Earth Day 2021: A day for sorrow or a moment for hope?

Earth Day 2021 falls well into the second year of the global COVID crisis. Will it be a day for sorrow or a moment for hope? The first Earth Day in 1970 encompassed both, born as much from the anguish of the pesticide disaster documented in Silent Spring and the blazing Cuyahoga River as from the promise of NASA's Earthrise.

The pandemic has cast a cruel light on the state of public health services and health systems, broadcasting the chronic lack of capacity to manage emerging public health risks. At the same time, the climate crisis, the most 'super-wicked' of all problems, threatens to further turn the screw.

Climate change presents a clear and present risk of disrupting and overwhelming health systems, hampering progress towards Universal Health Coverage (UHC) particularly where fragilities are the greatest. Despite numerous reasons for alarm,the collective global effort to respond and recover from COVID has revealed that an often-divided world is able to work together to tackle the pandemic, offering hope that overcoming the climate crisis may also be possible.

Climate change and health risks

Like the threat of COVID, the health risks from climate change are immediate. Unlike COVID, these risks are projected to rise over the coming decades unless rapid and profound action is taken. Climate change is of course not the direct cause of the emergence or transmission of COVID. However, the health impacts of both crises interact in several important ways: both share several overarching drivers and impact similar vulnerable populations. They also require overlapping health sector responses, either to deal with current threats or to ensure that opportunities to build back better are not missed.

Health sector responses to the COVID pandemic can leave health systems more resilient and more adapted to climate-related events. The global collaboration we have witnessed in the response to the COVID pandemic provides lessons to replicate in the response to the climate and health challenge.

In addition, beyond simply helping us to 'cope' with climate impacts, the convergence of COVID and climate change offers the real promise of tackling both crises simultaneously by building truly sustainable health systems, which decouple progress towards UHC from carbon emissions.

Embedding a One Health approach that integrates human, animal, and environmental health data in the Public Health Surveillance and Risk Assessment of our COVID-19 response operations - to shift the focus upstream from response to preparedness, and ultimately prevention, is one such example.

Similarly, in Emergency Preparedness, Response and Recovery, developing multi-hazard emergency preparedness and response plans that incorporate both pandemic and climate change-related threats, support improved governance and coordination, and include financing mechanisms for emergencies offers huge benefits.

Climate resilience cuts across health and other sectors

When considering the expansion of capacity for COVID testing, isolation, and treatment, using renewable and/or hybrid energy sources to provide a reliable electricity supply should be the norm. The procurement of essential medical commodities for pandemic and disaster response can prioritize local production to ensure a steady, sustainable supply of commodities that also reduces transport emissions.

Plans for the all-important vaccine deployment should include investments in energy-efficient, sustainable cold chain infrastructure and supply systems that also strengthen health sectors, such as low carbon transportation, recyclable medical equipment and packaging, environmentally friendly cooling options, and the use of low carbon/renewable energy sources.

Beyond the emergency response, building back better to deliver green, resilient, and inclusive development is perhaps where the greatest gains can be made. This will require further investments in climate-smart healthcare infrastructure and large-scale shifts to renewable energy generation as well as the promotion of active transportation (walking and cycling).

When rebuilding, refurbishing, or retrofitting disaster-affected healthcare facilities, the adoption of green building principles, such as the use of nature-based solutions for flood or wildfire protection as well as day-to-day heat buffering, is of paramount importance.

Catalyzing public and private sector investments through innovative financing mechanisms will be crucial to support climate-smart measures that will require multisectoral resources outside the traditional health or climate sectors, including energy, agriculture, water, urban planning, transport, and environment. Allied fields such as digital health, although not focused on climate mitigation as an explicit outcome, may also provide climate benefits.

The pandemic has already reshaped the world, magnifying gaps in health systems and exacerbating pre-existing inequalities. Climate change will redefine our planet.We need to act now and build on the unprecedented international collaboration that has developed over the last year to enhance health system resilience to both climate change and current and future pandemics.

Let's work to ensure that hope outweighs sorrow by Earth Day 2022!