.png?sfvrsn=6d0e27cd_1 "Partnership for Change - v7 (1)")
Video statement
The Health-Care Professional Associations constituency of PMNCH (the largest alliance for women’s, children’s and adolescents’ health) strongly supports the call for real, immediate and bold action to address the climate crisis, as outlined in the Healthy Climate Prescription letter. This action can prevent a health crisis for women, children and adolescents, with a strong focus on the most vulnerable.
At the 26th Conference of the Parties of the United Framework Convention on Climate Change (COP26), we join other health professionals in demanding that global leaders take ambitious and decisive action on climate change. It is vital to keep the rise in global temperatures below 1.5°C to save millions of lives and avoid widespread harm to health.
Disruption to vital services
The climate crisis is an unprecedented threat to human health. It impacts directly and indirectly on key determinants of health, such as food security, clean water, air quality and disease vectors. The effects are grossly unfair and unequal. Those who have contributed least to global greenhouse gas emissions – particularly women, newborns, children, and adolescents – are impacted the most, especially those living in low- and middle-income countries. Women and girls may lose vital access to sexual and reproductive health (SRH) services due to restricted mobility and damage to health facilities, roads and other essential infrastructure during extreme weather events. They and their newborns will be more vulnerable to sexual violence, sexual exploitation, abuse, trafficking, and intimate partner violence, while child marriage and unplanned pregnancies increase as more girls are forced to drop out of school. Climate change increases exposure to such events.
Midwives working in the community can only do so much to offset the impacts of climate change on SRH services. They work in the communities where women and girls live, but can only provide limited support without sufficient resources, such as contraceptive supplies. So, while midwives can and do provide a primary health service for women, girls, and newborns, in fragile settings it may not meet all their needs.
“To strengthen health systems and their ability to respond to climate events, governments must uphold and invest in SRH services and the midwives who provide this care. In fact, the midwife-led model of care should be celebrated as a sustainable example of primary health service delivery, providing women and their families with support they need, close to where they live. Midwives have been decarbonising healthcare for centuries — it's time we recognize their value and learn from their approach”, Franka Cadée, President, International Confederation of Midwives.
Systemic gender inequalities multiply the impact of climate change on provision of services and on women’s ability to resist climate impacts. Women constitute most of the world’s poor and are most vulnerable to extreme weather events. They are more likely to die during environmental disasters, as they are too often discouraged from learning survival skills such as swimming and climbing. When droughts or floods make food scarce, women are more likely to go hungry so their families can eat.
Harm to newborns, children and adolescents
Adverse effects of climate change reverberate across the lifespan because of the significant impact on pregnant mothers, the fetus and children. Numerous studies have demonstrated a link between prepregnancy and prenatal exposure to air pollutants and lower fertility and live birth rates in spontaneous conceptions and after in vitro fertilization and embryo transfer (IVF-ET). Adverse obstetric outcomes with higher rates of miscarriage, preterm birth and low birthweight are also noted. Air pollution is associated with 20% of newborn deaths worldwide, most related to complications of low birth weight and preterm birth. In children under the age of 5 years, mortality due to outdoor fine particulate pollution related to lower respiratory infection ranges between 7.2% and 13.6%.
“Newborns, one of the most vulnerable societal groups, are dying from climate change, the greatest global health threat of our century. Research demonstrates the impact with the increasing rates in newborn morbidity and mortality. We must focus the collaborative strength of all health-care organizations to raise awareness and advocate for immediate action before it is too late”. Karen Walker, President, Council of International Neonatal Nurses.
“FIGO joins a broad coalition of international researchers and the medical community in stating that the current climate crisis presents an imminent health risk to pregnant people, developing fetuses and reproductive health, and recognising we need society-wide solutions, government policies and global cooperation to address and reduce contributors to climate change, including fossil fuel production”. Jeanne A Conry, President elect, International Federation of Gynecology and Obstetrics.
The Lancet Countdown on health and climate change finds children to be the population group most affected by climate change globally. A child born today will live in a planet four degrees warmer than the preindustrial average, and climate change will impact their physical and mental health from infancy to adulthood.Under current climate policy pledges, children born in 2020 will experience a two- to sevenfold increase in extreme weather events, particularly heatwaves, compared to people born in 1960. Health-care professionals who care for children are on the front line: supporting families displaced due to climate change, providing better health services and access to treatment of vector-borne illnesses and heat stroke, providing expanded vaccine access, and promoting better housing structures.
