How climate change is making us sick — and rich countries don’t want to pay up

Only about one in three governments — 35% — pointed out the impact of climate change on their citizens’ health in their yearly United Nations (UN) Debate statements in 2023 — down from 50% in 2022, according to the latest edition of the Lancet Countdown report  on health and climate change.

During UN General Debate sessions governments address the General Assembly — the body’s main policymaking unit — about issues in world politics they believe should be prioritised and require international action. 

But public health experts at the world’s largest annual climate change meeting, of which the 29th gathering — COP29 — is taking place in Baku, Azerbaijan until next week, warn that government leaders who are negotiating by how much their countries need to cut carbon emissions are actually negotiating with people’s health.     

“Climate change is making us sick,” said Maria Neira, director of environment, climate change and health at the World Health Organization (WHO) at a press conference on Tuesday.

“It’s affecting the way in which we are producing food, how polluted the water we drink and the air we breathe are, it influences who gets displaced, how heatwaves are now killing people around the world, and of course, it impacts our mental health.”  

The Lancet’s newest report found that in South Africa, babies and adults older than 65, for whom climate change is worse, endured between five and six heatwave days — when the weather is abnormally hot — in 2023, compared with three such days per year in the previous decade.  

And because exposure to heat also makes people less productive, this has translated into 181-million potential work hours lost last year — an increase of 34% from the 1990—1999 average. Construction workers in South Africa were hit the hardest, the report found, with about half of their potential work hours lost — and with that their income too.  

South Africa is at the beginning of one of its hottest summers ever, says the SA Weather Service, and it’s right in line with what the rest of the world is experiencing. 

According to the World Meteorological Organisation’s State of the Climate 2024 Update, released at COP29, 2024 is on track to be the warmest year on record.

The January-September 2024 global mean temperature was 1.45°C above the pre-industrial average, dangerously close to the 1.5°C rise in temperature that 196 countries, including South Africa, who signed a legally binding agreement in Paris in 2015, pledged not to exceed to avoid the catastrophic consequences of more floods, droughts and illness. 

For that to happen, states need to ramp up their efforts to cut warming gases — but that costs a lot of money, because they have to ditch fossil fuels — coal, oil and gas — and rather use solar or wind energy to generate power. That’s because burning coal and oil releases lots of greenhouse gases into the air, which forms a type of blanket around the Earth and makes the air warmer and warmer.  

COP, which stands for conference of the parties (the countries that have signed the UN Framework Convention on Climate Change, the UNFCCC, in 1992), is the decision-making body for all things climate change. Leaders from signatory countries are at COP29 to fight out who needs to pay what to stop the Earth’s atmosphere from heating up further. 

And it’s a fight for justice. 

Because wealthier countries are more industrialised than poorer states, they’ve emitted considerably more greenhouse gases into the air than their developing counterparts, and have therefore contributed the most to climate change.   

“This is a story of avoidable injustice. The rich cause the problem; the poor pay the highest price,” UN secretary-general António Guterres, said at the opening of the World Leaders Climate Action Summit at this year’s conference on Tuesday.  

In a study released just two weeks before COP29 kicked off, Oxfam found that “the richest billionaires emit more carbon in an hour and a half than the average person does in a lifetime”. Unless emissions plummet and adaptation soars, said Guterres, “every economy will face far greater fury”.

Countries at COP29 have to agree on how much, and through which channels, wealthy countries will have to pay to help emerging economies like South Africa move to greener forms of energy — and fund plans to prepare for the devastating consequences of floods and droughts as a result of it.

And the president-elect of the country that emits the most greenhouse gases per person — the US — isn’t in Baku. He’s called climate change a “hoax” and a “scam” and, the New York Times reports, is likely to, for a second time (after his first presidency between 2017 and 2021) pull out of the Paris Agreement, and “abandon plans to give financial aid to poor countries”.  

Meanwhile, it’s not just the environment, but also people’s health that’s suffering — and that goes far beyond heat-related diseases. 

Here are five reasons why. 

