COP28: the climate summit’s first Health Day points to what needs to change in NZ


Climate change has many effects, but one of the most significant will feature for the first time at COP28 – its impact on human health.

Now under way in Dubai, the latest Conference of the Parties to the UN Framework Convention on Climate Change includes a day dedicated to human health and climate action, Taking place on December 3, it will be attended by a record number of health ministers from many governments.

Health Day is a big deal. Health is – or should be – at the centre of climate policy. Nations do not progress if the health of their population fails. We also know climate change is a serious threat to good health.

In the past 20 years, for example, the number of heat-related deaths among people aged 65 and over has increased by 70% worldwide. Rising temperatures, altered rainfall patterns and the displacement of millions of people by floods and fires may amplify the spread of significant infectious diseases, such as dengue and cholera.

In New Zealand, extreme flooding in Hawkes Bay and Tairawhiti in early 2023 meant thousands were cut off from essential supplies. Many were trapped in homes that could not be repaired. There were 11 deaths from drowning and injury.

How probable is it that these extraordinarily heavy rains were due to climate change? According to a study led by Luke Harrington from the University of Waikato, 75% probable. With extreme weather events more likely in future, addressing the consequences for human health becomes more urgent.

Flooding in Hawkes Bay after Cyclone Gabrielle in early 2023 caused 11 deaths.
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Healthy adaptations

Health has long been on the margin of climate negotiations. The focus has been on loss and damage to property and land.

Health programmes have seldom been at the front of the queue when global climate funds are distributed. It’s estimated less than one cent in every dollar spent by international development agencies on adaptation to climate change has gone to health projects.

And yet we know reducing the risks of climate change in the long term can also provide opportunities to lift the health of populations rapidly.




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These so-called “co-benefits” to human health may be greater than the cost of the climate interventions that enable them. One study of project options to reduce global air pollution, for example, found the median value of health co-benefits was roughly double the median cost of the project.

Closer to home, research has estimated best-practice bike infrastructure in Auckland would return health benefits 10-25 times greater than the costs involved.

Meat farming and production have significant climate impacts, whereas plant-based and flexitarian diets are typically healthier for people, environments and the climate. They can also cut food bills by up to a third, according to an Oxford University study.

cyclist on cycle lane in central Auckland
Better bike infrastructure in Auckland would return health benefits 10-25 times greater than the costs involved.
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A climate and health strategy

Health Day at COP28 is a significant opportunity to raise the profile of these interconnections and co-benefits. It will attract many senior politicians who might not otherwise attend the negotiations.

It also provides a platform for governments, international agencies, global funding bodies and the private sector to highlight initiatives and gather support.




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The programme includes presentations on green healthcare, case studies in building health resilience, best-practice approaches to measuring the burden of disease due to climate change, and health funding priorities for agencies such as the Global Climate Fund.

One session will “showcase progress and new commitments to capture the vast health benefits of climate mitigation policies”. The closing session will “set out a roadmap and opportunities for action”.

The programme also suggests the basis for a New Zealand national climate and health strategy, so it is a pity Health Minister Shane Reti will not be attending. The new government is also repealing climate-related policies introduced by the previous administration, but it is not clear what will replace them.

Without the Three Waters infrastructure project, for instance, how will local governments be funded to sustain safe water supplies? Remember, the outbreak of campylobacteriosis in Havelock North in 2016, the largest mass poisoning in the country’s history, was caused by heavy rain washing sheep faeces into an unprotected water supply.




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Painstaking reforms to the Resource Management Act (which everyone agrees is cumbersome and out of time) will be shelved under the National-Act coalition agreement. This has serious climate-health implications.

Urban density done well, for example, saves commuting time and cuts greenhouse emissions, and improves health with cleaner air and more physical activity. But large-scale changes in land use like this require legislation fit for purpose.

Meanwhile, according to a recent poll, two-thirds of New Zealanders expect to see severe climate impacts in their region in the next decade, mostly floods and fires. How will New Zealand manage when these impacts mount up?

The Health Day at COP28 points to what is required. Health must be brought to the centre of climate policy. As the director-general of the World Health Organization, Tedros Ghebreyesus, has put it:

Prioritising health is not just a choice, it is the foundation of resilient societies.



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