WHO 2nd Global Air Pollution
& Health Conference 

Health is compromised at every stage of the fossil fuel lifecycle:

• Extraction: Communities near extraction sites face increased risks of respiratory diseases, cancers, cardiovascular issues, and developmental defects. In the US for instance, coal particulates are linked to heart disease, cancer, respiratory illness, and stroke, the four leading death causes of the country. Additional concerns include noise pollution, ecosystem degradation, and water contamination.

• Processing, production and transportation: Proximity to refineries and manufacturing plants is linked to higher incidences of respiratory illnesses, including childhood asthma, due to exposure to pollutants.

• Combustion: Burning fossil fuels releases pollutants contributing to air, water, and soil contamination, leading to health issues such as respiratory and cardiovascular diseases. Combustion is also a significant driver of climate change, which exacerbates health risks through extreme weather events and altered disease patterns.

• Toxic Waste Disposal: Refinery waste, coal ash, and gas flaring release heavy metals and other toxic substances that remain in the environment and human bodies for decades, leading to long-term health consequences.

The 2023 report of the Lancet Countdown on health and climate change emphasizes that burning fossil fuels has accelerated climate change, leading to increased health issues and fatalities worldwide, especially:

• Air Pollution and Mortality: Fossil fuel-related air pollution is a significant contributor to premature deaths globally. In 2021, air pollution was linked to approximately 8.1 million deaths, with outdoor pollution accounting for 4.7 million of these fatalities.

• Health Conditions: Exposure to pollutants from fossil fuel combustion is associated with various health issues, including respiratory diseases, cardiovascular diseases, and aggravated asthma. Vulnerable populations, such as the undernourished, very young, elderly, and those with preexisting health conditions, are at heightened risk.

• Healthcare threat: Climate change, exacerbated by fossil fuel use, imposes substantial economic burdens. These include increased healthcare costs due to pollution-related illnesses and losses in productivity. In the United States, climate change costs tens of billions of dollars annually, affecting health and disrupting daily life.

The 2024 report of the Lancet Countdown on health and climate change highlights that inadequate and unjust climate change action is leaving the most underserved communities most exposed to the health effects of climate change, most unprepared for the transition away from fossil fuels, and most exposed to the health harms of energy poverty and fossil fuel-derived air pollution. 

• A persistent increase in investment in fossil fuels is increasing the value of assets that will become stranded and expanding the size of a workforce whose employment opportunities will wane as the world transitions to healthy, renewable energy in line with international agreements 

• An unjust transition to renewable energy could perpetuate harmful global power dynamics, leaving the most vulnerable populations, including Indigenous peoples, exposed to the health harms of extractive industries. 

Fossil Fuel Combustion is choking cities: 

• As the world continues to urbanise, cities are hotspots for air pollution: 41% of cities in the world have air pollution that is over 7 times higher than the WHO’s recommendation. 97% of cities in low- and middle-income countries have unsafe levels of air pollution.

• Cities account for around 75% of global energy consumption and 70% of global greenhouse gas emissions – figures that are set to rise.

• The high energy demands of cities lead to the combustion of fossil fuels, releasing pollutants into the atmosphere (especially from transport, construction, and industry). Other key sources include burning waste and solid fuels like coal and wood in homes.

• In several cities around the world, pollutants have recently decreased as a result of clean air regulations that have limited emissions from sources such as motor vehicles, fossil fuel power plants and major industries. These decreases have brought substantial improvements in public health in settlements within these regions, and yet air quality remains one of the greatest environmental risks to health. 

Children and youth are disproportionately vulnerable to derived air pollution due to faster breathing, greater inhalation relative to body weight, narrower airways, proximity to exhausts and surface dust, inhaling even more pollutants. Air pollution especially affects children in low income populations worldwide, as a subgroup of the population most affected by air pollution, and have been designated as the primary beneficiaries of policies to reduce fossil fuel emissions over the next two decades.

To meet the growing demand for a finite resource, the industry has increasingly turned to so-called "unconventional" exploration methods over the past few decades. One such method, hydraulic fracturing (fracking), extracts oil and gas from deep within the earth but releases hazardous air pollutants in the process. Fracking exemplifies the paradox of governments pledging to fight climate change while simultaneously enabling practices that exacerbate environmental and public health risks.

The ninth edition of the Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking and Associated Gas and Oil Infrastructure argues that more than a decade of research on fracking reveals alarming trends for people and the environment, especially:

• Air Pollution: Fracking emits hazardous pollutants like VOCs and particulate matter, causing respiratory and other health issues in nearby communities

• Water Contamination & Shortages: Fracking chemicals and released toxins pollute groundwater, while excessive water use depletes local supplies..

• Weak Regulations: Existing rules fail to prevent fracking’s risks, as oversight is inconsistent and insufficient.

• Abandoned Wells: Idle and orphaned wells leak methane and other pollutants, harming air, water, and ecosystems.

• Climate Crisis Acceleration: Fracking releases large amounts of methane, worsening global warming.