UNICEF finds that almost every child in the world is exposed to at least one climate and environmental hazard, shock or stress (heatwaves, cyclones, air pollution, flooding and water scarcity).Approximately one third of children are exposed to four or more stresses, which significantly reduces their chances of surviving and thriving. According to the UNICEF Children’s Climate Risk Index, 1 billion children (nearly half of all alive today) live in countries at extremely high risks from climate change, meaning they are significantly more likely to die, or to survive with decreased quality of life.
“The health consequences of climate change are greatest in children. Children breathe more, they respond more to heat, their immune systems are still developing, and their lungs are more susceptible to damage from ground-level ozone. Unless we act now, present and future generations of children will continue to bear an unacceptably high disease burden from climate change. As Greta Thunberg, a youth activist, said at the World Economic Forum in 2019, “Our house is on fire.” Errol R Alden, Immediate Past President, International Pediatric Association.
Adolescents are at a critical point in their biological, emotional and social development, so they are particularly vulnerable to climate change. The climate crisis threatens their well-being and their ability to connect with others, hold positive values and contribute to society. It also impacts their safety, resilience, independence, education and learning abilities, skills and employability. Research indicates that climate change is a serious threat to the mental health of both children and adolescents. It may also impair their cognitive development and academic achievements. For example, the ability of children to learn may decrease in air temperatures higher than 23 °C.
Rates of post-traumatic stress disorder, anxiety and depression among adolescents increase significantly after a climate-related disaster, while eco-anxiety and climate anxiety are generally widespread. Similar impacts are seen among women and children. Extreme weather events can also evoke negative feelings of distress, helplessness and increased aggression and violence. They may exacerbate psychotic illnesses, such as bipolar disorder and schizophrenia, which most commonly emerge in late adolescence.
“It is evident that adolescents and young people are and will continue to be among those most affected by climate change implications, as it directly threatens our health, safety and education. We should not forget that numerous young people are part of the health workforce today and have contributed as leaders in raising awareness about taking action and mobilizing our peers. As part of the health workforce, we young people are in a unique position to address climate change by providing evidence-based information to our communities and encouraging healthcare institutions to act now. We ask stakeholders to consider and incorporate our inputs to the outcomes of COP26 as climate change cannot be tackled without young healthcare professionals at the table”. Eglė Janušonytė, Former Vice President, International Federation of Medical Students Associations .
Climate impacts multiply in fragile settings
By creating economic shocks and natural resource scarcity, climate change can increase the chances of conflict, especially in already fragile humanitarian settings. 29 out of the 33 countries with extremely high risk to climate change are already defined as fragile settings. This exacerbates the difficult conditions for service delivery by health-care professionals to those most in need. Extreme weather events can also lead to severe damage to health infrastructure, reducing access to resources and commodities for health-care professionals.
“Right around the world we have seen the disastrous effects of climate change and the humanitarian crises it has produced. Searing heat, massive uncontrollable fires and devastating floods have become more frequent, and the people who suffer most are the poor, who have done the least to create and perpetuate this crisis.
Nurses working in humanitarian settings have seen the terrible suffering climate change has created for individuals, families and whole communities. They have seen how such events threaten the very existence of healthcare in the most vulnerable communities of the world. There is one chance to put this right, one chance to ensure that the world’s most vulnerable people can continue to have access to the care and treatment they need. To fail now would be catastrophic. The world’s nurses are no longer willing to stay silent about this: everyone must play their part, but governments can make the biggest difference; to fail to do what is necessary would be unforgivable. Remember the words of the young climate change activist Greta Thunberg: no one is too small to make a difference.” Annette Kennedy, President, International Council of Nurses.
It’s time for immediate and bold action
The world must recognize the burden that climate change inflicts on women’s, children’s and adolescents’ health and rights. We call upon governments to put the health of women, children and adolescents at the center of climate action by adopting a human rights-based approach to climate change adaptation and mitigation. They should also facilitate empowerment of women, children and adolescents to take leadership roles in climate change adaptation.
As health professionals, we are already seeing the impacts of climate change on human health. We call upon all health professionals to sign the Healthy Climate Prescription letter and urge our national leaders to take immediate and bold action in Glasgow.
PMNCH Health-Care Professional Associations constituency leadership: Errol R Alden, Immediate Past President, International Pediatric Association, Franka Cadée, President, International Confederation of Midwives, Mary Ann Lumsden, CEO, International Federation of Gynecology and Obstetrics, Eglė Janušonytė, Former Vice Chair, International Federation of Medical Students Associations and Carole Kenner, CEO, Council of International Neonatal Nurses.