1. Heat will make life risky for new moms and their babies

Less than 3% of funds to combat climate change focus on things that can keep pregnant women and kids safe, a Unicef report shows. “Yet children are 30% of the world’s population — and 100% its future,” said Abheet Solomon, who leads the Healthy Environments for Healthy Children programme at the UN agency, at Tuesday’s press conference.

During pregnancy, a woman already struggles to keep cool because of the changes in her body to support the growing foetus. Add extra heat from outside, like on very hot days or during a heatwave, and it becomes even more difficult. Because of the chain of chemical reactions that follow, the chances of early labour, miscarriage, stillbirths or birth defects rise, shows yet another big analysis, published in Nature Medicine last week.   

2. Infectious diseases will spread easier — or crop up where they’ve never been

As weather patterns change, how far and fast germs spread will change too. For example, in Africa, the mosquitoes which carry the parasite that causes malaria have, since the start of the 1900s, steadily crept northwards from their original tropical climes. They’ve also slowly moved into higher-lying areas (where it was previously too cold for mosquitoes to survive). This means that malaria could become widespread in the highlands of East Africa — where it previously was uncommon.

But it’s not only diseases carried by insects that will become more widespread. Floods and storms, which experts say will worsen as the climate changes, can wash roads away and stop people from getting to a clinic. When someone with HIV or tuberculosis, for instance, can’t carry on taking their medicine, the germs causing these diseases can start multiplying in their bodies again and make it easier for the disease to spread.

3. Breathing could become a struggle

Some of the gases making the Earth hotter are also polluting the air. For people who already have a lung problem (say, asthma or chronic obstructive pulmonary disease — in which the airways narrow and so make someone short of breath), breathing could become even harder when it’s very hot. That’s because your body struggles to deal with heat when you already battle to breathe, Caradee Wright, a public health specialist who leads the Climate Change and Health Research Programme at the Medical Research Council, told Bhekisisa last year. 

It’s a double whammy for people who live in areas with dirty air, such as Secunda in Mpumalanga, where chemical plants and power stations billow greenhouse gases, sulphur dioxide and tiny bits of solids into the air. 

4. Many (more) people will go hungry

Climate change is already making it hard for people to get enough to eat to stay healthy, the new Lancet Countdown report shows. It’s not only that extreme weather events  such as droughts or severe storms destroy crops, but in future, farmers could also struggle to grow enough food. 

A 2021 modelling study, for example, shows that because of warmer conditions and erratic rainfall linked to human activities, the world’s farming yields dropped by 20% over the past 60 years. This, the authors say, is the same as if the amount of food produced by farmers is stuck at the level it was in 2013 — only the planet’s population grew by almost 600-million people between 2013 and 2020. 

Even when there is enough food available, people may not be able to get it or safely store and cook it when severe weather hits, as researchers found in the aftermath of the disastrous floods in KwaZulu-Natal in 2022.

5. Stress about climate change will get people down

In a large study published in 2021, more than half of the 10,000 under-25s asked about how climate change makes them feel said they experience negative emotions like anxiety, sadness, guilt and feeling powerless. Three out of four young people are frightened about the future.

But worries about the future’s climate is only one part of what gets us down, says Collins Iwuji, a principal investigator on a Wellcome Trust-funded study about the effects of floods on people’s mental health in four African countries, including South Africa. 

For example, when a destructive flood hits, people can lose their home, jobs or family members “in the blink of an eye”. This sudden loss creates a feeling of despondency, he says, and when people have to flee their homes on top of that, they often lose their social support networks too. It’s not hard for serious problems like anxiety, depression and post-traumatic stress disorder — a mental health condition caused by a terrifying event — to set in and, says Iwuji, “this can persist for years”. 

Mia Malan is the founder and editor-in-chief of Bhekisisa. She has worked in newsrooms in Johannesburg, Nairobi and Washington, DC, winning more than 30 awards for her radio, print and television work.

Linda Pretorius is Bhekisisa’s content editor. She has a PhD in biosystems from the University of Pretoria has been working as a science writer, editor and proofreader in the book industry and for academic journals over the past 15 years. At Bhekisisa she helps authors to shape and develop their stories to pack a punch.

This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.