WHO AFRO Participation at COP26 and COP27

events and call for Action at COP28

WHO AFRO builds on its strong involvement on climate and health globally, with active participation to the COP26 and COP27. The recognition by the UK COP26 Presidency of the importance of the health dimensions of climate change has opened up opportunities to raise the profile of health at the COPs and to continue the scale up of support to Member States in key areas such as building climate-resilient, environmentally sustainable health systems, and facilities and addressing the need for access of health in multilateral climate finance. Up to date, twenty four AFRO countries (Burkina Faso, Cape Verde, Central African Republic, Cote d’ Ivoire, DRC, Ethiopia, Gabon, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mauritania, Mozambique, Nigeria, Republic of Congo, Republic of Tanzania, Rwanda, Sao Tome and Principe, Sierra Leone, Togo, Uganda, Zambia) have already engaged to the COP26 Health Initiatives by developing their countries’ commitments for “Climate Resilient Health Systems” and “Low Carbon Sustainable Health Systems” and confirmed their high-level commitments, while more AFRO member states are considering their high-level engagements to the COP26 Health Programme.

Additionally, WHO AFRO is strongly involved in the “Alliance for Transformative Action on Climate and Health (ATACH)” initiative, launched in 2022 to build a climate-resilient and low-carbon health system. who supported countries (24 of the 47 AFRO countries as of March 2023) to engage in this initiative.

ATACH focuses on 5 Thematic Areas:

Financing the Health Commitments on Climate Resilient and Sustainable Low Carbon Health Systems.
Climate Resilient Health Systems.
Low Carbon Sustainable Health Systems.
Supply chains.
Nutrition; taking stock of the recently launched initiative on Climate Action and Nutrition (I-CAN), during the COP27.

1. COP 26 Health Programme on Climate Resilient and Sustainable Low Carbon Health Systems

Towards the path to the COP26, AFRO co-organized, co-chaired and facilitated the Regional Consultation on Climate Change and Health in collaboration with WHO-HQ and the Global Climate and Health Alliance, the 4^th May 2021. A special session for presenting 5 Climate Change and Health Case studies from AFRO Countries (Ghana, Sao Tome and Principe, Ethiopia, Madagascar, Mozambique) was coordinated by AFRO RO. AFRO Countries have been assisted to prepare their Case studies on Climate Change and Health with the purpose to feed the Special COP26 Report and to be presented during the UNFCCC COP26 in Glasgow. Case studies have been received so far from several countries including Ethiopia, Ghana, Kenya, Madagascar, Malawi, Mozambique, Sao Tome and Principe, South Africa, and Zimbabwe.

AFRO Participation to the COP26: Climate change as a health issue

The 26^th Conference of the Parties to the United Nations Framework Convention on Climate Change (UNFCCC) took place from the 31^st October to 12^th November 2021, in Glasgow UK, while WHO hosted the 4^th Global Conference on Health & Climate Change (6 November 2021) in partnership with the Global Climate and Health Alliance (GCHA), and the Glasgow Caledonian University and its Centre for Climate Justice, at the margins of the COP26 in Glasgow.

Climate change is resulting in lower health outcomes, increasing mortality driving health inequities especially in the African region, which while one of the lowest emitting Regions is a major recipient of the consequences of climate change on health. The COP26 Health Programme has been established to bring stronger health focus and ambition to COP26. Key health priorities for COP26 include:

Building climate resilient health systems;
Developing low carbon sustainable health systems;
Adaptation Research for Health;
The inclusion of health priorities in Nationally Determined Contributions; and
Raising the voice of health professionals as advocates for stronger ambition on climate change

Health has since been chosen as a COP26 science priority cluster, something further highlighted by the presence of a high number of Ministries of Health delegates, representatives of the Health Care sector, Health and Climate Researchers and overall stakeholders. It should be noted that representatives from the Ministries of Health of the AFRO countries participated in the event and specifically from: Cabo Verde, Central African Republic, Cote d’ Ivoire Kenya, Madagascar, Malawi, Sao Tome and Principe and Togo. The COP26 Health Programme aimed to bring together countries in a position to state their ambition to develop climate resilient sustainable health systems and engage into 2 specific Commitment areas.

