By Hon. Prof. Kariuki Muigua, OGW, PhD, C.Arb, FCIArb is a Professor of Environmental Law and Dispute Resolution at the University of Nairobi, Member of Permanent Court of Arbitration, Leading Environmental Law Scholar, Respected Sustainable Development Policy Advisor, Top Natural Resources Lawyer, Highly-Regarded Dispute Resolution Expert and Awardee of the Order of Grand Warrior (OGW) of Kenya by H.E. the President of Republic of Kenya. He is The African ADR Practitioner of the Year 2022, The African Arbitrator of the Year 2022, ADR Practitioner of the Year in Kenya 2021, CIArb (Kenya) Lifetime Achievement Award 2021 and ADR Publisher of the Year 2021 and Author of the Kenya’s First ESG Book: Embracing Environmental Social and Governance (ESG) tenets for Sustainable Development” (Glenwood, Nairobi, July 2023) and Kenya’s First Two Climate Change Law Book: Combating Climate Change for Sustainability (Glenwood, Nairobi, October 2023), Achieving Climate Justice for Development (Glenwood, Nairobi, October 2023) and Promoting Rule of Law for Sustainable Development (Glenwood, Nairobi, January 2024)*
In order to place health at the centre of climate action, it is imperative for countries to ensure that health is central to climate change mitigation and adaptation policies. The COP 28 Declaration on Climate and Health urges countries to strengthen the development and implementation of policies that maximize the health gains from mitigation and adaptation actions and prevent worsening health impacts from climate change, including through close partnerships with Indigenous Peoples, local communities, women and girls, children and youth, healthcare workers and practitioners, persons with disabilities and the populations most vulnerable to the health impacts of climate change.
It is also vital for all countries through their NDCs to prioritise SDG 3 targets such as ending epidemics and communicable diseases, fostering access to Universal Health Care and medicines by linking them to climate-induced health risks prevention, contingency health strategy development, and communicable diseases prevention as key strategies for climate action. In addition, it is important for countries to pursue climate change adaptation actions prioritizing health and SDG 3 such as enhancing vaccination and prevention against water and vector borne diseases, and increasing access to clean drinking water; increasing health facilities; and building of infrastructure that protects against heat such as ventilation or shaded areas.
There is also need for countries to pursue adaptation interventions such as urgent nutrition support, surveillance systems, and emergency response centers in order to cushion the health sector against the adverse impacts of climate change. It has also been pointed out that key intervention strategies required to place health at the centre of climate action include strengthening health systems to predict, detect, prepare, and respond to climate risks and disasters, by, for example, building climate-informed surveillance and early warning systems, increasing health workforce capacity in climate-health, and climate proofing healthcare infrastructure.
Another key measure towards placing health at the centre of climate action is reducing greenhouse gas emissions from the health sector. It has rightly been observed that the health sector is not only affected by climate change but also contributes to the magnitude of the crisis, being responsible for around 5 percent of global greenhouse gas emissions. It is therefore essential for all countries to ensure that their health sectors and health systems transition to low-carbon, high-quality service delivery, such as through clean, renewable energy for infrastructure and fleets, and low-carbon medicines and equipment.
The COP 28 Declaration on Climate and Health also urges all countries to embrace measures to curb emissions and reduce waste in the health sector, such as by assessing the greenhouse gas emissions of health systems, and developing action plans, nationally determined decarbonization targets, and procurement standards for national health systems, including supply chains. Curbing greenhouse emissions in the health sector is therefore an important approach in placing health at the centre of climate action. It is also pertinent to ensure that the health sector and health systems are climate resilient.
A climate resilient health system is one that is capable to anticipate, respond to, cope with, recover from and adapt to climate-related shocks and stress, so as to bring sustained improvements in population health, despite an unstable climate. Climate resilient health systems provide an opportunity for sustainable human development due to their ability to reduce the effects of climate change on health while promoting better health.
WHO urges countries to build better, more climate-resilient and environmentally sustainable health systems by ensuring that core services, environmental sustainability and climate resilience are central components of UHC and primary health care; supporting health systems to leapfrog to cheaper, more reliable and cleaner solutions, while decarbonizing high-emitting health systems; and mainstreaming climate resilience and environmental sustainability into health service investments, including the capacity of the health workforce. Further, there is need to accelerate the realization of the SDGs. It has rightly been argued that climate change is rapidly affecting most of the SDGs especially those relating to access to basic human needs including food, safe drinking water and sanitation, energy, and clean air therefore affecting both physical and mental health.
