Climate change and health: From Paris to Fiji in Bonn, now headed to Katowice

by Dr. Yassen Tcholakov MD, MIH

Climate change and health

Human influence on the climate system is clear and there is now compelling evidence to substantiate the numerous health risks posed by climate change [1]. Many countries already have to deal with increasing burdens of disease caused by air pollution, extreme weather events, changes in vector borne disease patterns and the direct impacts of heatwaves, floods, and droughts [2]. Climate change is considered as both one of the greatest threats and opportunities for health [3].

Key issues for global health within climate change negotiations

International policy to address challenges posed by climate change is discussed at the United Nations Framework Convention on Climate Change (UNFCCC), a UN treaty which has existed since 1992, which brings together all countries and which has been responsible most notably for the Kyoto Protocol (1997) and the Paris Agreement (2015) [5]. Health has long been recognized as being impacted by climate change and appears in the first article of the UNFCCC; however, it has seldom been given a priority in climate negotiations [6][7]. Health has largely been isolated in specific discussion on adaptation under the Nairobi work programme on impacts, vulnerability, and adaptation to climate change (NWP) [8].[1] Thus isolated in a work program, strongly confined in scope to interacting with the UNFCCC on the single topic of adaptation to climate change, health has not fulfilled its true potential and probably still has a policy space that it can occupy in climate change negotiations at the UNFCCC.

The Opportunity

We are currently at a crucial moment in climate change negotiations: the Paris Agreement, which can serve as one of the most important public health treaties of the 21st century, outlines an important agenda which can only be realised if the rules of its implementation are fair, clear, and encourage ambition. Those rules will be decided in 2018.

Despite strong presence of the health sector in the periphery of climate change meetings in recent years [9], the health sector has only minimally interacted with the environmental negotiations [10]. The majority of health sector activities have been occurring outside negotiation spaces and have served as meeting points for the health sector researchers to discuss sector specific interventions rather than interfacing with the issues negotiated through the political process. Nevertheless, all this could change. Indeed, the election as Director General of the World Health Organization (WHO) of Dr. Tedros Adhanom, who has repeatedly expressed his commitment to engaging with climate change, probably will mean a closer interaction between the two UN bodies. We have already witnessed the appointment appointment of Dr. Joy St John to the position of Assistant Director General for Climate and Other Determinants of Health; the involvement of climate champion and past Governor of California,  Arnold Schwarzenegger at the latest climate change conference; and a greater interest of health NGOs to participate in political advocacy within the UNFCCC.


Hopefully, the health sector will not only expand its activities but most importantly focus them on the issues most central to the protection of health while interfacing advocacy activities with the core issues discussed by environmental negotiators in the policy space which is fundamentally theirs. The most important issues, which some health NGOs have already identified as being important in climate change negotiations [11], and which I would hope other members of the health sector to support are:

●      Strong rules implementation of the Paris Agreement: allowing countries to rapidly increase their ambitions;

●      Support of a low temperature increase target of 1.5 degree Celsius;

●      Fulfillment and strengthening of past commitment on Loss and damages associated with climate change;

●      Consideration of health in development of national determined contributions;

●      Continued work on health sector adaptation to climate change.


Yassen Tcholakov is the chief resident in Public Health and Preventive Medicine at the McGill University and is pursuing further training at the London School of Hygiene and Tropical Medicine. He has completed medical training at the University of Montreal and he holds a Master of International Health from the University of Copenhagen. He has participated in UNFCCC meetings since 2013, and has most importantly followed all the negotiations of the Paris Agreement, and conducted analyses of the nationally determined contributions of parties to the UNFCCC. Yassen has varied advocacy experience in global health representing various organizations in front of the UN including the WHO, the WMA, and the IFMSA. He has worked on topics such as global health, sustainable development, and climate change. His areas of interest include education, civic engagement, environmental protection, and diplomacy.



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2.     Climate change and health: Fact Sheet. World Health Organization. Available at:

3.     Watts  N  et  al.  Health  and  climate  change:policy  responses  to  protect  public  health.  The Lancet  2015. Available  at:

4.     Infographics on health and climate change. World Health Organization. Available at:

5.     United Nations Framework Convention on Climate Change. 1992. Available  at:

6.     Tcholakov Y., et al. “The Road to Paris: What is at Stake for Health in COP21 Negotiations?” WMJ vol 61.3 (Oct. 2015): 115. Print.

7.     Wiley E., Tcholakov Y., Claudel Pétrin-Desrosiers, Lujain Al-Qodmani. Health in Intended Nationally Determined Contributions (INDCs). Global Climate and Health Alliance, World Medical Association (2015). Available at:


9.     WMA  Climate  Change  and  Health  Care  Advocacy  Kit.  World  Medical  Association  2009.

10.  Wiley E., Tcholakov Y., et al. “The Climate/Health Nexus at COP21 & Beyond” WMJ vol 61.4 (Dec. 2015): 158. Print.

11.  WMA Declaration of Delhi on Health and Climate Change. World Medical Association. 2017. Available at: