The Centre for Sustainable Healthcare at COP26

From October 31 to November 12, the UK hosted COP26 in Glasgow, bringing world leaders together to address climate change. Whilst COP26 has been praised as the first COP which has seen a strong presence from the health community, the outcome of these climate negotiations clearly did not go far enough to protect human health and wellbeing. Current emissions targets and vague Net Zero pledges put us on track for warming over the critical 2-degree limit of atmospheric warming by end of the century. Climate-vulnerable communities were left without adequate funding and structures in place for building resilience to climate change or support for the inevitable loss and damage it will cause to lives and livelihoods. 

We were privileged to be given observer status for COP26 and sent a delegation of 10 staff and associates to represent our voice at the 2-week conference. Along with the WHO, IFMSA, HCWH, Greener NHS, GCHA and many others, we pushed for health to be included in the final negotiations outcome, but were disappointed that health is still not considered integral to the global response to the climate and ecological crisis.

There were, however, signs from individual countries that the health agenda is increasingly recognised, with 50 countries signing up during the conference to the WHO COP26 Health programme, committing to building climate-resilient, sustainable healthcare systems as a priority. However, countries have already cited insufficient funding as a major barrier to implementing any real changes.  

What is clear from a health perspective, is that COP26 could represent a watershed moment for the health and climate agenda. Collaboration among health sector leaders and organisations was unprecedented, and there is real appetite for organising an even more co-ordinated and strategic health community response for the next COP in Egypt. Understanding and sharing learned knowledge of the role of health observers at COP, identifying the opportunities for input into the formal negotiations process and meaningfully collaborating with other sectors should be priorities for further talks next year. The health community has a real opportunity to build on this early momentum to protect climate change action from industry greenwash, and place human wellbeing at the core of global response.   

Daily Recaps from COP26

To increase transparency and feedback to the health community throughout the COP26 summit, CSH published a daily recap blog summarising the COP26 developments, health implications, and potential solutions. These blogs are linked below:


What did COP26 achieve?

Mitigation: Keep 1.5 alive

  • Continued pledge to keep global temp <1.5 and reduce C02 by 45% by 2030 compared to 2010, and Net Zero by 2050
  • Emissions pledges put us on track for 2.5 degree warming (4 degrees before Paris). Could limit to 1.8 or 1.9 if “net zero” pledges are fulfilled, but many are very weak
  • First ever reference to coal and fossil fuel subsidies “phase down coal power and inefficient fossil fuel subsidies”
  • First methane pledge (led by US and EU) to reduce by 30% by 2030
  • Ministers to meet again next year to submit stronger 2030 emissions targets, and to have 2050 plans (Glasgow Climate Pact)

Article 6:

  • Agreed to ban double-counting, but allowing old carbon credits.
  • Common timeframes agreed: 10 year periods eg 2025 -> 2035
  • Agreed to transparency using a standardised set of tables etc


  • Failure to reach $100 billion pledge (reached $79 billion in 2019) but continued pledge to do so with increased pledges made
  • Developed countries to double financing by 2025 with more proportionally to adaptation
  • Adaptation fund ($356 million), least developed countries fund ($413 million)
  • Increased role of private and financial sector to mobilise funds (also pledges to de-carbonise financial services sector)

Adaptation Loss and Damage:

  • Glasgow-Sharm el-Sheikh work programme for the Global Goal on Adaptation
  • Double adaptation funding between 2019-2025 ($40 billion)
  • Loss and damages are largely unresolved, with strong opposition from developed nations.
  • Scotland, EU and Belgium made small pledges ($1 million from EU)
  • Agreement to further operationalise the Santiago Network (technical assistance and capacity for loss and damage)
  • Glasgow dialogue on funding for loss and damage (climate-vulnerable countries initially wanted a more formal mechanism)

Other outcomes:

  • India annouced commitment to net zero by 2070
  • Halt and reverse forest loss and land degradation pledge by 141 countries by 2030
  • 46 countries (including UK and Canada) to phase out domestic coal and to end public support for unabated fossil fuel by 2022
  • Denmark and Costa Rica launched the Beyond Oil & Gas Alliance (BOGA), which seeks to deliver a managed and just transition away from oil and gas production. The alliance also includes Sweden, Greenland, France, Ireland, Quebec and Wales. 
  • The High Level Panel for a Sustainable Ocean Economy announced the United States of America as a new member and reaffirmed their commitment to sustainably manage 100% of their national ocean area.

Outcomes for Health:

  • COP26 Health Programme (UK, WHO, HCWH)
    • 50 countries commit to climate-resilient and low-carbon health systems
    • 45 of these commit to sustainable and low-carbon health systems
    • Includes eg. Argentina, Fiji, Egypt, US, UK, UAE,Germany, Bangladesh
  • 94% include health as part of NDCs
  • 85% of countries have a designated climate and health point of contact in their health ministries

Learn more about COP26 and why it is important for the health community.

How can CSH support the development of sustainable and low carbon health systems?

CSH provides:

  • A range of training courses in sustainability, health and healthcare that equips health professionals with the knowledge and motivation to deliver low carbon healthcare. Individuals can book these, or trusts, ICSs, and other organisations can block book a private course
  • The Green Ward Competition, an award-winning leadership and engagement programme mentors six teams within a Trust in identifying carbon hotspots within their service and then supports them to develop, implement, and evaluate sustainable quality improvement projects
  • The SusQI framework, an innovative approach for holistically improving healthcare by assessing quality through environmental, social, and financial impacts — these three factors combine to form the 'triple bottom line.' By integrating CSH's four sustainable healthcare principles, health professionals can address environmental challenges and social inequalities while simultaneously saving money
  • Sustainable Specialties Scholarships and Fellowships which support clinicians in each specialty to develop research skills, leadership, and engagement with patients, clincial bodies and industry to ensure change at local and national levels
  • Carbon footprinting and triple bottom line analysis, where in-house experts can analysing your carbon footprint at the organisation, department, or clinical pathway level
  • Green space and health initiatives. The NHS Forest is a national alliance of over 200 UK health sites working to transform their green space and to realise its potential for health, wellbeing and biodiversity
  • Specialty networks that facilitate resource sharing, discussion and peer support

Additional resources: