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We are reminded every day about the imperative to improve access to healthcare and the importance of promoting health equity. In doing so, it should also be acknowledged that health equity is impacted by specific realities depending on geographic location—in particular, climate change plays a key role in public health and patient outcomes.
Today, there is an indisputable link between the climate crisis and the growing burden of disease and lack of health care access that disproportionality impact vulnerable populations. There is, however, renewed optimism about bold solutions that can work for patients and the planet by leveraging the lessons of COVID-19 collaboration, and moving towards integrated thinking on climate change and health equity in a step-by-step fashion.
According to the World Health Organization, more than 12.5 million people die from diseases caused by environmental factors. Of those, 8.2 million deaths come from non-communicable diseases such as cancer, respiratory illness and heart conditions. Air pollution alone, for example, has been estimated to contribute to 62,000 lung cancer deaths and 712,000 cardiac and respiratory disease deaths per year worldwide.
The environment’s negative impacts on health are often more heavily concentrated in vulnerable communities. The resulting cascade of major climate events can further upend already fragile health systems and infrastructure. These patient populations and communities can be found across high-, middle- and low-income countries, making it a global issue.
Policymakers and healthcare stakeholders have long advocated for efforts to improve the environment as a way to further improve the health of patients. Today, we have the opportunity to expand that thinking, and build a solid bridge between climate change policy and broader multistakeholder efforts to address health equity.
Companies like mine have committed to enhance health equity, including broad access to innovative medicines across geographies and socioeconomic groups. And we are increasingly conscious about the interplay between health equity and environmental policy: acknowledging and understanding this connection is a foundational step in informing how to address both with holistic public policies.
The link between climate change and health care access
The Bristol Myers Squibb Foundation, an independent charitable organisation which my company supports, has seen firsthand how environmental events can negatively impact access to medicines. For example, following Hurricane Maria in 2017, it collaborated closely with organisations such as the Migrant Clinician Network to improve community-based clinical preparedness and community mobilisation for future natural disasters. The Foundation also supported CancerCare as it worked with food and transportation partners, and healthcare clinics to ensure that cancer treatment was not disrupted for patients.
In the aftermath of major environmental events such as heatwaves, storms and floods, public health challenges are exacerbated in affected communities, causing additional disruptions in already unstable food and health care systems, followed by increases in food-, water- and vector-borne diseases. We’ve witnessed how this, coupled with the rise of mental health issues following natural disasters, increases the likelihood that vulnerable communities fall further behind as healthcare disparities increase.
In terms of healthcare access, many of these affected communities have pre-existing health system infrastructure issues prior to an environmental event. In the aftermath of a disaster, these systems are frequently unable to manage the additional burden without assistance. For the purposes of advancing access to innovative medicines for vulnerable populations, the lack of existing capacity to safely diagnose disease, and then deliver and administer medicines safely, becomes even more complex after a major environmental event.
Dialogue as a First Step
Additional dialogue, documentation, and information sharing by stakeholders is a critical first step in formulating public policy. The complexity of the climate crisis, its causes and impacts on health disparities, and the number of private, public and civic entities involved require thoughtful and constructive discussion and information sharing. The collaborative lessons from the COVID-19 pandemic, such as information sharing, multistakeholder collaboration and timely formation of global partnerships, can and should be used to inform this process.
Additionally, organisations like the OECD, which have long served as convening agents, provide an opportune platform to promote the sharing of expertise, and unite member countries, NGOs and industries around common purposes to improve the health of our planet and its people. It is a natural place to explore the interrelatedness of climate change and health equity as well as potential solutions.
Proceed with thoughtful and deliberate urgency
The OECD Environmental Ministerial: Ensuring a Resilient & Healthy Environment reminded us of the urgency of the climate crisis and presents an opportunity to couple climate discussions with health equity. In order to do so, we should keep several principles in mind:
- First, as a practical matter, we can prioritise data collection that demonstrates the connection between climate change and health equity, and informs creation of effective policy solutions.
- Second, we must keep patients, health care providers and other key public health stakeholders top-of-mind when evaluating how to best address climate change. As a step further, we should embed health equity conversations at the onset of environmental policy development, including research and analysis. Key to this is acknowledging that climate change and health system capacity is a key Social Determinant of Health (SDOH) for patients.
- Third, for health-related solutions, we should ensure that the private sector, including the biopharmaceutical industry, has a seat at the table to bring insights and expertise to the discussion. Experience with global health issues indicates the value of learning from each other and co-creating solutions.
- Finally, we shouldn’t forget to look at ourselves. We should foster a greater understanding and recognition of how stakeholders around the table contribute to climate change, and what we can collectively do first to alleviate it. For example, my company is signatory to UN Global Compact, which includes environmental sustainability principles, and we’ve also made a number of environmental commitments as part of sustainability goals planning. Last year, a group of 50 countries committed to develop climate resilient and low-carbon health systems. Commitments like these put stakeholders on solid footing to meet agreed upon goals and to propose additional solutions.
Our goal should also be clear: we are seeking to develop integrated environmental policy solutions and frameworks that aim to prevent or alleviate the effects of climate change and bolster health infrastructure in vulnerable communities prone to these events, while at the same time accounting for and responding to natural disasters after they occur.
The OECD Forum’s Engagement Group on Climate and Health presents an opportunity for the global community to come together to amplify this process. By joining hands, we can start our journey in developing tailored solutions to address these challenges for patients and our planet.