The COP 26 Health Commitments are therefore:

Commitment area 1: Climate resilient health systems

Commit to conduct climate change and health vulnerability and adaptation assessments (V&As) at population level and/or health care facility level by a stated target date;
Commit to develop a health National Adaptation Plan (HNAP) informed by the health V&A, which forms part of the National Adaptation Plan (NAP) to be published by a stated target date; and
Commit to use the V&A and HNAP to facilitate access to climate change funding for health (e.g. project proposals submitted to the Global Environmental Facility (GEF), Green Climate Fund (GCF) or Adaptation Fund (AF) or GCF Readiness programme).

WHO AFRO and HQ have already been assisting countries on all 3 targets of Commitment Area 1 for conducting/updating V&As and H-NAPs, reviewing the National Adaptation Plans and making sure Health is a uniquely distinct sector of high priority. In addition, we have been assisting countries to develop and submit GCF Readiness proposals, with Sierra Leone and Mauritius already having their proposals under the 1st and 2nd review stage by the GCF. Therefore, one of our key tasks is to ensure and further assist countries implement those commitments. Accessing finance is one of the key actions required to ensure that this can be fully achieved.

This commitment aims to get member states to fully commit to developing a national health and climate change plan/strategy which is based on a systematic assessment of the vulnerability and adaptive capacity of the health systems to climate change.

Commitment area 2: Sustainable low carbon health systems

Commit to set a target date by which to achieve health system with net zero emissions, ideally by 2050
Commit to develop an action plan or roadmap by a set date to develop a sustainable low carbon health system (including supply chains), which also considers human exposure to air pollution and the role the health sector can play in reducing exposure to air pollution through its activities and its actions.

The health sector is a major contributor to greenhouse gas emissions, accounting for around 4.6% globally. This provides the health sector with a brilliant opportunity to exhibit leadership on emission reduction, contribute to national climate targets, build greater health facility resilience, and directly confront the nexus between climate and health.

Globally, 50+ countries have committed up to date, with expectations for the number to rise in the forthcoming period.

Some COP26 key messages for the Health Sector:

Health community has shown up in record numbers: The healthy prescription letter has been signed by 45 million health professionals;
The health argument for climate action is clear: COP26 report with 10 recommendations, would lead to benefits for both climate and health;
Countries are starting to see these connections, and action is now also happening in health sector itself: 51 countries have signed up to country commitments but the process is ongoing;
Many countries are still largely unprepared and unsupported in regard to climate and health;
COP26 built some important entry points for further enhancing the climate and health agenda in the COP27 in Egypt.

Some general key outcomes of the COP26:

Mitigation: Parties to accelerate efforts towards the phase-out of unabated coal power and inefficient fossil fuel subsidies, recognizing the need for support towards a just transition; The UNFCCC will produce annual synthesis reports for NDCs.
Adaptation Finance: Developed countries are urged to double their collective provision of climate finance for adaptation to developing countries from 2019 levels by 2025;
Loss & Damage: Dialogue between parties to discuss the arrangements for the funding of activities to avert, minimize and address loss and damage associated with the adverse impacts of climate change;
Collaboration: Urgent need to close the gaps in implementation towards the goals of the Paris Agreement; UN Secretary General is invited to convene the world leaders in 2023 to consider ambition to 2030;
Health: the health community mobilised in unprecedented numbers, calling for urgent action in the months leading to COP, and delivering the health argument for climate action to many different sectors and leaders at COP. Over 50 countries committed to transform their health sector to be resilient and sustainable, and the health community has become a more visible and relevant part of the climate negotiations.

WHO AFRO participation at the COP27

Arab Republic of Egypt hosted the 27^th Conference of the Parties (COP27) to the United Nations Framework Convention on Climate Change (UNFCCC), in Sharm El Sheik from 6 to 18 November 2022.

COP27 has been critical for resolving pending issues on finance, support on adaptation and resilience, and implementation of the climate commitments. Specifically, the key outcomes of the COP27 on the Agreement on New “Loss and Damage” Fund for Vulnerable Countries, as well as the acknowledgment that climate change is a common concern of humankind, and that Parties should, among else consider their respective obligations on human rights, the right to a clean, healthy and sustainable environment and the right to health, will open new opportunities for global collaboration that can be further monitored and promoted through existing initiative and mechanisms such as the “Alliance for Transformative Action on Climate and Health (ATACH)”.

During COP27, WHO through the support of WHO HQ and representation of WHO Regional Offices engaged in several initiatives on mainstreaming health in climate negotiations via promoting the health argument for climate actions, the resilience of health systems and its leadership role in reducing emissions, strengthening and reinforcing international cooperation and supporting the most vulnerable countries and population groups. WHO in collaboration with the Wellcome Trust and partners hosted the Health Pavilion at the COP27 UN Climate Conference, which took place in Sharm El-Sheikh, Egypt from 6 to 18 November 2022. The COP27 Health Pavilion convened the global health community and its partners to ensure health and equity are placed at the center of the climate negotiations.

