Lancet Countdown on Health and Climate Change – Explained, pointwise

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Climate change is the greatest global health threat facing the world in the 21st century. Lancet Countdown is an international, multidisciplinary collaboration, dedicated to monitoring the evolving health profile of climate change. It provides an independent assessment of the delivery of commitments made by governments worldwide under the Paris Agreement. It is published annually by the medical journal The Lancet. The 2022 Report ‘Lancet Countdown on Health and Climate Change: Health at the mercy of Fossil Fuels’ has revealed that governments and companies continue to follow strategies that increasingly threaten the health and survival of all people alive today, and of future generations. The report has highlighted that the continued dependence on fossil fuels is compounding the health impacts of the multiple crises the world is facing including the fallouts of the COVID-19 pandemic, the war in Ukraine, the cost of living crisis, and climate change. The Report has findings and recommendations related to 5 broad aspects: (a) Health hazards, exposures, and impacts; (b) Adaptation, Planning, and Resilience for Health; (c) Mitigation Actions and Health Co-benefits; (d) Economics and Finance; (e) Public and political engagement.

Health Hazards, Exposures, and Impacts

With an average global surface heating of 1·1°C, climate change is increasingly affecting mental and physical health. Changing climatic conditions are: (a) Increasing the risk of heat-related illness; (b) Changing the pattern of infectious disease transmission; (c) Increasing health risks from extreme events like heatwaves; (d) Putting sanitation at risk; (e) Having multidimensional impacts on food and water security. These impacts often occur simultaneously, exacerbating the pressure on health and health-supporting systems. The simultaneous occurrence can potentially trigger cascading impacts on the social and natural systems that control good health.

With the world projected to heat by 2·4–3·5°C by 2100, there is a need for greater urgency to accelerate mitigation and adaptation to prevent the devastating health outcomes of a heating world.


The Report also points out increasing exposure to heat waves e.g., in 2021, heat exposure led to the loss of 470 billion potential labour hours, a 37% increase from the period 1990–99. 87% of the losses in low HDI countries were in the agricultural sector.

Heat-related mortality for people older than 65 years increased by approximately 68% between 2000–04 and 2017–21.

29% more global land area was affected by extreme drought for at least one month in a year in 2012–21 than in 1951–60.

Heatwave days were associated with 98 million more people reporting moderate to severe food insecurity in 2020.

Adaptation, Planning, and Resilience for Health

The Report points out that there are some signs of progress in the adaptation to climate change. The national and city- level assessment of the climate-related health risks are gradually increasing. There is evidence that suggests that the strengthening of health systems might have reduced the impact of extreme events.

However, data show that the pace and scale of climate change adaptation, planning, and resilience is far from what is necessary to reduce the health impacts of climate change. Despite increasing temperatures, only 27% of urban centres have at least a moderate level of greenness, and just 28 (33%) of 84 countries report having heat-related early warning systems for health. Funding to support health adaptation remains grossly insufficient and is seldom influenced by vulnerability and adaptation assessments.

In 2022, unprecedented global health, economic, and conflict events have critically worsened public health. Climate change has exacerbated the impacts of many of these events. Without global coordination, transparency, and cooperation between governments, communities, civil society, businesses, and public health leaders, the world will remain vulnerable to international emergencies. The gap between the health impacts of climate change, and adaptation investment and implementation continues to increase, to the detriment of all.


In 2021, only 51% of countries (48 put of 95) reported having completed a climate change and health vulnerability and adaptation assessment. However, these assessments strongly impacted resource allocation in less than 10% (9) of the countries.

Only 49 out of 95 countries have a National Health and Climate Change Plan in place in 2021.

Less than 40% of countries had climate-informed health surveillance systems in place for vector-borne, waterborne, or airborne diseases.

Despite helping to prevent heat-related illness, air conditioning was also responsible for 0·9 gigatonnes of CO2 emissions and 24,000 deaths were attributable to PM2·5 exposure in 2020.

149·6 million people were settled less than 1 metre above the current sea level. They are living in regions increasingly at risk from the hazards of the rising seas.

Mitigation Actions and Health Co-benefits

After COVID-19 pandemic lockdowns were lifted and restrictions were eased, CO2 emissions rebounded to record levels in 2021. With each year that global greenhouse gas emissions do not fall, reaching net-zero by 2050 becomes more challenging, putting lives at increased risk from climate change.

The energy crisis has been worsened by war in Ukraine. It has threatened to deteriorate the energy situation, and has undermined progress and exacerbated energy poverty. However, increasing energy efficiency, conservation, and the use of renewable energy sources could give healthier, more resilient, and self-sufficient energy systems. Millions of lives could be saved each year by accelerating transition to cleaner fuels, healthier diets, and active modes of travel.


