The Lancet Commission on Health and Climate Change maps out the impacts of climate change, and the necessary policy responses, to ensure the highest attainable standards of health for populations worldwide.

This Commission is multidisciplinary and international, with strong collaboration between academic centres in Europe and China.

In June 2015 the commission published its results in the Lancet journal. Victor Galaz and My Svensdotter from the centre have been members of the commission, which has brought together international climate scientists, economists, energy experts and health professionals.

Together they have mapped out the impacts of climate change on health and suggested a range of necessary policy responses.

No-regret options
The commission concludes that the effects of climate change are already being felt around the world, and that future projections "pose an unacceptably high and potentially catastrophic risk to human health".

The direct effects include increased heat stress, floods, drought, and increased frequency of intense storms, whereas the indirect effects range from air pollution and the spread of disease vectors to food insecurity, displacement, and mental ill health.

Whereas the commission come to the conclusion that the implications of climate change "threatens to undermine the last fifty years of gains in development and global health", the team of scientists also highlight many opportunities.

Tackling climate change could be the "greatest global health opportunity of the 21st century," they write. In fact, many mitigation and adaptation measures to climate change are "no­-regret options", which can lead to direct reductions in the burden of disease, alleviate poverty, address global inequity, and enhance resilience of both people and ecosystems.

Ecosystem services key
The team of scientists behind the commission includes British, Chinese, German, Kenyan and Swedish researchers and stresses that the know-how and technologies needed already exist.

Now there is an increasing need for bold political commitment that can ensure that the expertise, technology, and finance to prevent further significant climate change is readily available.

One interesting way forward is so-called ecosystem-based adaptation, says Victor Galaz:

"Ecosystems and their services contribute to human health in multiple ways and they can act as buffers, increasing the resilience of social-ecological system to climate-induced hazards and disasters."

Restoration of mangrove forests for protecting coastal areas and conservation of forests to regulate water flow for flood vulnerable communities are two examples of such ecosystem-based adaptation strategies.

They are often more cost­ effective than hard­engineered solutions, and can be combined with engineered infrastructure or other technological approaches. Moreover, they tend to provide both disaster risk reduction functions, and enable improvements in livelihoods and food security, especially in poor and vulnerable settings.

Green areas and green infrastructure in cities can be particularly beneficial in this context. They provide both climate change mitigating and adaptation measures (e.g. carbon sequestration and enhancing various regulating ecosystem services). Moreover, they also come with a multiple health benefits, like clean air, temperature regulation and recreational opportunities.

"Green urban design can reduce obesity and improve mental health through increased physical activity and social connectivity. Increased neighbourhood green spaces reduces both morbidity and mortality from many cardiovascular and respiratory diseases and stress­related illnesses," the authors write.

Deal with complexity
The commission also highlights that climate change affects human health in many indirect ways that play out through long causal chains that propagate through ecological and human systems in increasingly complex ways.

Such complex interactions often also result in "surprises" – situations in which the behaviour in a system, or across systems, differs qualitatively from expectations or previous experiences. This poses difficult but manageable challenges to policymaking due to limited predictability.

"Even in the face of uncertainties, policy makers and communities can prepare if they focus on measures that create multiple societal and environmental benefits, and enable social actors to respond, adapt and innovate as a response to change,” says Victor Galaz.

The commission’s ten recommendations to accelerate action in the climate-health nexus over the next five years are summarised below:

1. Invest in climate change and public health research, monitoring, and surveillance.

2. Scale-up financing for climate resilient health systems world­wide.    

3. Protect cardiovascular and respiratory health by ensuring a rapid phase out of coal from the global energy mix.

4. Encourage a transition to cities that support and promote lifestyles that are healthy for the individual and for the planet.

5. Establish the framework for a strong, predictable, and international carbon pricing mechanism.

6. Rapidly expand access to renewable energy in low- income and middle­income countries, thus providing reliable electricity for communities and health facilities.

7. Ensure that the health impacts of national energy policies are built­in to the government regulation and decision making processes.

8. Adopt mechanisms to facilitate collaboration between Ministries of Health and other government departments.

9. Agree and implement an international agreement that supports countries in transitioning to a low­carbon economy.

10. To help drive this transition, the 2015 Lancet Commission on Health and Climate Change will develop a new, independent Countdown 2030: Global Health and Climate Action.