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A decade after Paris, COP30 must transform climate promises into measurable health protection, embedding adaptation metrics, transparent reporting, and resilient systems to confront the human toll of a warming world
Image Source: Getty Images
This article is part of the essay series: "Expectations from COP30"
Climate change has emerged as the greatest threat to human lives, health, livelihoods, and well-being in the 21st century. Around the world, extreme weather and shifting climate patterns are increasing the burden of climate-sensitive diseases and raising mortality from extreme heat. Droughts are undermining food and water security, floods are driving infectious disease outbreaks, and intensifying storms are overwhelming health services. These impacts expose a dangerous gap in our global climate response: adaptation efforts have not kept pace with the escalating health threats.
The first Global Stocktake established under the 2015 Paris Agreement has laid this bare. Its official decision report noted that climate impacts are being felt in every region while current adaptation responses remain fragmented, incremental, and unequally distributed. In particular, health adaptation has lagged; around 3.6 billion people are now highly vulnerable to the impacts of climate change, with health systems in many countries unprepared to deal with the strain. Developing nations need an estimated US$215-387 billion annually for adaptation by 2030; however, actual funding falls far short.
Against this backdrop, COP28 (the Conference of the Parties to the United Nations (UN) Framework Convention on Climate Change), in Dubai, marked a turning point for the climate-health nexus. For the first time in UN climate diplomacy, health took centre stage: the conference featured a dedicated Health Day and a high-level Climate-Health Ministerial, and 143 countries signed a first-ever Declaration on Climate and Health. Furthermore, the new United Arab Emirates (UAE) Global Framework for Climate Resilience, adopted at COP28, set the targets for 2030 across climate risk assessment, planning, and implementation, including strengthening health systems against climate shocks.
COP30 arrives just as the earlier pledge to double adaptation finance by 2025 comes due, and will likely fall short (by 2023, only US$26 billion of the ~US$40 billion target for developing countries has been delivered).
COP30 in Belém, Brazil, marks a watershed moment for the climate-health agenda. The Global Stocktake has made clear that health adaptation lags far behind climate ambition. The conference must turn this recognition into results by embedding measurable health outcomes within Article 7 through a core set of Global Goal on Adaptation (GGA) indicators, reporting them transparently under Article 13, and aligning the emerging Loss and Damage framework with the realities of public-health systems. The challenge also extends beyond traditional health threats, encompassing fossil-fuel dependence, antimicrobial resistance (AMR), microplastic exposure, and even new stressors such as the water-hungry expansion of Artificial Intelligence (AI) data centres that compete with aquifers already strained by drought.
COP30 is a crucial moment to close the health adaptation gap. A major milestone anticipated is the adoption of a comprehensive GGA framework, comprising particular targets and indicators. After years of work, Parties have converged on seven thematic areas (covering sectors such as water, food, ecosystems, and health) and have drafted a set of about 100 indicators to measure progress. Finalising this framework at COP30 can create a blueprint for integrating health into all levels of adaptation planning. For example, one proposed health indicator is the change in the annual rate of heat-related occupational injuries and deaths, which is a tangible metric that would encourage countries to monitor and reduce the human toll of extreme heat.
Delivering on these plans will require significantly ramped-up support. Adaptation has long been the poor cousin of mitigation in climate finance; currently, only about one-third of public climate finance is earmarked for adaptation, and as little as 3 percent of all climate finance in 2023 may have reached adaptation projects. COP30 arrives just as the earlier pledge to double adaptation finance by 2025 comes due, and will likely fall short (by 2023, only US$26 billion of the ~US$40 billion target for developing countries has been delivered).
Health outcomes are an intuitive yardstick for adaptation success. If Parties agree at COP30 on a shared set of health metrics under the GGA, they can then incorporate these into their national reporting and stocktake contributions.
However, today, most reporting has centred on emissions reductions; metrics for adaptation and resilience are far less standardised. This is where integrating health can make a difference. Health outcomes are an intuitive yardstick for adaptation success. If Parties agree at COP30 on a shared set of health metrics under the GGA, they can then incorporate these into their national reporting and stocktake contributions. For instance, countries could report trends related to heat-related mortality, or the number of hospitals that have achieved climate-resilient standards, or the incidence of climate-sensitive diseases over time. Such data would inject a human dimension into the dry accounting of climate progress, putting pressure on governments to act in the event of rising heat deaths or malaria resurging in new areas.
