Climate and Health at COP30
Sophie Gepp from Centre for Planetary Health Policy(CPHP) and Co-Chair of the GHHG Steering Committee shares her reflections from COP30 in Belém.
The Lancet Countdown on Health and Climate Change 2025 leaves no room for doubt: climate change has long since become an acute global health crisis. Heatwaves, extreme weather events, food insecurity, and shifting disease patterns are already placing significant strain on people and health systems worldwide - with particularly severe consequences for vulnerable populations.
COP30 in Belém took place under distinctive circumstances. Hosted by Brazil in Belém, the gateway to the Amazon, forest protection, deforestation, and Indigenous rights moved more strongly into the center of political and public attention than at many previous COPs.
Another defining feature was the strong and highly visible presence of civil society. After several COPs held in countries with severely restricted opportunities for protest and participation, social movements, Indigenous communities, and local actors were once again clearly present. Large demonstrations, the People’s COP, and coordinated actions by Indigenous groups lent political weight to demands for recognition and demarcation of Indigenous territories as well as for direct financial support.
At the same time, the conference took place in a challenging geopolitical context. The withdrawal of the United States, global cuts in development cooperation, and an overall tense multilateral environment undermined trust in international pledges. This was compounded by the continued significant influence of fossil fuel interests - according to analyses by Kick Big Polluters Out, roughly one in 25 participants was affiliated with the fossil fuel industry.
Health in the Climate Negotiations
What role does health play in climate negotiations? At COP30, health appeared on three levels: as a political argument for ambitious climate action, through sectoral initiatives and commitments, and explicitly and implicitly within key negotiation tracks. Ultimately, one point remains decisive: the best outcome for health is an overall ambitious result of the COP.
1. Health as an Argument for Climate Action
Health is often described as the “human face of climate change.” At COP30, health actors made clear that climate change is not an abstract future threat, but a present-day reality that already determines life and death, disease, work capacity, and social stability - and that ambitious climate action saves lives here and now.
This message was reinforced through coordinated actions, side events, and a large demonstration by health professionals. Physicians, nurses, and public health experts helped translate often highly technical negotiations into national and local contexts and make them understandable to the broader public.
For the first time, the health argument was also reflected in final negotiation outcomes: COP decisions explicitly referenced the health co-benefits of climate action. The “Mutirão” decision highlighted the economic and social opportunities of climate action - including economic growth, job creation, improved energy access and security, and better public health. In addition, decisions on Just Transition explicitly mentioned health gains resulting from reduced air pollution.
2. Health-Related Initiatives
Beyond the negotiations, health policy initiatives and commitments within the UNFCCC context have increasingly emerged in recent years. At COP26 (2021), a Health Programme was launched for the first time; more than 80 countries have since joined, committing to climate-resilient and/or low-emission health systems. COP28 (2023) significantly increased the visibility of health, including through the first Health Day and the Declaration on Climate and Health, which has now been endorsed by over 150 countries.
The Brazilian presidency also placed health prominently on the COP30 agenda - as part of the Action Agenda, through preparatory conferences in Brazil, a Health Day, and the launch of the Belém Health Action Plan on Adaptation in the Health Sector (BHAP).
The BHAP positions itself as a global roadmap to strengthen climate-resilient health systems and is based on three pillars:
- Surveillance and early warning systems for climate-related health risks
- Evidence-based policymaking and capacity building
- Innovation and sustainable health service delivery systems
The plan places a strong emphasis on equity and vulnerability but is clearly limited to adaptation within the health sector. To date, it is supported by around 30 countries and 50 organizations. Political buy-in is therefore visible but limited. Several countries expressed dissatisfaction, citing restricted opportunities for co-design, formulations that go beyond existing UN-agreed language, and what they perceive as an overly narrow focus on adaptation. This criticism is partially shared by civil society actors.
A key question will be whether and how elements of the BHAP are effectively implemented, adequately financed, and systematically aligned with existing UNFCCC and WHO processes.
An important signal also came from the Health Day, with the announcement of USD 300 million by a Climate and Health Funders Coalition. These funds are intended to support adaptation measures, the expansion of climate-resilient health systems, and evidence-based policy processes. This year, the Health Pavilion once again helped to increase the visibility of health issues and strengthen the professional exchange between relevant stakeholders.
