Dr. Jeni Miller: “We do not have the luxury to set aside working on the climate crisis”

This is Pandemic Planet. The podcast where we talk about the urgent health security threats facing the world, the geopolitical and societal challenges they present, and how the United States can best lead health security efforts abroad while protecting Americans at home. Pandemic Planet is the podcast series of the CSIS Commission on Strengthening America's Health Security. While our sister podcast series, coronavirus crisis update, focuses on what's happening in America, here on Pandemic Planet will look at the global and geopolitical effects of health security threats. Welcome to Pandemic Planet. Hello and welcome to a new episode. I'm Catherine Bliss with the CSIS Global Health Policy Center. It's my pleasure today to speak with Dr. Jenny Miller, Executive Director of the Global Climate and Health Alliance. The Alliance is a network of researchers, professional associations, and non-governmental organizations focused on health and environmental issues, and they're from countries around the world, including Canada, India, the United Kingdom, New Zealand, Brazil, Chile, Spain, and South Africa, and many others as well. So today we'll be talking about the various ways in which climate change impacts health, how best to reach policy makers with information and recommendations for addressing the climate health link, and what Jenny expects to come out of the next conference of parties to the UN Framework Convention on Climate Change, which is scheduled to meet next month in Charmelle Shake, Egypt. Jenny, welcome to the podcast. Thank you, Catherine. I'm very pleased to be here with you. So climate change is a big topic. You've been working at the intersection of these two issues on environment and health for more than two decades. So I want to start by asking, you know, what experts like you, when you talk about the impacts of climate change on health, what really do you mean? Are you talking about the risks of air pollution or extreme weather events, or is it more about the risks of emerging infectious diseases, the potential for zoonotic diseases, and viral jump from animals to humans, thanks to changing conditions and land use patterns? What really are you talking about when you bring these two concepts together? Yeah, thanks, Catherine. You know, really it is all of those things. And as you said, it is a big topic. And the thing is when I tell people that, you know, non-experts, when I tell people that I work on climate and health, they're often surprised and they, you know, say, well, what's the connection? But as soon as I start giving them concrete examples, they're like, oh, of course, of course. So just to give some of those examples, in the US, we just had Hurricane Fiona come through in Hammer Puerto Rico and then Hurricane Ian hit Florida and moved on from there. And, you know, hurricanes are normal in the region, but hurricanes now are bigger. They drop more rain and they become more extreme due to climate change. And the health impacts of those are right now pretty obvious in Florida, which is where I grew up. Unfortunately, I believe they're still in the process of counting up the bodies of people who died in the storm. In some parts of Florida, there is now raw sewage as well as oil and gas contamination in some of the waterways. So those are exposing people to the potential spread of disease and toxic chemicals. In a few communities that many homes were flattened. So people are out of their homes. They're experiencing stress. They may have lost their medications that they need for ongoing medical conditions. They may have trouble resuming kind of the stability of their day-to-day lives, getting to work, getting to school, all of those things that enable somebody to go on about having a healthy and stable life. And we're seeing this kind of all across the country and all around the world. I'm from California now and we see extreme wildfires every year with injuries and deaths. And wildfire smoke, blanketing, large population centers like San Francisco. So people are breathing in air pollution from wildfire smoke. Last year in Canada, we saw hundreds of people die from a heat wave. People are experiencing mental health impacts. And then you mentioned air pollution. That's both comes from one of the drivers of climate change, which is, I'm early from burning fossil fuels, creates air pollution directly as well as driving climate change. But then also a warming climate makes air pollution worse. So yes, that's also part of what we're talking about. And then as you say, we're seeing infectious diseases and vector-borne diseases moving into different regions, different places, then we've seen them before because ecosystems are changing. And so all of those things are part of that intersection of climate change and health. The one other thing I'll say though is that intersection of climate change and health is a place where we have potential to see benefits. The climate action we need to take can benefit people's health by doing things like reducing air pollution and giving us cleaner water, and soil, and more livable, walkable cities and things like that. So they intersect in a number of ways that impacts are really can be quite severe and are ramping up as we see the planet continue to warm. But then there is that potential to go a different direction. So it sounds like it's a pretty complex cascade of issues. I mean, even just thinking about an extreme weather event like you explained to you, Hurricane Fiona or Hurricane Ian. I mean, you have the direct impacts people dying because of the being in the way of the storm and then the disease that is associated with contaminated water and the other infections that we know can often come in the wake of natural storms and natural disasters like that. But then you have the, you know, additional, maybe indirect impacts of the mental health stresses of displacement and homelessness or really not having, as you said, access to school and work and the normal day-to-day functions. But also the missed medical appointments, the missed prevention and treatment that people rely on for non-communicable diseases or other things that are unrelated. I mean, so even just taking like that one example, it's really a complex set of issues that sounds like really will need to bring together a number of different kinds of sectors in order to address the whole set of issues. I wanted to ask you to say a bit about the global climate and health alliance because, you know, if you look at your list of partners, you've got, you know, people from a number or organizations really from a number of different sectors. And so could you say just a little bit about, you know, how you were formed, who your members are and what your objectives are in this