Why Climate Change Matters to Global Health
Rob Abbott, ISPOR CEO and Executive Director
The end of things happens in two ways: slowly, and not so slowly. The 6000-year experiment that is recorded human history is in danger of collapse—we just haven’t accepted it yet. We continue to believe cultural messaging that we can carry on as before and mitigate any negative impacts. This is willful blindness, reinforced by the fact that we have always been able to either redeem our mistakes or walk away from them, to heal the past with the future, never imagining that we would run out of new frontiers, that we would run out of the future.
The “collapse” I allude to above is being accelerated by climate change. I am therefore gratified that this special issue of Value & Outcomes Spotlight is centered on the topic. I have had the rare privilege of working on 6 continents and so I have also borne witness to the cascading impacts of climate change around the world. While the focus of much reporting on climate change has centered on ecological impacts, it is important to remember that there is ultimately no separation of human life from nature; we do not live at a remove from the manifold changes in the natural world—we are very squarely in the picture. Nowhere is this more evident than in disease management.
"The 6000-year experiment that is recorded human history is in danger of collapse—we just haven’t accepted it yet."
A recent study of the economics of biodiversity commissioned by the UK Treasury and published in February of 2021 reports that biodiversity is declining faster than at any time in human history. Climate change is an important driver of this decline. Sir Partha Dasgupta, an Emeritus Professor of Economics at Cambridge University and lead author of the study, was blunt in his appraisal of humanity’s capacity to live on Earth sustainably:
Our demands far exceed nature’s capacity to supply us with the goods and services we all rely on. We would require 1.6 Earths to maintain the world’s current living standards. Humanity faces an urgent choice. Continuing down our current path presents extreme risks and uncertainty for our economies. Choosing a sustainable path will require transformative change, underpinned by levels of ambition, coordination and political will akin to, or even greater than, those of the Marshall Plan[i].
Released against the backdrop of the COVID-19 pandemic, the study sounded an ominous chord with its warning that this disease could be “just the tip of the iceberg” of pandemic diseases driven by the destruction of nature. As humans take over or change the habitats of wild animals, many species are driven to extinction but those that remain— bats, rodents, and various primates—are far more likely to host dangerous pathogens that can make the jump to humans and ignite disease. Most efforts to prevent the spread of diseases focus on vaccine development, early diagnosis, and containment, but these well-intentioned efforts are akin to treating the symptoms without addressing the underlying cause: the driver of the disease. The discovery and confirmation of monkeypox (a viral disease) in the United Kingdom in May of 2022—the first time this disease had spread outside Central and West Africa—only confirms this point. From mid-May onward, cases of monkeypox were reported around the world, and on July 23rd, the Director-General of the World Health Organization, for the second time in 2 years, declared the outbreak a public health emergency of international concern.
"I welcome an exploration of how climate change affects human health—and perhaps more pointedly, what ISPOR can do to help shape a new direction in the discourse on climate change"
Throughout the second half of 2018, much of California (the most populous state in the United States and the world’s 4th largest economy) was on fire, literally—a million acres turned to ash—and yet there was collective denial that climate change, and therefore human behavior, was a contributing factor[ii]. Worse, there was a belief that we can carry on making the same bad choices and mitigate the impacts. This is what psychologists refer to as cognitive dissonance, the mental discomfort of a person who simultaneously holds two or more contradictory beliefs. We may believe that the fires consuming large swaths of California are not linked to climate change, but in the face of evidence that suggests this is exactly what is happening, we will find a way to resolve the contradiction to reduce our discomfort. Sadly, too many people are reducing their discomfort by practicing magical thinking[iii] or retreating into complacency. In a revealing editorial published on February 16, 2019 in The New York Times, David Wallace-Wells, author of The Uninhabitable Earth, acknowledged as much:
I know the science is true, I know the threat is all encompassing, and I know its effects, should emissions continue unabated, will be terrifying. And yet, when I imagine my life 3 decades from now, or the life of my daughter 5 decades from now, I have to admit that I am not imagining a world on fire but one similar to the one we have now. That is how hard it is to shake complacency. We are all living in delusion, unable to really process the news from science that climate change amounts to an all-encompassing threat. Indeed, a threat the size of life itself.
There is such pathos embedded in the delusion that Wallace-Wells describes. A substantial percentage of the human literati know that if we continue on our present course, we will author our ecological—and by extension, civilizational—doom, and yet we continue. We have burned so much carbon into the atmosphere that CO2 levels are higher than they have been in 3 million years; each day the extra heat that is trapped near our planet is equivalent to 400,000 Hiroshima bombs. There are no known technologies that can be deployed at world scale to reverse such warming. It is with this in mind that I welcome an exploration of how climate change affects human health— and perhaps more pointedly, what ISPOR can do to help shape a new direction in the discourse on climate change. It seems clear, for instance, that an increased exploration of the social determinants of health, including climate change, and the need to appropriately value these is something our society could undertake. Equally, examining the evidence and offering commentary on the value of interventions that address the spread of disease from animals to humans may be an important area of future discussion. I welcome input from our members on where and how they believe ISPOR can contribute to maximum impact on the human health implications of climate change.
[i] The Marshall Plan, named for United States Secretary of State, George C. Marshall (and known officially as the European Recovery Program) was an American initiative passed in 1948 to facilitate the provision of foreign aid to Western Europe. Under the program, the United States transferred over $13 billion in economic recovery programs to Western European economies after the end of World War II. The corporatized democracy of postwar Western Europe was to be built on the reorganization of energy flows.
[ii] The summer of 2021 may one day be viewed as a turning point, a moment when the true nature of climate change, the human nature at the heart of it, began to take a firmer hold in our collective consciousness. Both Greenville and Paradise, California were “lost” to wildfires, the towns utterly consumed by wildfires that were beyond human control.
[iii] In psychology, magical thinking is the belief that one's thoughts can trigger effects in the world or that thinking something is the same as doing it. In psychiatry, magical thinking is a disorder of thought content; it denotes the false belief that one's thoughts, actions, or words will cause or prevent a specific consequence in some way that defies or circumvents commonly understood laws of causality.
