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Agreements made at COP29 fell short of the ambition and focus needed to fully address the impacts of climate change on health and maximise the benefits of action, according to experts from the London School of Hygiene & Tropical Medicine (LSHTM).

As the dust settles on the 29th UN Climate Change Conference in Baku, they acknowledged some progress towards integrating health into the climate agenda, but said significant shortfalls remained. 

At COP29, LSHTM researchers proper financing for climate action to protect health, and highlighted the need for a just transition to net zero, taking into account current and historical inequalities in carbon emissions. 

By the end of the two-week negotiations, richer countries to provide $300 billion a year to poorer countries by 2035 to support their efforts to tackle climate change. While as a step in the right direction, the agreement falls well short of the $1.3 trillion that developing countries , and will have significant implications for the health and livelihoods of people living in climate-vulnerable countries that often have the least resources to adapt and transition to a low-carbon economy. 

Commenting on the outcome, Shakoor Hajat, Professor of Global Environmental Health at LSHTM and COP29 delegate, said: “The amount committed in the new agreement is certainly disappointing, but also doesn't make clear whether this will be grants or loans. Many of the most climate vulnerable countries already pay more servicing existing loans from other countries than they do on their own health systems. The COP29 agreement must only be a starting point for further negotiations and the additional finance needed to save lives.”

Speaking at a pre-COP event hosted by LSHTM, Dr Vanessa Kerry, Founder of SEED Global Health, WHO Director-General Special Envoy for Climate Change & Health, and LSHTM alumna, also emphasised the importance of highlighting the economic costs of the health impacts of climate change. 

Members of the health community have the outcome of the finance agreement at COP will fail to protect millions of lives, especially those most vulnerable to the impacts of climate change, such as developing countries and small island nations. 

In addition to finance, a key focus of COP discussions is around commitments to climate change mitigation, or actions to transition away from fossil fuels and reduce the amount of greenhouse gases entering the atmosphere. During side events at COP29, LSHTM researchers and partners of the Pathfinder Initiative the urgent need to cut greenhouse gas emissions across all sectors. They highlighted the overwhelming evidence of near-term health benefits through reduced air pollution from fossil fuel phase out, more sustainable diets, and increased physical activity from promoting active transport.  

Despite ambitious statements from the COP29 Presidency on addressing mitigation, little progress was seen in the final agreements, with some unresolved discussions postponed to COP30. 

Rachel Juel, who represented the Children, Cities and Climate Action Lab, LSHTM and YOUNGO at COP29, said: “Postponing discussions delays critical climate action and costs lives. Urgent action is needed to create the systemic change we need to tackle the climate crisis and protect health. Most critically, action must be led by developed countries, who are currently failing to take full responsibility in leading the transfer of climate finance to developing countries, increasing the already disproportionate burden of climate impacts on countries on the frontline.

“Despite this, there were some small steps signalling progress for health. Parties received quality criteria for integrating health into Nationally Determined Contributions, and the Global Goal on Adaptation included specific language on cross-cutting indicators related to the health of children and young people, and specific indicators that capture information about human rights (including health), and people that are typically at increased risk of ill-health due to climate change, such as those living with disabilities, migrants, children, young people, and Indigenous Peoples.”

Outside the official negotiations, momentum in the climate and health intersection continued to grow. The World Health Organization (WHO) launched the , highlighting health as the argument for climate action, and outlining priorities from the global health community for governments, policymakers and other sectors to put health at the centre of climate solutions. 

On Health Day (18 November), the was established, co-led by the United Kingdom, Egypt, United Arab Emirates, Azerbaijan and Brazil, in partnership with the WHO. This initiative aims to bridge efforts across COP presidencies to drive global climate-health initiatives, and ensure that health remains central in climate discussions towards COP30 in Belém.

Speaking at hosted by the Wellcome Trust at the UK COP29 Pavilion on ‘The Road to Belém: Connecting Health, Science and Indigenous Knowledge’, Hugh Sharma Waddington, Assistant Professor at LSHTM shared findings from the Pathfinder Initiative on the health benefits and cost-effectiveness of nature-based solutions, as well as highlighting evidence on the health benefits of cross-sectoral actions.

Dr Sharma Waddington said: “Evidencing the growing health impacts of climate change and the major near-term health benefits of action, and communicating this to decision makers is key as we look ahead to COP30 and beyond. We need to keep pushing for health to be at the centre of climate action and highlighting solutions that work for both people and the planet.”

During a panel discussion on ‘Advancing climate action for health at COP29 and beyond’ at the pre-COP LSHTM conference, Sarah Whitmee, Assistant Professor at LSHTM, said: “What we need to push for beyond this COP is to branch out beyond the healthcare sector. We need to engage with ministers from across transport, energy and finance sectors. As a research community, we need to provide evidence on both the cost of inaction, and the health benefits of effective climate solutions.”