In the frames of the COP27 WHO AFRO supported the participation of MoH Delegates from 12 AFRO member states^[1], aiming to raise the profile of health in National Delegations, and co-organized a series of side events at the WHO’s Health Pavilion as well as other Pavilions. Specifically, AFRO co-organized and participated in a series of side events and round table discussions on: “Building Resilient and Sustainable Low Carbon Health Systems in Africa and Middle East”, “Advancing African Climate Change & Health Policies and Networking”, “Wildland Fires: Planetary and Public Health Solutions”, “Health and Energy Platform of Action (HEPA): Tackling the health-energy-climate nexus through increased capacity, finance and actions on the ground to accelerate clean cooking”, “Principe “One Health” et protection environnementale”, “Relations santé environnement-biodiversité: cas pratiques de collaboration intersectorielle dans les pays du Bassin du Congo et perspectives”, “Global warming and the next pandemic: the growing pest threat”.

WHO AFRO builds on its strong involvment on climate and health globally, with active participation to the COP26 and COP27. The recognition by the UK COP26 Presidency of the importance of the health dimensions of climate change has opened up opportunities to raise the profile of health at the COPs and to continue the scale up of support to Member States in key areas such as building climate-resilient, environmentally sustainable health systems, and facilities and addressing the need for access of health in multilateral climate finance. Up to date, twenty three AFRO countries (Burkina Faso, Cape Verde, Central African Republic, Cote d’ Ivoire, DRC, Ethiopia, Gabon, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mauritania, Mozambique, Nigeria, Republic of Tanzania, Rwanda, Sao Tome and Principe, Sierra Leone, Togo, Uganda, Zambia) have already engaged to the COP26 Health Initiatives by developing their countries’ commitments for “Climate Resilient Health Systems” and “Low Carbon Sustainable Health Systems” and confirmed their high-level commitments, while more AFRO member states are considering their high-level engagements to the COP26 Health Programme.

Some important strategic multilateral contacts were established between AFRO/HQ and AFRO countries’ representatives during the COP27, including:

- - Enhancement of contacts with the Wellcome Trust Fund (WTF) team. A multilateral meeting was organized to discuss the progress and opportunities for AFRO state members’ participation from the COP26 to the COP27. Key areas of priorities as well as tips for an enhanced participation of the health sector to forthcoming COPs has been among the key topics of discussion. A multilateral communication will be maintained also through the HQ, considering the current financial support provided to 6 AFRO Member states by a Wellcome Trust award, which also foresees the financial support for the organization of the next Clim-Health meeting.
  - Several bilateral meetings were organized with Donors and partners such as the Amref, Clean Air Fund, FCDO, GIZ, LSHTM, USAID, UNEP, for further promoting the climate and health portfolio in the African Region.
  - The COP27 High-level side event “Alliance for Transformative Action on Climate and Health (ATACH)”, 9^th November 2022, with special focus on financing climate resilient, low carbon health systems, deep dived on the global opportunities and gaps on climate and health financing.

Call for Action COP28

Confer with the UAE Presidency, and key supportive Member States, donors, civil society and academic groupings to develop a plan to ensure constructive health input into the COP preparations throughout 2023, and eventually to COP28.
Review lessons learned from COP27 and previous COPs to ensure that our future engagement is as effective as possible in the primary aim of positively impacting the negotiations, as well as the secondary aim of guiding and building the climate and health community.
Work through and ensure alignment with other relevant processes, including: preparations for WHA; WHO Regional committees including particularly EMR; Health and Environment Ministerial meeting in EUR and potentially elsewhere; health and related tracks of G7 and G20 Presidency.
Promote call for climate action through intersectoral approaches for achieving health co-benefits of identified actions.
Continue to work with partners outside of the COP process, e.g. providing evidence and key messages to health civil society campaigning on climate and health, ion order to help build public pressure for stronger action.
Continue to connect the political and negotiation processes through COP and WHA to WHO’s programmatic work, including evidence and monitoring, and country support initiatives, e.g. through the ATACH.
Follow up on the political interest by donor countries to ensure that the increased demand is matched by financial support to WHO climate change and related programmes across the 3 levels of the Organization.