Actualizing the SDGs and the Sustainable Development agenda can help countries confront climate change while fostering good health and well-being for all. Countries should therefore pursue policies that work towards accelerating achievement of the SDGs, including SDG3; by reducing poverty and hunger; improving health and livelihoods; strengthening social protection systems, promoting food security and improved nutrition, fostering access to clean sources of energy, safe drinking water, and sanitation and hygiene for all; and work towards achieving UHC.
Finally, there is need to combat inequalities within and among countries in the health sector through measures such as accelerating health financing. It has been pointed out that people in developing countries may be the most vulnerable to health risks as a result of climate change. Further, WHO also asserts that areas with weak health infrastructure mostly in developing countries will be the least able to cope with health risks associated with climate change without assistance to prepare and respond.
Finance for health and climate change has been identified as vital in helping developing countries and vulnerable populations to implement health-relevant adaptation and mitigation actions. However, health systems and actors face challenges in accessing finance for health and climate change activities, particularly in low and middle-income countries. This challenge underscores the need to better leverage synergies at the intersection of climate change and health in order to improve the efficiency and effectiveness of finance flows.
The COP 28 Declaration on Climate and Health proposes measures towards unlocking climate finance for health including encouraging the scaling up of investments in climate and health from domestic budgets, multilateral development banks, multilateral climate funds, health financing institutions, philanthropies, bilateral development agencies, and private sector actors; encouraging international finance providers, including development banks, to strengthen the synergies between their climate and health portfolios, and enhance their support for country-led projects and programs in the health-climate nexus; sharing learnings and best practices on financing and implementing climate health interventions, and develop a common understanding of existing needs for climate-health finance, grounded in country priorities and needs; and improving monitoring, transparency and evaluation efforts of climate finance, as relevant, including for climate-health initiatives, in order to strengthen common understanding of its efficiency and effectiveness, and to maximize the delivery of positive health outcomes. There is need to unlock climate finance for health in order to place health at the centre of climate action.
*This is an extract from the Book: Promoting Rule of Law for Sustainable Development (Glenwood, Nairobi, January 2024) by Hon. Prof. Kariuki Muigua, OGW, PhD, Professor of Environmental Law and Dispute Resolution, Senior Advocate of Kenya, Chartered Arbitrator, Kenya’s ADR Practitioner of the Year 2021 (Nairobi Legal Awards), ADR Lifetime Achievement Award 2021 (CIArb Kenya), African Arbitrator of the Year 2022, Africa ADR Practitioner of the Year 2022, Member of National Environment Tribunal (NET) Emeritus (2017 to 2023) and Member of Permanent Court of Arbitration nominated by Republic of Kenya. Prof. Kariuki Muigua is a foremost Environmental Law and Natural Resources Lawyer and Scholar, Sustainable Development Advocate and Conflict Management Expert in Kenya. Prof. Kariuki Muigua teaches Environmental Law and Dispute resolution at the University of Nairobi School of Law, The Center for Advanced Studies in Environmental Law and Policy (CASELAP) and Wangari Maathai Institute for Peace and Environmental Studies. He has published numerous books and articles on Environmental Law, Environmental Justice Conflict Management, Alternative Dispute Resolution and Sustainable Development. Prof. Muigua is also a Chartered Arbitrator, an Accredited Mediator, the Managing Partner of Kariuki Muigua & Co. Advocates and Africa Trustee Emeritus of the Chartered Institute of Arbitrators 2019-2022. Prof. Muigua is a 2023 recipient of President of the Republic of Kenya Order of Grand Warrior (OGW) Award for his service to the Nation as a Distinguished Expert, Academic and Scholar in Dispute Resolution and recognized among the top 5 leading lawyers and dispute resolution experts in Band 1 in Kenya by the Chambers Global Guide 2024 and was listed in the Inaugural THE LAWYER AFRICA Litigation Hall of Fame 2023 as one of the Top 50 Most Distinguished Litigation Lawyers in Kenya and the Top Arbitrator in Kenya in 2023.
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