Fracking is causing particular harm to vulnerable communities: 

• Drilling and fracking operations have severe health and safety risks for workers are often overaggerating on their promise of job creation to local communities.

• Fracking has been linked to cancer in children, with studies showing a two-to three-fold increase in leukemia among children who lived near a fracking well during early life—or while their mothers were pregnant with them, as well as higher rates of leukemia among children and young adults living in areas dense with oil and gas wells.

• The damage and health harms caused by fracking to indigenous territories is particularly serious because it threatens the cultural survival of indigenous peoples.

• In a letter led by the Global Climate and Health Alliance, Physicians for Social Responsibility, and Health Care Without Harm, hundreds of health professionals and institutions worldwide insist on the severe global health risks posed by the continued extraction and use of fossil fuels. They advocate for a legally binding global plan, termed the Fossil Fuel Non-Proliferation Treaty.

• Their letter emphasized the moral imperative at the very heart of their commitment: “Health professionals work hard to save lives. It is our duty to prioritize our patients’ safety, dignity and comfort and we are duty-bound to speak out about the serious global health risks posed by the continued extraction and use of fossil fuels.”

• Notable signatories include the World Health Organization, the International Pediatric Association, the World Medical Association, and the World Federation of Public Health Associations, among others. 

• Dr Tedros Adhanom Ghebreyesus, WHO Director General, declared: “Addiction to fossil fuels is not just an act of environmental vandalism. From the health perspective, it is an act of self-sabotage. This addiction not only drives the climate crisis but is a major contributor to air pollution.”

• In its COP29 special report on Climate Change & Health, the WHO highlighted that mechanisms such as the Fossil Fuel Non-Proliferation Treaty could play a pivotal role in minimizing the influence of industries that undermine public health and climate goals, clearly stating that “there is no path forward to improve the health of people and the planet that does not lead with a rapid phase out of fossil fuels” , and that green energy transition would offer significant health co-benefits, especially in low-income countries. 

This collective call to action for global cooperation to phase out fossil fuels and transition to sustainable energy solutions to protect public health is now reinforced at the WHO 2nd Global Air Pollution and Health Conference with a clear call to action for a Fossil Fuel Treaty:  “We call on governments, businesses, development agencies as well as philanthropies to invest more in clean air and health, supporting a just and inclusive clean energy transition, supporting fossil fuel non-proliferation treaties as well as the provision of cleaner fuels and technologies especially in low- and middle-income countries. Better health will only be achieved if resources are also ensured for Universal Health Coverage with accessible and affordable health care for all.”

A health-based just transition that ensures the shift to new energy systems does not perpetuate socio-environmental injustices, particularly for the most vulnerable communities in the Global South, should:

• Address Historical Responsibility: The Global North, responsible for 92% of historical excess emissions, must lead a rapid and equitable phase out and provide financial and technological support to the Global South.

• Protect Public Health: Health must be a central pillar of energy transition policies. This includes prioritizing truly diverse, accessible renewable energy sources over interim solutions like liquefied petroleum gas (LPG), which do not reduce indoor air pollution and still contribute to climate change.

• Hold Polluters Accountable: The Polluter Pays Principle should be enforced to ensure fossil fuel companies bear the cost of environmental damage, including land remediation, healthcare support, and community compensation.

• Phase Out Fossil Fuel Subsidies: Governments must redirect fossil fuel subsidies towards sustainable infrastructure, diverse and accessible renewable energy sources, and social protection programs that prioritize public health.

A health-based Just Transition should shift to healthier energy systems, not just "zero carbon" ones:

• The extraction of critical minerals for renewable energy technologies poses environmental and social challenges. Environmental impacts include biodiversity loss from deforestation, toxic waste and radioactive contamination from rare earth processing, and excessive water use in lithium mining, worsening local scarcity. Social impacts involve community displacement, loss of traditional culture and livelihoods, and human rights violations, such as child labor in cobalt mining. Geopolitical concerns arise from supply chain dependencies, particularly in China, and the rise of illegal mining, which fuels environmental destruction and criminal activities.

• “Stop polluting the air we breathe, prevent diseases and save lives”, not only requires bold actions but also a redefinition of what it means to create new energy systems that protect everyone’s health.

• It cannot be considered a health-based just transition if it replicates the fossil fuel industry's exploitative model and ensures clean air only for a few and massive health impacts on most people's bodies, especially in vulnerable communities.

The path forward for a Just Transition that leaves no one’s health behind will imply: 

• Degrowth and Adaptation: a gradual scale down consumption and infrastructure use with a shift toward low-tech solutions, self-reliance, and locally managed sustainable energy projects can enhance energy sovereignty and ensure solutions align with unique regional needs.

• Global Cooperation and Inclusive Governance: A just transition must include meaningful participation from affected communities, particularly Indigenous groups, in decision-making.

The adoption of a Fossil Fuel Treaty as a comprehensive solution to address the root cause of the climate crisis while promoting health equity. Reducing dependence on fossil fuels can save millions of lives annually, lower healthcare costs associated with pollution-related diseases, and alleviate health disparities in low-income, marginalized communities that disproportionately suffer from fossil fuel pollution.