Why COP28 outcomes matter: insights on addressing climate change, fossil fuels, and global health resilience

World leaders convened once more at the 28th Conference of the Parties (COP) on Climate Change, held in Dubai in December 2023, to deliberate upon strategies for addressing the pressing issue of climate change. However, a growing sentiment of scepticism pervades public perception regarding the efficacy of COP gatherings, attributed to perceived inefficacies, political impediments, and a perceived lack of authenticity in addressing the complex challenges posed by climate change. Compounded by the hosting of COP28 by a fossil fuel-exporting nation and the forthcoming COP29 similarly being hosted by a nation with vested interests in fossil fuels, alongside an observed surge in the presence of fossil fuel lobbyists within these forums, disillusionment proliferates, casting doubts upon the significance of these international assemblies and their will to address climate change. This editorial examines why the outcomes of COP28 matter to nursing, highlighting the importance of a dedicated health declaration and the allocation of resources for health-focused initiatives.

Why should nurses care about the outcomes of COP28?

The COP deliberations have far-reaching ramifications, as these decisions wield profound influence over the health and wellbeing of eight billion people, and bear overarching implications for the survival of our planet and the welfare of present and future generations. The escalating trajectory of global temperatures, extreme weather phenomena, rising sea levels, and ecosystem transformations risk food security, water accessibility, public health, and overall societal wellbeing. The impacts of climate change disrupt economies, making it harder for businesses to succeed and for people to find work (The Intergovernmental Panel on Climate Change, 2022). The severity of climate change consequences hinges upon the efficacy of international collaboration, such as those at COP28, in mitigating climate change. Identifying effective strategies to tackle climate change requires political will to support innovation and economic growth, especially in green technologies and sustainable practices.

The Health Day event during COP28 marked a significant moment in the culmination of decades of global health advocacy, emphasising the urgent need for climate action to protect public health. A key outcome of this event was the endorsement of the COP28 United Arab Emirates (UAE) Declaration on Climate and Health by Health Ministers from over 140 countries (World Health Organization, 2023). This declaration has sparked optimism for increased global commitment and collaborative efforts toward building a healthier and more resilient future.

Against the backdrop of COP28, the Global Stocktake highlighted the profound lessons learned from the COVID-19 pandemic, emphasising the exacerbation of existing inequalities and vulnerabilities within healthcare systems worldwide. This collective reflection spurred a global commitment to advancing climate-resilient development, strengthening healthcare infrastructure, promoting cross-sectoral collaboration to reduce greenhouse gas emissions, maximising the health benefits of climate action, and fostering resilient communities for current and future generations. Central to this commitment is the transformation of health systems into resilient, low-carbon, sustainable, and equitable entities. COP28 called for action on:

• Strengthening the formulation and execution of policies that maximise health benefits from mitigation and adaptation actions, preventing exacerbated health impacts from climate change. Emphasis was placed on partnerships with Indigenous Peoples, local communities, women, youth, healthcare workers, persons with disabilities, and other vulnerable populations.

• Promoting global collaboration on human, animal, environmental, and climate health challenges through implementing a One Health approach. This includes addressing environmental determinants of health, researching linkages between environmental factors and antimicrobial resistance, and intensifying efforts for early detection of zoonotic spill-overs for effective pandemic prevention, preparedness, and response.

• Recognising the interdependence of climate resilience and population health, prioritising and implementing adaptation actions across food and agriculture sectors, water and sanitation, housing, urban planning, healthcare, transport, and energy to deliver positive health outcomes.

• Enhancing health systems’ ability to anticipate and implement adaptation interventions against climate-sensitive diseases and health risks. This involves bolstering climate-health information services, surveillance, early warning and response systems, and cultivating a climate-ready health workforce. The commitment underscores the bidirectional relationship between healthy populations and climate resilience, emphasising successful adaptation across diverse sectors (World Health Organization, 2023).

However, while significant financial commitments have been made, effective implementation of these resources will be crucial, but, still needs to be explored (COP28, 2023). Subsequent COPs will require even greater political will, financial allocations, and collaborative partnerships at national and international levels. Ongoing discussions on phasing out fossil fuels and supporting developing nations will remain important, with equity and justice being central considerations.

Nurses’ climate activism at COP28

Ahead of COP28, the International Council of Nurses (ICN) joined the chorus calling for climate action, stressing that ongoing inaction jeopardises nurses and healthcare systems dealing with climate change-related challenges (ICN, 2023). COP28 provided a platform for nurses to share knowledge and experiences across borders and sectors, fostering collaboration and advocacy for phasing out fossil fuels, just and equitable transition, building resilient health systems, and strengthening the healthcare workforce.

Unlike COP27, nurses had a more prominent presence at COP28, leading interdisciplinary sessions and creating platforms for nursing voices to be heard. They also incorporated unique approaches, such as showcasing children's artwork expressing concerns about planetary health as the symbolism of children’s voices being unheard at COP meetings. Nurses led discussions on key issues such as maternal and child health, healthcare workforce challenges, community-healthcare partnerships, and the environmental sustainability of digital health interventions (ClimaHealth, 2023). Throughout COP28, it continued to be evident that the strength of nursing is in its unique perspective on the impact of climate change on health, gleaned from interactions with patients, families, and colleagues and its role in health promotion. Moving forward, it is essential to continue building on this momentum and showcasing nurse-led climate action from both the global south and north.

Challenges for nursing: education and capacity building

At COP 28, global nurses identified that one persistent challenge for nursing is increasing its capacity to participate in climate change action (Lokmic-Tomkins et al., 2023) and boosting the visibility of nurse-led initiatives at all levels. Education on planetary health should begin early in nursing programs, while nurses also need comprehensive support to engage effectively in decision-making processes at local, national, and international levels. This includes developing business and management skills to participate in negotiations and decision-making. Nursing Climate Resources for Health Education (N-CRHE) by the Global Consortium on Climate and Health Education, offering free climate change materials and education for nurses at all levels, is one resource soon available to nurses globally to increase their capacity to participate in climate action (Global Consortium on Climate and Health Education, 2024). Similarly, the Alliance of Nurses for Healthy Environments (ANHE) hosts the Global Nurses Climate Change Committee (ANHE, 2024a) where nurses from around the world come together to share resources, learn about the climate and health impacts affecting their regions, and provide opportunities for collaboration. ANHE Latinoamerica is leading a virtual exchange in which students, professors, and nursing professionals from 13 countries on the American continent participate and speak about nursing actions in the climate and health nexus (ANHE, 2024b).

Conclusion

The outcomes of COP meetings profoundly impact the health and wellbeing of over eight billion people and this planet. Nurses must care about what these outcomes are as they impact us in every aspect of how we care for people and the planet. Nursing engagement at COP is increasing, but we must build on the momentum to continually expand nursing involvement in climate change action on a global scale. From fund implementation challenges to the need for increased global representation, the call to each nursing professional is to continue the energy and enthusiasm of the nurses present at COP28 not only for increased visibility and participation, but also, for a transformation of nursing roles from advocacy to actionable items, ensuring that every nurse becomes an active contributor to climate change mitigation and resilience in advocating for our collective voice and meaningful actions to foster a tide of change to offer the next generations a better opportunity to inherit a healthier planet.