WMA Declaration of Delhi on Health and Climate Change

Adopted by the 60^th WMA General Assembly, New Delhi, India, October 2009
and revised by the 68^th WMA General Assembly, Chicago, United States, October 2017
and by the 77^th WMA General Assembly, Rotterdam, the Netherlands, October 2026

PREAMBLE

The World Health Organization (WHO) has declared climate change to be the greatest threat to human health in the 21^st century. The influence of human activity on the planet and its climate is significant, with recent emissions of greenhouse gases being the highest in history. Recent global environmental changes have had widespread impacts on human health and natural systems.

Compelling evidence substantiates the numerous health risks posed by anthropogenic climate change which threaten all countries. These include more frequent and severe heatwaves, droughts, floods and other extreme weather events such as storms and wildfires. Climate change and an associated loss of biodiversity are already leading to territorial expansion of vector-borne diseases, increases in chronic cardiac and respiratory diseases increased trauma from extreme weather events, impacts of climate-related events and environmental changes on mental health, and various other health effects. There is reduced availability and quality of potable water, and worsening food insecurity leading to malnutrition and population displacement. Climate change is universal in reach and yet inequitable in impact disproportionately harming populations that have contributed minimally to global emissions and with fewer resources and less capacity to adapt.

Addressing climate change presents opportunities to improve health and well-being through the health co-benefits of low-carbon solutions and by enabling action on the social determinants of health through mitigation and adaptation strategies. Transitioning to renewable energy, promoting the use of active transport, such as cycling and walking, and dietary change, toward a healthy diet that is nutritionally balanced, culturally appropriate, and compatible with a sustainable environment, may contribute to improved health and well-being.

As recognised by the WMA Declaration of Oslo on Social Determinants of Health, social determinants of health are those factors that correlate to health through exposure before and after people are born and as they grow, live, and work. They vary between and within countries. Those with generally the poorest health and lowest life expectancy will be least able to adapt to the adverse effects of climate change, thereby exacerbating adverse social determinants of health.

Recognizing that health, land, and identity are intrinsically interconnected for many communities, the WMA affirms that Indigenous Peoples’ cultural, spiritual, and social identities are deeply tied to their lands, territories, and resources. Their distinct rights, knowledge systems, and stewardship responsibilities are essential to effective climate action and to the protection and promotion of health.

Research, monitoring and surveillance are integral to an effective climate change response.

The 2015 Paris Agreement highlights a transition to a new model of global collaboration to address climate change and presents an opportunity for the health sector to contribute to climate action. It includes a series of actions to be undertaken by each party to achieve the long-term goal of limiting the increase in global average temperature to less than 1.5 C above pre-industrial levels. However, current research shows that the target will not be met due to lack of action in the reduction of greenhouse gases, increasing the risk of reaching a tipping point where climate shifts are irreversible, thus creating new global health challenges.

As stated in the International Code of Medical Ethics, medical professionals have a moral and clinical obligation to “contribute to the health and well-being of the populations the[y] serve[] and society as a whole, including future generations”, and to support the creation of healthy environments. They are also called upon to “strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.” Whether or not individual states are parties to the Paris Agreement, medical organisations have an obligation to address the climate emergency affecting human and planetary health.

As recognised by the WMA Statement on Divestment from Fossil Fuels, a rapid and equitable global phase-out of fossil fuels is required to protect the health and well-being of current and future generations. Without transitioning toward affordable and renewable energy, global public health will be negatively impacted and gains will be undermined. A just transition must also address the accumulated and ongoing health impacts experienced by workers and communities historically exposed to fossil fuel extraction, processing, and combustion.

RECOMMENDATIONS

The WMA and its constituent members appeal to national governments and non-state actors to recognise the serious health consequences of climate change and to implement strategies to mitigate and adapt to its effects in line with the right to health and the rights of future generations.

The WMA and its constituent members urge national governments in particular to:

1. ensure the fulfilment of national commitments to international agreements, including both mitigation and adaptation measures, as well as action on loss and damage, while prioritising a just transition for affected communities that assures adaptation interventions are equitable and prioritise the needs of the populations most at risk,
2. provide climate financing that includes designated funds to support the strengthening and resilience of global, national and local health systems, develop policies regarding the co-benefits of health and climate action (including support for sustainable food systems and clean energy transitions) and sufficient global, national, and local financing for equitable climate mitigation, adaptation measures, disaster risk reduction, and the attainment of the Sustainable Development Goals (SDGs),
3. support and invest in public health and climate change research to ensure a better understanding of adaptation needs and health co-benefits, including assessing impacts on communities and individuals, particularly those experiencing vulnerability, and known and emergent disease burdens,
4. urge national governments, where relevant and appropriate, to recognize and uphold the distinct rights of Indigenous Peoples in climate and health policy, including the right to self-determination and to maintain traditional medicines and healing practices, and to ensure non-discriminatory access to health services,
5. invest in capacity building and educational opportunities for physicians and other health professionals to be well-prepared for climate-related disasters and to understand and address the health impacts of climate change,
6. encourage and facilitate the active participation of health sector representatives in the development and implementation of climate change preparedness plans and emergency planning and response on local, regional, national, and international levels,
7. provide for the health and well-being of people displaced by environmental causes, including climate refugees, while addressing the root causes of displacement,
8. facilitate collaboration between health authorities and other government sectors to ensure that health is considered in all relevant policies, national commitments, and sustainability strategies.

Constituent members and their physician members worldwide should:

9. educate themselves about the health effects of climate change and be prepared to diagnose, treat and manage health effects of these climate-related illnesses in individual patients,
10. be prepared for the infrastructure disruptions that accompany climate-related emergencies, in particular by planning in advance for the delivery of health services and increased patient care demands and supply chain disruptions during these crisis situations,
11. advocate for sustainable, low-carbon and resilient practices across the health sector to reduce the environmental impact of health care facilities and practices (including pollution, resource use, and waste),
12. encourage and support advocacy for environmental protection and greenhouse gas emissions reductions including through appropriate emissions trading systems and/or carbon taxes and divestment from fossil fuels,
13. work with health–care institutions, and individual physicians to adopt and implement climate policies and act as role models by reducing carbon emissions, waste and pollution,
14. recognise environmental factors as key social determinants of health (SDH), assess for environmental determinants of health in patient history-taking and encourage governments to foster collaboration between the health and non-health sectors in addressing these factors,
15. educate patients and the public on the physical and mental health effects of climate change,
16. support the epidemiological, translational, clinical and basic science research necessary to make evidence-based global climate change policy decisions related to health care and treatment.

The WMA and its constituent members should:

17. encourage sustainable, low-carbon living including active lifestyle and sustainable production and consumption practices that respect planetary boundaries,
18. seek to raise professional and public awareness of the impact of the environment and climate change on personal, community and societal health,
19. work towards the integration of key health and climate change concepts and competencies in undergraduate, post-graduate and continuing medical education curricula,
20. collaborate with the WHO and other stakeholders, to produce educational and advocacy materials on climate change for medical associations, physicians, other health professionals, as well as the general public,
21. advocate for their respective governments to finance, and promote research into the effects of climate change on health, and systemically collaborate with NGOs and health professionals to raise awareness on the health effects of climate change,
22. work collaboratively with governments, NGOs, businesses, civil societies and others to create alert systems of climate-related events to health systems and physicians, in order to ensure timely and accurate information regarding the management of emerging health events,
23. include the climate emergency on their agendas and actively participate in developing and advancing policies, guidelines, and initiatives that mitigate the effects of climate change on health, while emphasising the ethical responsibility of health professionals to safeguard the health and wellbeing of both current and future generations.