Elsevier

The Lancet

Volume 397, Issue 10269, 9–15 January 2021, Pages 129-170
The Lancet

Review
The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises

https://doi.org/10.1016/S0140-6736(20)32290-XGet rights and content

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For the Chinese, French, German, and Spanish translations of the abstract see Supplementary Materials section.

Section snippets

Executive summary

The Lancet Countdown is an international collaboration established to provide an independent, global monitoring system dedicated to tracking the emerging health profile of the changing climate.

The 2020 report presents 43 indicators across five sections: climate change impacts, exposures, and vulnerabilities; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. This report represents the findings

Section 1: climate change impacts, exposures, and vulnerabilities

A changing climate threatens to undermine the past 50 years of gains in public health, disrupting the wellbeing of communities and the foundations on which health systems are built.28 The effects of climate change are pervasive and impact the food, air, water, and shelter that society depend on, extending across every region of the world and every income group. These effects act to exacerbate existing inequities, with vulnerable populations within and between countries affected more frequently

Section 2: adaptation, planning, and resilience for health

With a growing understanding of the human costs of a warming climate, the need for adaptation measures to protect health is now more important than ever. The COVID-19 pandemic makes clear the challenges faced by health systems around the world resulting from large unexpected shifts in demand without sufficient adaptation or integration of health services across other sectors.124 As this public health crisis continues, and is compounded by climate-attributable risks, rapid and proactive

Section 3: mitigation actions and health co-benefits

In 2018, greenhouse gas emissions rose to an unprecedented 51·8 gigatonnes of CO2 equivalent (GtCO2e; 55·3 GtCO2e including land use change), with fossil fuel emissions from transport, power generation, and industry accounting for 37·5 GtCO2e (72%).146 The vast majority of the growth in emissions, the economy, and the demand for energy occurred in low-income and middle-income countries, despite global economic headwinds.147

COVID-19 has had a profound effect on the global economy and on

Section 4: economics and finance

Section 1 described the emerging human symptoms of climate change, and sections 2 and 3 detailed efforts to adapt and mitigate against the worst of these effects. In turn, section 4 examines the financial and economic dimensions of the impacts of climate change and the efforts to respond.

The Intergovernmental Panel on Climate Change estimate that limiting warming to 1·5°C would require an annual investment in the energy system equivalent to around 2·5% of global GDP until 2035.82 Such

Section 5: public and political engagement

As previous sections made clear, the health impacts of climate change are multiplying, disproportionately affecting those who have contributed least to rising global temperatures. The public are voicing concern as individuals, and as members of communities and new social movements, urging for greater ambition from those with the power to curb carbon emissions.203, 204, 205, 206, 207, 208, 209, 210

This section tracks engagement in health and climate change across multiple parts of society,

Conclusion: the 2020 report of The Lancet Countdown

With the global average temperature having risen to 1·2°C more than that in preindustrial times, the indicators contained in the 2020 report provide insights into the health impacts of climate change today and in the future. Extremes of heat affect vulnerable populations the most, with some 296 000 deaths occurring as a result of high temperatures in 2018 (indicator 1.1.3).

The climate suitability for the transmission of a range of infectious diseases—dengue fever, malaria, and those caused by

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