Beyond outcomes, Parties might establish metrics for adaptive capacity in the health sector. For instance, the percentage of healthcare facilities with climate-resilient infrastructure (for example, flood defences, backup power for heatwaves, sustainable cooling systems) could be an indicator.
Crucially, any adopted metrics should be reported through the transparency framework. From 2024, the Enhanced Transparency Framework prompts countries to submit Biennial Transparency Reports (BTRs) that include adaptation information. If COP30 provides clear guidance that Parties “measure what matters most - people’s health” and include a core set of health indicators in their reporting, it will greatly enhance our collective understanding of climate progress. It would enable the 2028 Global Stocktake (the second stocktake) to answer not just how many gigatons of emissions were cut, but also how many lives were saved or lost as a result of climate action (or inaction.
Looking past COP30, it is evident that realising the linkages between climate and health in a practical way would need a sustained effort in many different areas. The two crises, the climate crisis and the global health crisis, are intertwined. The piling up of crises means that our strategies have to be comprehensive. To illustrate, rising temperatures and altered rainfall patterns contribute not only to the fast spread of diseases but also to the worsening of AMR: it is believed that floods may spread antibiotic-resistant bacteria if they cause the mixing of sewage with the communities that are receiving it and at the same time more frequent infections will lead to heavier antibiotic use, which in turn will increase resistance.
The outcome document of COP28 for the first time mentioned the need for a transition away from fossil fuels, indicating that the era of coal, oil, and gas without limitations is coming to an end. Although the statement was meticulous, it still contained some loopholes that the COP30 should certainly deal with this controversial issue again.
Fossil fuels phase-out is another important issue on the table in the coming days, as it is the root of both climate change and acute health problems. The outcome document of COP28 for the first time mentioned the need for a transition away from fossil fuels, indicating that the era of coal, oil, and gas without limitations is coming to an end. Although the statement was meticulous, it still contained some loopholes that the COP30 should certainly deal with this controversial issue again. In addition to a health-related perspective, this would also reduce plastic production and other toxic materials released into the atmosphere from the oil industry. At present, more than 99 percent of plastics are derived from fossil fuel feedstocks, and the entire plastic cycle (from manufacturing to waste burning) is a major source of greenhouse emissions. Among the greenhouse gases is microplastic pollution, which spreads across water, soil, and even air. It also raises several concerns about human health (ranging from lung inflammation to potential endocrine disruption).
The emerging challenges on the horizon demand cautious vigilance. As societies adapt and technological solutions expand, new environmental health issues can arise. For instance, the push for digitalisation and AI, while beneficial in many ways, is leading to a boom in energy-hungry AI data centres. These massive server farms generate heat and often rely on water-based cooling, and many are being built in water-scarce areas. Large AI-focused data centres can consume on the order of millions of gallons of water per day, equivalent to the needs of tens of thousands of people.
The key point is that climate solutions or new industries themselves should not undermine public health or resilience. As the march toward a more high-tech future commences, the climate-health lens must be factored in to assess the sustainability of such developments. The world cannot afford a climate policy that is blind to its human toll, nor a health policy that fails to account for the challenges associated with the climate elephant in the room. By squarely aligning adaptation and transparency efforts with health priorities, and by funding relief for climate harms to health, countries can make climate action a story of human survival and dignity, not just emission curves and temperature graphs. As the saying goes, “What gets measured gets managed”. By measuring the right things and moving towards positive health outcomes, COP30 can help ensure that in the era of climate change, humanity not only survives but thrives.
K.S. Uplabdh Gopal is an Associate Fellow with the Health Initiative at the Observer Research Foundation.
The views expressed above belong to the author(s). ORF research and analyses now available on Telegram! Click here to access our curated content — blogs, longforms and interviews.
Dr. K. S. Uplabdh Gopal is an Associate Fellow within the Health Initiative at ORF. His focus lies in researching and advocating for policies that ...
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