period of really focused on climate change, but also, you know, this period of really dealing with pandemic crisis as well? Yeah, absolutely. So the global climate and health alliance came together in 2011 on the margins of one of the UN climate negotiations, the climate negotiations that were in Durban that year. And was formed by a number of health organizations, some more health professional organizations, some were health and environment advocacy NGOs, some were other sorts of health NGOs. And all of them had in common that they had begun to recognize the threat that climate change posed to people's health, but did not really see the health dimension of the issue being recognized or elevated in international discussions and national and international policy making around this. And even though those organizations had been elevating the issue in their work, they really felt that there was a need for a joint global voice of the health community engaging on this issue. We've grown from our founding to we're now about 130 members from all over the world. We define health organizations rather broadly. My own background is in public health and as a public health practitioner, I'm very well aware that in order to enable people to have their healthiest lives, you don't just need doctors, nurses and folks, you know, hospitals and clinics as vitally important as those are, but you also need to work in a variety of other ways to create the conditions for people to be healthy. And so we include in our membership public health organizations, but also many development organizations in countries around the world that have a central focus or a significant focus on health because they too are health organizations. And the work that we do is really aimed at protecting people from those impacts of climate change that we were just talking about, doing everything in our power to move governments to take the actions needed to protect people's health and to mitigate climate change so that we won't see a increasingly worsening climate catastrophe. And at the same time, also to maximize those health benefits that we could see from climate policies and particularly if those climate policies build in health from the get go. And so really that's our core mission is to bring the joint health voice to pushing for action on climate change to protect health and ensuring that we get the greatest win-win, the greatest health benefits from that climate action that we're pushing for. So, you know, we've all been a little fixated on COVID-19 and the pandemic for the past few years and there have been some people who've said, well, we really can't deal with climate change issues right now. We have to deal with this pandemic crisis first. But, you know, it sounds like your organization is really trying to make everybody aware of is that we really have to think about health issues and potentially, you know, pandemic issues in every element of our policies, whether, you know, around environment or addressing some of the drivers of climate change and others. So, how do you, as an alliance, kind of respond to this idea like, oh, well, we have this health crisis now so we can deal with climate change later. During this period of pandemic, have your efforts kind of been stymied or is there, you know, kind of some way in which you all have kind of really accelerated and be doubled your efforts to move this agenda forward? Yeah, that's a great question. Absolutely. We are of the view that we have to keep working on the climate crisis alongside the pandemic, alongside the war in Ukraine, alongside the myriad other things that are going on. At this point, we are at a point where scientists and researchers and health foundations that I work with and others in the space talk about not just a climate crisis, but a climate catastrophe. So, anytime that we had to kind of kick the can down the road, we've used it up and then some. And so, those in the know about climate change see such an urgency about it that it can be astonishing that others don't recognize that urgency. So, we can't. We do not have the luxury to set aside working on the climate crisis while we're addressing the pandemic. And I would even say that climate change is often talked about as a threat multiplier. So, the impacts of climate change compounded the challenges of responding to the pandemic because, for example, in some places there had already been significant climate aggravated drought for many years that had impacted access to food. And then the impacts on supply chains due to the pandemic compounded those effects. So, these are not independent crises. These are crises that intersect with one another in really devastating ways. And in terms of the effect that the pandemic has had on addressing climate change, their number factors there, I think the pandemic has shown the world just how devastating a health crisis can be in its own right. It's health is not sort of a nice to have. Once you get the economy sorted out, it can actually turn the world upside down. But also, some of the governmental responses to the pandemic have served to mobilize the health community around climate change. And I'll just give you an example of what happened in 2020 around April, May of 2020. Governments in high-income countries had started to develop these pandemic economic recovery packages because the economies were being impacted by the pandemic. Funds from those economic recovery packages were being directed to carbon intensive industries. Health professionals that I work with were angry when they saw that happening because they were in hospitals, they were in clinics, they were out contact tracing as public health professionals working extremely hard to deal with this pandemic, you know, this global pandemic. And then they saw governments making decisions to reinvest in carbon intensive industries that would worsen the climate crisis knowing full well, you know, health professionals knew full well that that climate crisis would drive further health crises. And so they mobilized around a letter to G20 leaders objecting to this and calling for a healthy and green recovery. And that mobilization got signed on from organizations representing 40 million health professionals. The following year, last year in the lead up to the UN climate negotiations, the pandemic recovery mobilization was followed by an even greater support for a letter to national negotiators going to those climate negotiations signed by over 600 organizations representing 46 million health professionals. That's about two thirds to three-fourths of the health workforce. And in that letter, the health community called for things like a rapid and just phase out of fossil fuels, as well as financing to support lower income countries to make the transition to mitigate climate change and also to