Human-caused climate change is a major threat to the planet and its inhabitants. Increases in extreme heat events have already caused devastating losses and damages across the globe, including species extinctions, human mortality and morbidity, increased incidence of vector-borne diseases, and mental health challenges associated with trauma and displacement. And will continue to do so if climate action is not taken as a priority. On March 20, 2023, the Intergovernmental Panel on Climate Change (IPCC) launched the Sixth Assessment Report with an overview of the state of knowledge on the science of climate change and a bold take-home warning, “Pace and scale of climate action are insufficient to tackle climate change”. Ambitious and immediate actions were also the key message of the 2022 Lancet Countdown Report, which called for a health-centred, low-carbon response to the climate crisis.
Global warming is undoubtedly a direct consequence of human activities, mostly from emissions of greenhouse gases. Between 2011 and 2020, the global surface temperature increased by 1.1 °C compared to between 1850 and 1900. According to the IPCC report, it is likely that global warming will exceed 1.5 °C during the 21st century, and to limit warming below 2 °C, immediate and deep reductions in emission of global greenhouse gases will be required. If achieved, rapid and sustained reductions in greenhouse gas emissions would substantially slow down global warming within 20 years, with significant changes in atmospheric composition within a few years. However, despite commitments, the carbon intensity of the global energy system has decreased by less than 1% since 1992, the year the UN Framework Convention on Climate Change was adopted, and governments continue to subsidise fossil fuels with hundreds of billions of US$ annually while failing to allocate the money to a just transition to clean energy.
The transition to clean energy sources will have the greatest impact in reducing greenhouse gases with health benefits that can enable a climate-resilient development, and should be at the centre of every government agenda and National Adaptation Plan (NAP). South American countries are not currently delivering adaptation responses proportionally to the increasing risks their populations face. Despite the almost universal access to electricity in South American homes, only half is generated from clean sources, with a substantial difference between urban and rural areas. Although on a global level the region contributes only to 6% of total greenhouse gas emissions, fossil fuels are the primary energy source for road transport in the region (95%), which is also marked by extremely high levels of urban pollution. Living with the worst air quality in the region, Peruvians and Bolivians are exposed to an annual level of pollution more than five times above the WHO-defined levels for a healthy life. Mitigation plans focused on decarbonising road transport and increasing access to clean energy sources, especially in rural areas, could deliver major physical and mental health benefits for South Americans.
A just transition is one that happens simultaneously in all regions and can only be possible with international collaboration. The IPCC Assessment Report calls for a so-called many folds increase in global financing if the climate goals are to be achieved. However, in reality, there is no shortage of capital available; what we are missing is the political commitment to allocate the money to the right places and close this financial gap.
It is also clear that a just transition will have to prioritise vulnerable regions and communities that, despite contributing the least to climate change, are the most affected and have the least resources. Indigenous Communities and regions in Central and South America are among those facing the largest adverse impacts. Extreme weather events, including droughts and floods, directly impact crop growth and duration, increasing pressure on food systems and threatening food and water security, especially for those already in vulnerable situations. In South America, 168.7 million people are already affected by moderate or severe food insecurity. The additional pressure from climate change will jeopardise efforts to meet the 2030 WHO agenda for Sustainable Development.
South American countries have a compounding issue with a paucity of data on the progress of mitigation actions and a historically low allocation of resources to climate-related actions. In this issue, The Lancet Countdown South America published its first report as part of a broader effort to understand better the links between public health and climate change at the regional level, collect and analyse data on the progress of mitigation and adaptation plans, and provide the evidence needed to push the climate agenda in the region.
When defining adaptation plans, each country must identify its pressing climate change-related health risks and develop adequate adaptation plans. Although a global perspective is essential to create awareness and engagement, reliable regional data is important for policymakers, governments, and stakeholders for the development of effective, evidence-based, and data-driven adaptation and mitigation plans. The Countdown South America includes important data on key indicators for the region and calls on governments and stakeholders of the region to initiate and accelerate a coordinated response to address climate-related challenges in the region. In a press conference ahead of the report launch on March 23, 2023, authors reinforced that “it is imperative that South American countries develop NAPs with a cross-sectional approach to health”. Among all 12 countries investigated, only Brazil has developed a specific Health-NAP, while Argentina, Colombia, Chile, and Peru have their Health-NAPs under development.
Immediate adoption of a health-centred approach focusing on transformational adaptation and climate justice, integrating adaptation and social protection, can still secure our sustainable future. There is a short window for action that is fast closing, but there is still time.