CSH@COP26 Day 8: Adaptation, loss and damage: Who will pay for the impacts on human health?

Today, the negotiations at COP26 focused on adaptation (what, how, where, who) and loss and damage (financial compensation, support, blame). Dr Rosie Spooner, CSH Quality Improvement Education Fellow, and CSH associates, Rebecca Gibbs and Dr Georgie Sowman attended the negotiations.

Unsurprisingly, the topic of damage and loss is closely linked to finance. Today, members of the Alliance of Small Island States, whose entire countries are at risk of disappearing as a result of rising sea levels, argued strongly for a pot of funding to be allocated specifically for loss and damage relief.

This funding would come on top of the existing financial commitments already agreed at COP26. Rich nations have been resistant to financial assistance for loss and damage due to a fear of accepting blame/liability, which may lead to further litigation. Therefore, disappointingly, no further funding was agreed to give assistance to those whose health and wellbeing have already been impacted, despite persuasive moral and ethical arguments on why this is essential. Undoubtedly, this will negatively impact on the health and wellbeing of those in small island states.

Adaptation has a lower profile than mitigation at the conference, in part because adaptation can be difficult to assess and therefore it can be hard to hold countries to account. In the UK Pavilion, we attended a discussion on the crucial role of cultural heritage adaption. MP Nadine Doyle explained how culture and climate change are inexplicably linked, shaping the landscapes in which we live and work. CSH delegates discussed the role of education around social prescribing in linking community and adaption through education in sustainable healthcare.

Outside of the main negotiations, Barak Obama gave a key note speech on progress towards meeting pledges made in Paris in 2015. He discussed progress and how many governments and corporations have now pledged action but also how much more is needed and pledges are not enough.

In the evening, at a parallel event, the Malin’s spotlight series focused on sustainable supply chains and the blue economy through the lens of health. The event brought together cross-sectional discussions across shipping procurement, which included suppliers, carriers, and providers of healthcare and shipping to look at positive solutions. The panel discussed the critical role of oceanic health in the climate emergency. The session was opened by Ambassador Peter Thompson, the Secretary General’s special envoy for the oceans, and Dr Richard Hixson, CSH trustee and ICU consultant, who emphasised the importance of placing health and the ocean at the centre of adaptation planning across all sectors.

Why did the negotiations matter to health?

The negotiations today are important for global health as the financial assistance required to help pay for the damage and loss as a result of climate change has not been secured, leaving many in the Alliance of Small Islands despondent.

As representatives of the health community, CSH joins the WHO in demanding that we close the financing gap for health adaptation and resilience, and invest specifically in plans for damage and loss to health.

Finally, one of the highlights of the day was meeting Jan Daley from American Forests, who explained the treeequity index – a measure derived from tree canopy cover, climate, demographic and socioeconomic data. It can be used to persuade urban planners of the need for more access to green spaces, which our project the NHS forest can help to deliver.


Dr Rosie Spooner, CSH Quality Improvement Education Fellow

CSH Resources

CSH assists healthcare professionals and provider organisations in making the transition to low-carbon practice, while also driving climate-friendly cultural change within the health workforce. We do this by:

  1. Developing and delivering education through courses, educational toolkits, and resources;
  2. Providing bespoke technical advice on sustainable quality improvement and carbon footprinting directly to healthcare organisations; and
  3. Providing the Green Space program to build capacity for low-carbon treatment options and community–wide prevention.
  4. Hosting and supporting networks to enable communities of like-minded people to collaborate on sustainability in their clinical specialty or area of interest.

Stay up to date with health news from COP26

Through the representation of 10 members of our network, the Centre for Sustainable Healthcare (CSH) is attending the ‘Blue Zone’ negotiations and presidency programme events as an official observer. To increase transparency and feedback to the health community throughout the COP26 summit, CSH is publishing a daily recap blog summarising the latest developments, health implications, and potential solutions. These blogs will be linked from our CSH@COP26 page.

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