have resources they need to adapt to the impacts they're already seeing. So I think the health community recognizes that we need to be dealing with these issues together. And seeing governments fail to do so has been a factor in actually mobilizing the health community to be more vocal and more active in calling for that. So you shared some pretty powerful examples here of kind of the community, the networks that you work with and others coming together and really seeing to the G20 leaders, hey, we need to take this on, we need to do a better job in the pandemic recovery focusing on the negotiators at the COP26, I guess the climate talks last year. When you think about reaching out to non-expert, particularly policymakers, say here in the US to the US Congress, for example, who health maybe one of a dozen or more issues that they're dealing with or when you're talking to congressional staff who might be focused on these issues, what do you find to be the most effective messages? Is it the messaging around this is, contastrophase not even looming, it's already here, these are some challenges that we're facing, how do you kind of frame the messaging and what are the asks that you make of Congress or congressional staff when you talk with them? I think it's important to remember that health is a shared human value and everybody cares about our own health, we care about the health of our families, we care about the health of people in our communities, it's important to all of us, even when we may be faced with circumstances where we have to make trade-offs, like working a job that exposes us to toxic chemicals or living in a neighborhood where our children are breathing polluted air, people know that that's not right and we know that that's not what we want for our families and recognizing that climate change is a health issue helps to depolarize it a bit, we're not talking about right or left here, we're talking about people's health and well-being and bringing more public support for the actions that need to happen to address climate change is a really important part of encouraging policymakers to move on the issue. I think the other really important part of this story is something that I referenced earlier on, which is that there are tremendous potential health benefits from some of the things that we need to do to address climate change, and that's not just the health benefit of protecting people from climate change, but additional health benefits. Air pollution is the most obvious example if we phase out fossil fuels and transition to clean energy, one of the tremendous benefits of that will be reduced air pollution. Those kinds of health benefits bring with them health cost savings. That's a point that I think policymakers listen up for because yes, they want to protect people's health, they may think that's important. They also are looking at the economy, at budgets, at public budgets. So those economic savings from the health code benefits are really powerful dimension of the climate and health story, and we can see those from reduced air pollution, we can see those if we support and increase access to healthier diets, those healthier diets are also compatible with more sustainable agricultural practices, in urban settings, making our cities more walkable and bikeable, and with better public transportation, so that we're reducing individual vehicle travel, we're reducing use of gas and emissions from vehicles. So we have cleaner air, people have more physical activity. All of these will result in people being able to be healthier as part of their day-to-day lives, and that will reduce those health costs, which in the United States are huge. And you also asked, you know, what are our main asks to policymakers? The biggest one really is we've got to make the clean energy transition. We've got to phase out fossil fuels. They are the major driver of climate change. We have clean energy solutions that need to be ramped up and taken to scale. Work still investing public funds in supporting fossil fuels. Those subsidies and benefits need to be shifted so that they're really driving the solutions, not furthering the problem. Those are major issues. But then also, we need to be ensuring that as we make those transitions, there will be communities whose livelihoods are impacted as we make the transitions from one type of economy to another. We need to have policies and public investment in supporting that transition so that those communities can come into the clean energy economy with different kinds of jobs that are also, you know, good jobs that enable them to support their families. We need to make sure that this is done in an equitable way in the US as around the world. The worst impacts of climate change and the worst impacts of the drivers of climate change are often experienced by disadvantaged communities, low-income communities, under-resourced communities and those inequities are visible across the US and they're visible globally as well. So we need to in addition to policymakers is address those inequities and make sure that as we move forward everyone has access to a healthy sustainable life. So one challenge it seems to me in trying to kind of address these kind of multi-sectoral issues really is that the effects of climate change on health are often, I mean the effects may be health-related but the responsibility for dealing with the issue is often the domain of some other sector and I'm just thinking I used to work on water-related issues and safe drinking water and sanitation and the impacts on people's health, diarrheal disease and other issues are very clear but when you're talking about setting up a pipe system that's not necessarily the health sector that's putting that in or if we're talking about some of the impacts of air pollution or unsustainable agricultural practices that's a different sector or you know if we're talking about needing to adapt housing to deal with more extreme heat you know again it's not the health sector and so some of the examples that you've given above also I think really you know address this multi-sectoral challenge how do you motivate those other sectors to kind of take on the health issues you talked about the economic benefits which is certainly motivating at a national scale but maybe not industry or sector by sector. Does it require you know really some kind of larger overarching kind of policy making body to say like all of you are going to work together to address this do you have to kind of mandate it or do you really see are there examples where you know even at a small scale it really has worked to bring these groups together to focus on improving health outcomes. Absolutely the solutions have to come across many sectors. Health care is responsible globally for about 5% of greenhouse gas emissions so you know we