Further delays in tackling greenhouse gas emissions at COP28 will be an act of negligence

Climate change is causing irreversible human harms, and putting the survival of millions of people at risk, as the latest report of the Lancet Countdown on health and climate change underlines.1 At the current 1·14°C of decadal average heating compared to pre-industrial times, heat-related deaths in people older than 65 years have increased by 85% since the 1990s, twice the level expected if temperatures had not changed.1 The higher frequency of heatwaves and droughts since 1981–2010 has pushed 127 million more people to moderate or severe food insecurity, and the climate is becoming more suitable for the transmission of many infectious diseases, increasing the risks of outbreaks and pandemics.1 These social and health impacts also have economic ramifications. [...]the COP28 UN Climate Change Conference in Dubai, United Arab Emirates, on Nov 30 to Dec 12, 2023, will be a negotiation about the survival of millions of people. [...]international negotiations have so far legitimised life-threatening inaction. Without binding international commitments, countries continue to subsidise fossil fuels; private bank lending to the fossil fuel sector has risen since the Paris Agreement; and the world's 20 largest oil and gas companies have increased their extraction plans and are on track to surpass their emissions consistent with the Paris Agreement by 173% by 2040—up from 112% in 2022.1 For COP28, the COP President is the Chief Executive Officer of the Abu Dhabi National Oil Company (ADNOC), the world's seventh largest national oil and gas company by market share.9 The COP28 presidency's focus on mitigation leans strongly on delaying the fossil fuel phase-out, and pursuing carbon capture and storage, a technology that is expensive and unproven at scale.10,11 Despite a net-zero centred marketing campaign, ADNOC has expanded its fossil fuel production plans since February, 2022 and is now on track to exceed emissions compatible with 1·5°C, according to its market share, by 188% by 2040.1 Single wind turbine, a coal burning power plant with pollution and electricity pylons in the background. acilo via Getty Images Against this backdrop, health will be included for the first time as a key theme in COP28, which will also hold the first climate health ministerial meeting.