Belem Health Action Plan a step forward but misses opportunity for climate crisis mitigation
As part of COP30, the Belem Health Action Plan was launched, recognising that the climate crisis is also a health crisis, and the growing need to strengthen the resilience of health systems. It has been endorsed by more than 40 countries and many development agencies and civil society organisations, as a positive step to strengthen the health response to climate change. While NCD Alliance welcomes its adoption, we regret the absence of mitigation, as only through reducing emissions can we truly tackle climate change and its increasing burden on health.
We welcome the proposed early warning system measures as an important resource to help people make informed decisions, particularly for people living with existing health conditions including NCDs, who are at heightened risk from climate-related hazards. This is particularly pertinent for air pollution, as exposure to wildfire smoke led to a record 154,000 deaths in 2024 in addition to heat, which now causes 546,000 deaths a year.
The Action Plan also calls on governments to identify a priority list of climate-related risks and diseases, and NCD Alliance strongly urges for NCDs to be recognised among the conditions most impacted by climate change. Air pollution kills around eight million people each year, with 86% of these deaths from NCDs; while extreme weather events exacerbate existing NCDs and increase health risks. Yet NCDs remain among the least commonly identified climate-sensitive health risks, appearing in just 22% of National Adaptation Plans and just 59% of Health National Adaptation Plans. When NCDs are excluded from climate risk assessments, the demand on health systems is underestimated during heatwaves, wildfires, floods and pollution episodes, placing millions of people at avoidable risk.
We strongly support the cross-cutting principles of the BHAP and are pleased to see the importance of both climate justice and social participation fully recognised. Climate change disproportionately harms people in vulnerable situations, including those living with NCDs, low-income communities, Indigenous peoples, and small island populations, making meaningful involvement crucial at every stage of policy processes.
While NCD Alliance welcomes adoption of the Belem Health Action Plan at COP30, its predominant focus on health sector adaptation is a missed opportunity to confront the crux of the issue. With the increasing health burden attributable to climate change, we regret the absence of mitigation in the action plan. We cannot adapt our way out of this crisis. Only through decisive action to reduce emissions can we prevent the escalating health risks that exceed the limits of adaptation.
Governments have made already commitments to do so. Earlier this year at the 78th session of the World Health Assembly, governments made a commitment to halve the mortality associated with human-caused air pollution by 2040. If implemented, efforts would also help mitigate greenhouse gas emissions as climate change and air pollution are both driven by fossils fuels. This would free up substantial resources across the health sector. We therefore urge alignment of the BHAP with this roadmap and commitments on air pollution in this year's Political Declaration on NCDs and Mental Health, as well as with the WHO Global Action Plan on Climate Change and Health.
More action is needed to reduce the burden of fossil fuels, which continue to cause 2.54 million deaths from outdoor air pollution and 2.3 million deaths from household air pollution every year, adding to the already devastating burden of mortality attributable to climate change. Accelerating the transition to clean energy is therefore essential for both climate and health. That is why complimentary measures such as the Belem Action Mechanism for a Global Just Transition (BAM), which has enjoyed broad support, are crucial. The Belem Health Action Plan is no doubt a positive step. Health must be at the forefront of climate discussions because the climate crisis is, fundamentally, a health crisis. We therefore encourage governments to endorse and implement the plan, taking essential steps to strengthen their health systems resilience against the impacts of climate change. But to truly protect communities, adaptation must go hand in hand with ambitious mitigation. Without rapid and far-reaching reductions in emissions, climate-driven health risks will continue to grow, outpacing health system capacities and the ability of adaptation measures.