3. Integrating Health Across Negotiation Tracks
Beyond specific health initiatives, health featured across several negotiation tracks. This section highlights three areas, though many additional decisions - such as those on finance, gender, or loss and damage - are also highly relevant for health. A detailed overview is provided in the COP30 debrief by the Global Climate and Health Alliance.
Mitigation
While the phase-out of fossil fuels was not formally part of the negotiations, it gained political momentum. President Lula raised the issue in his opening speech, and more than 80 countries later supported the call for a Transition Away from Fossil Fuels (TAFF) roadmap.
However, a formal breakthrough failed to materialize. Neither a TAFF roadmap nor a roadmap on deforestation was included in the final outcome document, nor was there an explicit reference to fossil fuels. COP30 therefore fell short of expectations on key issues for many countries and civil society actors. The conference also failed to provide a clear response to the ambition gap emerging after the submission of many new national climate plans.
Attention now turns to the announced follow-up process. In the coming months, roadmaps on fossil fuels and deforestation are to be further developed, and an initial international conference on fossil fuel phase-out is planned for April 2026 in Colombia. Health actors should actively engage in this process to systematically integrate health co-benefits.
Adaptation
Adaptation is central for the health sector, as it determines whether health systems can cope with rising temperatures, extreme weather events, and changing disease risks. At the same time, adaptation remains massively underfunded; the latest Adaptation Gap Report shows that required adaptation finance exceeds actual international financial flows by a factor of roughly twelve to fourteen.
A major focus of COP30 was agreement on indicators to measure global adaptation progress under the Global Goal on Adaptation (GGA). This concluded a two-year technical process involving numerous health organizations - a significant milestone for embedding health in UNFCCC processes. An expert group, including specialists in health, had initially identified 100 indicators from several thousand proposals. After intensive negotiations, a list of 59 adaptation indicators was adopted, including eight health-related indicators and several indicators on means of implementation (finance, technology transfer, and capacity building).
Despite this progress, the outcome remains mixed. Last-minute changes - some made behind closed doors - affected the feasibility and completeness of the indicator set. Significant uncertainties remain regarding operationalization, methodology, data availability, and financing for monitoring.
On finance, the final text references a tripling of adaptation finance, but only by 2035 and without a clear baseline - significantly weaker than the LDCs’ demand for USD 120 billion by 2030.
Procedurally, a two-year Baku Adaptation Roadmap was adopted, providing for further technical work (potentially including the indicators) and strengthened implementation, including in the health sector. This next phase offers countries an opportunity to make health-related adaptation more visible - provided it is politically supported and adequately financed.
Just Transition
COP30 also featured important negotiations on Just Transition. In this context, health was addressed in particular as a human right and in relation to clean cooking, air quality, occupational heat stress, the care economy, and informal work.
Health references were ultimately anchored in the decision text, and a Just Transition Mechanism was adopted. This mechanism, explicitly demanded and welcomed by civil society, represents a significant step forward.
Outlook
Multilateral cooperation is under considerable strain - both in international climate policy and in global health governance. Financing gaps, geopolitical tensions, and blockages by vested interests shape both fields.
Ten years after its adoption, the Paris Agreement nevertheless remains a central reference point. The WHO rightly describes it as a “fundamental public health agreement.” Prior to Paris, the world was heading toward around 4°C of warming; today, projections stand at approximately 2.8°C, or about 2.3–2.5°C with full implementation of national climate commitments. This demonstrates what multilateral cooperation can achieve - while also underscoring that it remains insufficient to protect people and health.
This year’s advisory opinion of the International Court of Justice clearly emphasized that states are legally obliged under international law to pursue effective climate action to prevent significant harm to people and health, particularly for present and future generations.
It is clear that the COP process requires reform to better meet these challenges and to strengthen this crucial forum in which all countries have a seat at the table. At the same time, coalitions of ambitious states and actors willing to lead are essential.
It is vital that health actors engage at all levels and continue to emphasize one key message: ambitious climate policy is not only environmental or economic policy - it is large-scale preventive public health policy.