The carbon intensity of the global energy system decreased by less than 1% since 1992. Energy-related emissions reached a record high in 2021.

Despite improved access to clean fuels, biomass accounted for 31% of global household energy in 2020 and fossil fuels accounted for 26% .

Exposure to ambient anthropogenic PM2·5 contributed to 3·3 million deaths in 2020, of which 1·2 million were directly related to the combustion of fossil fuels.

Use of fossil fuels in road transport decreased by 0·8% in 2019, whereas use of electricity increased by 15·7%.

Lancet Countdown on Climate Change and Health UPSC

Source: The Times of India

Economics and Finance

The economic impacts of climate change are affecting livelihoods and the socioeconomic conditions that good physical and mental health depend on. Substantial and sustained investment in the low-carbon transition is essential to minimise these impacts for a healthy future. Both Governments and the private sector have crucial roles in making this happen. Investments and employment are slowly transitioning from fossil fuels to clean energy, and divestment from fossil fuel assets is also increasing.

However, the pace needs to be accelerated to prevent devastating economic and health impacts of climate change. Yet, governments continue to incentivise a carbon-intensive and health-harming economy by subsidising fossil fuels . Fossil fuel subsidies are often comparable to the national health budgets.

Oil and gas companies are on track to exceed their share of maximum emissions compatible with 1·5°C of heating by more than 100% in 2040. Increased regulations, scrutiny, and accountability mechanisms need to be urgently implemented to ensure the energy sector aligns its activities with agreed climate targets. Governments worldwide must urgently accelerate this transition, by setting regulations and redirecting investment to a low-carbon, healthy, and energy-resilient future.


The monetised value of global heat-related mortality was estimated to be US$144 billion in 2021, equivalent to the average income of 12·4 million people

The global potential loss of income from reduction in labour capacity due to extreme heat was US$ 669 billion. The agricultural sector was the most severely affected.

The monetised costs of premature mortality due to air pollution amounted to US$2·3 trillion in 2020, the equivalent of 2·7% of gross world product.

With more than 12 million employees, direct and indirect employment in renewable energy exceeded direct employment in fossil fuel extraction for the first time in 2020.

The current strategies of 15 of the largest oil and gas companies would lead to production exceeding their share of levels consistent with limiting the global average surface temperature rise to 1·5°C by 37% in 2030, and 103% in 2040.

Public and Political Engagement

Engagement in health and climate change reached its highest recorded level in 2021, with climate change solutions becoming an increasing focus of health and climate change engagement.

The COVID-19 pandemic continues to be a major driver of health and climate change engagement. The pandemic also drove engagement by individuals and by government leaders in health and climate change. This raises the question of whether increased engagement is contingent on the pandemic context.

Although health and climate change engagement increased in 2021, there is more engagement with health and climate change as separate issues. Similarly, media and scientific engagement in climate change continues to surpass engagement in health and climate change. Despite mounting evidence of the health burden of climate change, health and climate change have yet to be securely associated in the public, political, and corporate domains that are key to climate action.


Scientific engagement in health and climate change: The number of scientific papers investigating health and climate change increased by 22% from 2020 to 2021.

Government engagement in health and climate change: The proportion of countries referring to the association between health and climate change increased in both the 2021 UN General Assembly (to 60%) and in updated NDC submissions (to 86%).

What are the findings related to India?

First, Climate change is affecting almost every pillar of food security. The duration of the growth season for maize has decreased by 2% (compared to a 1981-2010). Rice and winter wheat have each decreased by 1%.

Second, From 2012-2021, infants under one year old experienced an average of 72 million more person-days of heatwaves per year (compared to 1985-2005). For the same period, adults over 65 experienced 301 million more person-days. This means that, on average, from 2012-2021, each infant experienced an additional 9 heatwave days per year while adults over 65 experienced an additional 3.7 per person.

Third, From 2000-2004 to 2017-2021, heat-related deaths increased by 55% in India.

Fourth, In 2021, Indians lost 2 billion potential labour hours due to heat exposure with income losses equivalent to about 5.4% of national GDP.

Fifth, From 1951-1960 to 2012-2021, the number of months suitable for dengue transmission by Aedes aegypti rose by 69%, reaching 5.6 months each year.


The Lancet Countdown on Health and Climate Change observes that gradual progress is being made in the mitigation efforts globally. Health is increasingly getting integrated into the climate change discourse. However, the progress is not commensurate with the pace required to contain the hazardous impacts associated with Climate Change. Hence, there is a need for greater coordination to step-up the efforts at the global level.

Syllabus: GS III, Environment Pollution and Degradation.

Source: Indian Express, The Times of India, The Lancet

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