do have a role to play directly I think in the US it's higher than that so we have a role to play in decarbonizing the health system itself and interestingly if you think about the role of a hospital or health care system in a community often they are kind of anchor institutions and at minimum they have significant supply chains that they rely on to provide their energy they're buying ambulances they have a supply chain for that the medications food dealing with their waste and so a hospital system or a health care system that sets targets to decarbonize itself and become more resilient to climate change and then requires its supply chain to meet those same targets can have significant influence into other sectors directly in that way and that's happening in you know a number of health systems national health systems last year at COP made commitments to start down that pathway but more broadly to answer your question it really is about having people around the table you know years and years ago there was an approach to policy development that's been referred to as health and all policies I would amend that now to say we need health and climate and all policies but really the approach there is getting representatives from those sectors into the room together to talk about where the win wins you know how can we make decisions together that benefit health but you know are beneficial for what we need to do on climate change and work for you know our agricultural needs our energy needs our housing needs etc and so it is about having the health community at the table and in those conversations but actually as you're suggesting that table needs to be set there needs to be a pulling together of the governmental leaders from those different sectors to be thinking about that work together and then bringing in those who deliver the results in those sectors as well so I think what the health and all policies movement showed is that this can be done and that it does result in benefits across sectors so yes the work has to happen across many sectors the other thing that I'll say is the health community I think has really recognized that climate change is impacting our patients the communities we serve we're not able to solve it alone because we don't have direct control over many of these other areas and that's exactly why the health community has become more activated and more vocal and more ready to actually go and participate in public hearings and policy decision making and advocacy and including street advocacy and activism because we recognize that there are things affecting the health of our patients and our communities that require other actors to change what they're doing and the health community is increasingly ready willing and able to call for those conversations in order to protect the health of their patients so you mentioned COP26 last year and some of the commitments that were made around health COP27 you know is coming up in a few weeks I guess one question is you know are you planning to go and if you are or even if you aren't to what extent do you expect health to be on the agenda I will personally be there my organization the global climate and health alliance always has a presence there and some of the work that we do there we're joined there by representatives from the health community doctors nurses med students public health professionals and a variety of health NGO representatives and we will be there speaking to national delegates talking to them about the importance of considering health in every bit of what they're doing and really thinking about health not as a kind of add-on issue but as something that is central to why we are addressing climate change if we're not protecting people's health we're sort of missing the boat but also some of the things that we've been talking about so far which is that if you think about health as you're designing your mitigation commitments you can come out with health benefits that save money that improve the well-being of your society while you're also addressing climate change so there are real reasons for the negotiators to be actively thinking about health when they're thinking about tracking how we're doing on climate change looking at health indicators is a valuable component of looking at whether we're doing well or whether we're doing poorly on climate change so we'll be there pushing that message in the company of a number of health professionals as of last year the World Health Organization has a physical presence in the the blue zone as it's called the negotiating area of the cop meeting so they will have a World Health Organization pavilion with a whole two weeks of programming on the intersection of climate and health inviting those who are at-cop and negotiating at-cop to learn more about this issue there will be health speakers at a number of other events and there will be official side events that center on health or that bring health into the conversation we're seeing more uptake in recent years of the health message and the recognition that climate change really is a health issue and health really is a climate change issue that there's a long way to go and so I expect to see more by way of integrating health into the discussion in the negotiations this year than we've seen in the past and I expect to come out wanting more and ready to push for more in following years we're in a position now where we have an uphill battle on climate change and we're seeing the devastating consequences on health all around us and so continuing to push for recognition of this that's not going to stop I expect to see more of it this year but we'll keep pushing for more beyond that as well Jenny Miller executive director of the global climate change and health alliance thank you very much for speaking with me we've talked about the ways in which the health sector itself can take charge of some of the climate-related risks and impact that it itself generates some of the different messages around the economic benefits of you know really looking at the intersection of climate and health some of the ways in which addressing climate change and making cities more livable more walkable more bikeable has added health benefits and of course the potential for additional movement and discussion at the global level in the coming weeks at the conference of parties in Charmel Shake Egypt thank you very much for speaking with me and good luck to you and your colleagues in the year ahead thank you so much Catherine it was a pleasure if you enjoyed this podcast check out our larger suite of CSIS podcasts from into Africa the Asia chess board China power AIDS 2020 the trade guys smart women smart power and more you can listen to them all on major streaming platforms like iTunes and Spotify visit csis.org/podcasts to see our full catalog