As the COP31 climate summit commences, global attention turns to an alarming climate phenomenon: a “super El Niño.” Currently, sea surface temperatures in the tropical Pacific Ocean have reached record highs, with forecasts predicting this could become the most intense El Niño ever recorded.
This El Niño poses a significant threat to global health. Preliminary analyses indicate that extreme heat alone could lead to nearly half a million deaths. Furthermore, there is a heightened risk of epidemics involving dengue fever, cholera, and other infectious diseases. The World Health Organization (WHO) has recognized these risks as substantial and faces the responsibility to act under international law. By designating El Niño as a public health emergency of international concern (PHEIC), the WHO could intensify its response to climate change without altering the legal definition of an “emergency.”
Given the threat to health, climate change may meet the legal criteria for a public health emergency of international concern
WHO was originally established with a focus on combating infectious diseases, which were seen as the primary barrier to global health. However, the organization now faces new challenges such as antimicrobial resistance and misinformation, which do not fit the traditional model of acute emergencies. Among these, climate change could necessitate a shift in WHO’s governance strategy. In 2021, a widely cited WHO report called climate change “the single biggest health threat facing humanity.” While WHO’s programs on climate change have expanded, the organization has yet to issue its most urgent alert regarding the climate crisis.
Climate Change as a Public Health Emergency
Climate change could satisfy the legal criteria for a PHEIC, defined by the International Health Regulations (IHR) as “an extraordinary event which is determined… to constitute a public health risk to other States through the international spread of disease, and to potentially require a coordinated international response.” Historically, PHEIC declarations have been limited to infectious disease outbreaks. However, broader interpretations could include other health emergencies, such as poisonings. In 2019, a legal analysis concluded that climate change met the PHEIC criteria, and since 2020, there have been repeated calls for its formal recognition as an emergency.
The health impacts of climate change are considerable, potentially responsible for millions of deaths. However, is climate change an “event”? The ongoing emergency regarding “the international spread of poliovirus” offers a parallel; declared in 2014, it remains active. Climate change, unlike acute events, is not easily categorized, yet its long-term impacts are undeniable.
With climate change as a backdrop, WHO’s role will extend far into the future, facing temperatures at least one degree higher until 2150 in the best-case scenario. This issue spans across more than a dozen future WHO director general terms, offering minimal incentive for immediate action. However, the current El Niño presents an immediate and defined challenge, with potential impacts surpassing those of past pandemics. Recognized by academics and health ministers, WHO has classified El Niño as a “Grade 3” emergency, its highest response level, yet without international legal recognition.
How WHO Can Approach New Emergencies
Although WHO has known of the El Niño threat for months, a coordinated international response could still significantly mitigate its health impacts. Following the 2024 IHR amendments, a PHEIC declaration could facilitate access to vaccines and control measures for diseases exacerbated by El Niño.
Forming an emergency committee to evaluate El Niño as a PHEIC could help address both immediate and long-term climate-health issues. Climate change, while a persistent emergency, also includes acute crises requiring specific responses, such as extreme weather and disease outbreaks.
El Niño represents a distinct event within the Earth’s climate system, combining various physical processes into a coherent, short-term phenomenon. Recognizing shorter-timescale weather events as potential PHEICs could allow WHO to address climate-related threats without necessitating a broader legal shift.
This unique El Niño could serve as a case study for WHO’s response to climate-related health threats. Similar to how the 2009 flu pandemic led to the PIP Framework, a climate-related PHEIC could initiate a dialogue on a framework dedicated to climate change and health, akin to the Framework Convention on Tobacco Control. Like tobacco, addressing climate change requires a long-term commitment to reducing its health impacts to zero.
Original Story at www.thinkglobalhealth.org