The World Health Organization (WHO) is being urged to declare climate change a Public Health Emergency of International Concern (PHEIC), its highest level of alert for a health emergency. This call to action comes from global climate and health expert Robb Butler, a former senior executive in the WHO, who argues that the criteria for such a declaration have been met.
Butler points to recent climate disasters across many countries, including floods in Nepal, heatwaves in Europe, and drought emergencies in Africa, as evidence that climate change is a pressing global health issue. He notes that climate-driven tragedies are unfolding in real-time, resulting in mass-casualty, cross-border health emergencies.
Declaring a Public Health Emergency
A PHEIC declaration would provide Ministries of Health with a stronger mandate to access climate finance mechanisms, which are currently dominated by environment and infrastructure sectors. Butler cites his recent visit to the Aral Sea Basin, where Ministers of Health in Kazakhstan and Uzbekistan are struggling to secure domestic climate-environment-health financing for vulnerable populations affected by the environmental disaster.
Historically, PHEIC declarations have accelerated donor commitments, emergency preparedness spending, and multilateral coordination. Declaring climate change a PHEIC would also align WHO action with current scientific consensus, rather than outdated risk models, and signal a shift from recognition to protection.
Addressing Barriers
Despite the potential benefits of a PHEIC declaration, there are barriers to its implementation. The latest United Nations Environment Programme (UNEP) report points to vested interests, institutional inertia, and perverse financial flows propping up polluting industries. These factors may be blunting the pressure that countries place on entities like WHO to use the tools at their disposal to mitigate and adapt to climate change.
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Other barriers include a narrow perspective or misunderstanding about what the International Health Regulations (IHR) can and cannot be used for.
Butler notes that health emergencies do not form an orderly queue, and that avoiding a PHEIC declaration does not make the emergency less real – it only makes the response weaker. He argues that the moment for coordinated global action to reduce harm is now, and that waiting longer will not make the case stronger – only more tragic.
Financing streams for climate health action are currently under-financed, and a PHEIC declaration would unlock more resources for health adaptation projects. Multilateral development banks, philanthropies, and climate funds might prioritize these projects, which are essential for building resilience in vulnerable populations. The Aral Sea Basin, where Ministers of Health in Kazakhstan and Uzbekistan are struggling to secure domestic climate-environment-health financing, is a prime example of the need for increased funding.
The UNEP report highlights the role of vested interests, institutional inertia, and perverse financial flows in propping up polluting industries, which can blunt the pressure on entities like WHO to take action on climate change. However, declaring climate change a PHEIC would signal a shift from recognition to protection and preserve the credibility of the International Health Regulations as a living instrument for 21st-century health threats.
Next Steps
Countries are concerned that a PHEIC declaration would imply scrutiny, accountability, new expectations for surveillance and preparedness, and uncomfortable debates about climate injustice, sovereignty, and capacity. Nevertheless, tackling a crisis of this magnitude requires coordinated global action, and a PHEIC declaration would provide a stronger mandate for Ministries of Health to access climate finance mechanisms. The WHO leadership has already acknowledged climate change as a health emergency, and the criteria for a PHEIC declaration have been met.