Cities and islands respond to climate change and health challenges

As climate change increasingly threatens public health, the World Health Organization (WHO) is working closely with Member States in the Western Pacific Region to strengthen climate resilience.

At the 10th Global Conference of the Alliance for Healthy Cities, held from 25-27 September 2024 in Seoul, Republic of Korea, WHO convened a special panel: Strategies for Healthy Cities and Islands Addressing the Climate Crisis. The panel, which took place on the second day of the conference, brought together mayors, city leaders and experts to discuss how urban and island communities in the Western Pacific can protect vulnerable populations and build climate-resilient health systems.

The WHO Western Pacific Region is home to 1.9 billion people. Three out of five people live in cities, and 100% of Pacific islanders live in vulnerable coastal areas. Rising sea levels, extreme weather events and environmental degradation pose serious risks to health infrastructure and community well-being. For small island developing states, the threats posed by climate change are severe, with health facilities and populations increasingly exposed to storms, floods and rising tides.

Speaking at the event, Dr Susan Mercado, Director of Programme Management for the WHO Western Pacific Region, emphasized the role of cities and islands in spearheading climate and health action. She stressed the need for transformative strategies that would "foster health-supportive environments in the face of climate challenges", building upon international commitments such as the 2015 Paris Agreement, COP28 UAE Declaration on Climate and Health and the 2030 Agenda for Sustainable Development "to accelerate local-level action on climate and health".

Dr Wilfried Kreisel, Chair of the Strategic Advisory Group of the WHO Asia-Pacific Centre for Environment and Health, called for bold, science-based solutions supported by data collected over more than three decades. "We stand at the precipice of an existential challenge for all of humanity. The climate crisis demands that we use science and technology to create solutions," he said. "By creating a global network of resilient cities and islands, we can unite to confront the greatest challenge of our time: the climate crisis."

"We have accumulated sufficient evidence in the past three decades," he said. "Now is the time to act."

Dr Kreisel outlined four key areas for collaboration in cities and islands − transitioning to renewable energy, enhancing coastal resilience, promoting sustainable urbanization and adopting a planetary health approach. He said strategic priorities should be financial investment, solidarity through mutual aid and adherence to a global framework.

Mr Gaafar J. Uherbelau, Palau Minister of Health and Human Services, shared how community-led adaptation - drawing on traditional and indigenous knowledge and practices - was essential in addressing the climate crisis.

He called for collective action: "Renovating and rebuilding health-care facilities requires financing. We need funds to build resilience. Rising sea levels are an enormous concern for us. The loss and damage to our health facilities in coastal areas is a great risk."

"At the rate we're going, we will all be vulnerable," he said. "We need to focus on human health, animal health and environmental health."

The impacts of climate change on health infrastructure are evident across the Pacific. Dr Siale 'Akau'ola, Minister of Health of Tonga, shared how communities in Tonga's outer islands are increasingly inundated by seawater during cyclones. Although the people of Tonga remain optimistic about the future, he said many are seeking refuge overseas.

Professor Vivian Lin, a health systems and urban health expert from the University of Hong Kong, highlighted how interconnected the world is and how everyone is impacted by the same risk factors. "A multisectoral approach to climate action and urban health is key to preventing the mortality and morbidity from climate hazards," she said. Professor Lin urged cities and islands to collaborate across governance structures to share solutions and tackle future challenges.

At the closing session, Dr Ruediger Krech, Director of the Department of Health Promotion at WHO headquarters in Geneva, emphasized the need for collaboration to safeguard public health against the growing impacts of climate change. He highlighted the importance of tackling the commercial factors that affect health, particularly the significant 6 trillion US dollars in global subsidies for the fossil fuel industry. Dr Krech urged for the creation of a legally binding treaty that prioritizes health and well-being.