WP on the Environment Statement to Protect Health

April, 2023

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The WONCA Working Party on the Environment Statement to Protect Health by committing to fossil fuel non-proliferation and climate action


The burning of fossil fuels (coal, oil and gas) has profound health impacts. It contributes to air pollution and is the major driver of climate change. Air pollution from burning fossil fuels has been estimated to contribute to approximately 1 in 5 deaths globally. Climate change is already affecting health and remains the greatest global health threat of the 21st century. Our reliance on coal, oil and gas threatens lives, livelihoods, and the ability of the planet to sustain human wellbeing.


In 2019 WONCA declared a climate emergency. However, greenhouse gas emissions (GHG) and global temperatures have continued to rise. Rising global temperatures are driving increasingly frequent and severe extreme weather events and rapidly escalating health impacts.


Limiting average global temperature rise to 1.5°C (2.7°F), compared to the pre-industrial era, is necessary to safeguard human health from potentially catastrophic climate change. To achieve this, the world will need to reduce GHG emissions by at least 6% annually between 2020 and 2030. Limiting heating to 1.5°C requires an end to the development of any new fossil fuel supply projects. Yet fossil fuel companies continue to develop new coal, oil and gas projects, and receive government subsidies. This undermines efforts by the global community to limit warming to 1.5°C and safeguard human health. 


The World Health Organization (WHO) has called for an end to fossil fuel subsidies and greater investment in clean energy as urgent public health interventions. WHO and leading health organisations around the world have endorsed a fossil fuel non-proliferation treaty that calls for:


  • an end to all new coal, oil and gas exploration and production;
  • phase-out of existing production of fossil fuels in line with the 1.5C global climate goal; and 
  • a just transition that addresses the needs of individuals, communities and countries to move away from fossil fuel energy systems towards more diverse, resilient and inclusive economies powered by renewable energy.
Health practitioners globally must show leadership in joining this call.Therefore, the World Organization of Family Doctors (WONCA):


  1. Recognises that to have any chance of limiting warming to 1.5°C, there can be no new fossil fuel projects.

  2. Recognises the morbidity and mortality caused by fossil fuel air pollution and the health benefits from transitioning to clean energy sources.

  3. Endorses the call for a Fossil Fuel Non-Proliferation Treaty,  including: non-proliferation of new coal, oil and gas developments; a phase out of existing fossil fuel production; and just support for individuals and communities impacted by the transition to renewable energy systems.

  4. Calls for the removal of subsidies for fossil fuel developments that undermine human health.

  5. Adopts sustainability as a core value in organisational operations, and in the delivery of healthcare around the world.

  6. Invites WONCA Member Organisations to recommit to the actions suggested in the WONCA 2019 Climate Emergency statement

  7. Calls on all global health organisations, medical colleges, and medical schools to endorse the call for a  Fossil Fuel Non-Proliferation Treaty

Accompanying notes 


These have been developed to support those considering the adoption of this position statement.




Fossil fuel is a term for coal, oil and natural gas, carbon rich fuels formed from the remains of plants and animals buried in the earth’s crust. When burned fossil fuels release greenhouse gases.


Greenhouse gases (GHG) are gases that trap heat in the atmosphere. This drives global warming and changes to the world’s climate system that can be dangerous to human health (climate change). The main greenhouse gases are carbon dioxide (CO2), methane (CH4), nitrous oxide (N20) and fluorinated gases (as found in some anaesthetic gases and respiratory inhalers). 


Climate change impacts health in many different ways. Information on the health impacts can be found on the World Health Organization  site with different language options.   


The 1.5°C target is the goal of the Paris Agreement, which was endorsed by 196 countries at the UN climate meeting COP21 in 2015. This goal was identified because beyond 1.5°C of warming the health and other impacts of climate change are expected to dramatically escalate. The Paris Agreement calls for countries to take meaningful climate action to reduce greenhouse gas emissions and limit global warming. There is a fixed amount of GHG we can burn if we are to keep temperature rises within certain limits. This is known as the carbon budget. If human activities around the globe continue to produce CO2 at current rates, we will deplete the remaining carbon budget in a little more than 10 yearsThere is a 50% chance that we will exceed the 1.5°C target in the next 5 years.


Subsidies are an amount of money given to an industry or business to deliver a product. Subsidies are usually given by governments and may be given in different forms (eg. direct payment or lower taxes). Globally, in 2020 subsidies were $5.9 trillion or 6.8% of Gross Domestic Product (GDP). Fossil fuel subsidies almost doubled in 2021, slowing progress towards climate goals and are expected to increase to 7.4% of GDP in 2025.


The Fossil Fuel Non-Proliferation Treatyis a campaign to create an agreement to stop fossil fuel exploration and expansion and phase out production in line with the Paris Agreement. It has been supported by the World Health Organisation, European Parliament, the Global Climate and Health Alliance and Healthcare Without Harm.


Explanatory notes


Fossil fuel proliferation has profound negative health impacts 


Emissions from fossil fuel combustion result in harmful air pollution. Global mortality from outdoor fine particle pollution attributed to fossil fuel combustion is estimated to be as high as 8.7 million deaths annually. Aside from fine particulates, the burning of fossil fuel results in a range of toxic pollutants including nitrogen dioxide, sulphur dioxide, ozone, and carbon monoxide. These are linked to a range of poor health outcomes including cardiovascular disease, respiratory disease, lung cancer, diabetes, premature births and cognitive decline. 


Climate change and health impacts are well described. These include those arising from increasingly frequent and severe extreme weather events (such as heatwaves, storms and floods), disruption to food systems, increases in vector borne diseases and mental health impacts. Furthermore, climate change impacts undermine many of the social determinants of health including reducing poverty, ensuring access to healthcare, ending hunger and achieving gender equality. Climate change worsens inequity and disproportionately impacts those already experiencing disadvantage and marginalisation.


Fossil fuel subsidies and emission gaps

Globally, fossil fuel subsidies in 2020 were $5.9 trillion or 6.8 percent of GDP. They are expected to increase to 7.4% of GDP in 2025. Subsidies are given to companies to deliver products. Fossil fuel subsidies encourage pollution (contributing to climate change and premature deaths from local air pollution), and are poorly targeted to support those with the greatest financial need. Removing subsidies and investing in renewable energy would promote more healthy, sustainable and equitable outcomes. 


The Emissions Gap Report measures the difference between countries' pledges to cut greenhouse gas emissions, and the amount of emission reduction needed to limit global temperature rise to 1.5°C by the year 2100. If countries achieved their current pledges under the Paris Agreement, 2.5°C of warming is expected to occur by the end of the century.

Healthcare sustainability and our carbon footprint

The healthcare sector contributes approximately 4.4% of total global carbon emissions or the equivalent emissions from 514 coal-fired power stations. Energy (primarily the combustion of fossil fuels) contributes more than half of healthcare’s climate footprint. Over 70% of health sector emissions are primarily derived from supply chains. This refers to the production, transport, and disposal of goods and services required to deliver healthcare (eg. medical devices, pharmaceuticals, food and hospital equipment). The healthcare sector has an opportunity to lead by example to reduce our GHG emissions and reliance on fossil fuels. We can do this by transitioning to low-carbon models of care and embedding sustainability as a core value.