global employment in this sector increased to 9.8 million, which exceeds the number of employees in the fossil fuel sector.
  • Recommendation 9: Implement an international treaty that facilitates the transition to a low-carbon economy. The signing of the Paris Agreement in 2015 by 195 countries contributed to progress in this area. The agreement “provides a framework for enhanced mitigation and adaptation and pledges to keep the global mean temperature rise to well below 2°C,” according to the paper. “Going forward, an enhanced [program] of work dedicated to health within the UN [United Nations] Framework Convention on Climate Change would provide a clear and essential entry point for health professionals at the national level, ensuring that the implementation of the Paris Agreement maximises the health opportunities for populations around the world.”
  • Recommendation 10: Develop a new, independent collaboration to provide expertise in implementing policies that mitigate climate change and promote public health, and to monitor progress over the next 15 years. The creation of the Lancet Countdown fulfills this recommendation.

While it may not seem obvious, healthcare providers have a key role in efforts to ease this global crisis. “Clinicians need to understand how important their voice is in advocating for climate change,” Dr Watts noted. “It is often framed as an environmental issue, but the world needs to understand it as a public health and clinical issue as well.”


  1. Watts N, Neil Adger W, Agnolucci P, et al. Health and climate change: policy responses to protect public health. Lancet. 2015; 386(10006):1861-1914.
  2. Watts NAmann MAyeb-Karlsson S, et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health [published online October 30, 2017]. Lancet. doi:10.1016/S0140-6736(17)32464-9
  3. At least 15 states join global alliance to phase out coal by 2030. Reuters. Accessed November 22, 2017.