COP28 Open Letter on fossil fuels from the Global Medical and Health Community

Dear COP 28 President-Designate Sultan Ahmed Al-Jaber,

This year, world leaders gathering in the UAE to take stock of their climate commitments will for the first time engage in official programming focused on health. We, the signatories of this letter, support your leadership in bringing health front and center at COP28.

As global health leaders, we are committed to achieving health and well-being for all – this is not possible without a safe and stable climate. The Paris Agreement enshrined the “right to health” as a core obligation for climate action. Yet, communities, health workers and health systems around the world already face the alarming impacts of a changing climate. Climate change-induced extreme weather events are becoming more frequent and severe – many countries are grappling with the health consequences of extreme heat, unprecedented storms, floods, food and water insecurity, wildfires and displacement. For COP28 to truly be a “health COP,” it must address the root cause of the climate crisis: the continued extraction and use of fossil fuels including coal, oil and gas. We call on the COP28 Presidency and the leaders of all countries to commit to an accelerated, just and equitable phase-out of fossil fuels as the decisive path to health for all.

Ending our dangerous dependency on fossil fuels will improve the health prospects of future generations and will save lives. Keeping the global temperature increase within the 1.5°C target of the Paris Agreement is essential to ensure good health and economic prosperity for all. This will only be possible if we rapidly phase out fossil fuels. Fossil fuel phase-out will limit global warming, thereby protecting health from the devastating impacts of extreme weather, and preventing further ecological degradation and biodiversity loss. Failing to do so will lead to overwhelming health consequences, as well as the loss of key natural resources and ecosystem services that are critical to both human and non-human species health, thereby undermining One Health and planetary health.

In addition to climate-related health impacts, air pollution caused in part by burning fossil fuels causes 7 million premature deaths annually. The economic costs of air pollution-related health impacts amounted to over US$8.1 trillion, or 6.1% of global GDP, in 2019.By improving air quality, governments can reduce the burden of disease from multiple cancers, heart disease, neurological conditions including stroke, and chronic and acute respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). Investments in clean energy sources will save hundreds of billions of dollars in health care costs associated with air pollution every year, while reducing economic losses from extreme weather events with damages worth US$253 billion (in 2021)

A full and rapid phase-out of fossil fuels is the most significant way to provide the clean air, water, and environment that are foundational to good health. We cannot rely on unreliable and inadequate solutions, like Carbon Capture and Storage (CCS), that extend the use of fossil fuels but do not generate the real and immediate health improvements which a renewable energy transition provides. False solutions like CCS risk making harmful emissions worse, straining the health of overburdened communities and delaying our progress toward meaningful climate progress.

The energy transition must be just and equitable for all. In transitioning to a clean energy future, there is an opportunity to undo the injustices of the fossil fuel dependent system, taking a systemic approach and emphasizing health, care and community well-being, leaving no one behind. Global leaders must ensure everyone, including fragile states and the most remote and excluded communities, has access to non-polluting, affordable, reliable, accessible and resilient clean energy, as well as to emerging technologies that make best use of this energy. A just transition offers the opportunity to reduce health inequities faced by minority and marginalized communities, especially with respect to the health effects of ongoing fossil fuel use and dependence.

Unlocking finance is essential to deliver a healthy and just transition. Achieving climate and health goals will only be feasible if we stop investing in fossil fuels and invest instead in proven climate and health solutions. Each year, countries spend hundreds of billions of dollars subsidizing the fossil fuel industry, money that could be spent investing in a healthy future. High-income countries, development finance institutions, and the private sector must dramatically increase – and fulfill – their commitments to drive investments in clean energy, clean air, and economic development for the communities most harmed by climate change and fossil fuel pollution.

Fossil fuel interests have no place at climate negotiations. The fossil fuel industry cannot be allowed to continue its decades-long campaign of obstructing climate action at the UNFCCC negotiations and beyond. Just as the tobacco industry is not allowed to participate in the WHO Framework Convention on Tobacco Control, it is imperative to safeguard global collaboration on climate progress from the lobbying, disinformation, and delays in favor of industry interests.

Without ambitious climate action, the burden on health care systems and health care workers will be insurmountable. Health gains made in recent decades will be in vain and we will see the harmful impacts of climate change ruin our chances for a safe, equitable and just future. 

In this extraordinary year, with health for the first time on the COP agenda, we urge you to deliver real climate progress: Commit to an accelerated, just and equitable phase-out of fossil fuels and invest in a renewable energy transition as the decisive path to health for all. 


Global Health Organization Leadership

Dr. Githinji Gitahi, CEO, Amref Health Africa

Dr. Pam Cipriano, President, International Council of Nurses

Dr. Salman Khan, Liaison Officer for Public Health Issues, International Federation of Medical Students’ AssocIations

Dr. Naveen Thacker, President, International Pediatric Association

Dr Christos Christou, International President, Médecins Sans Frontières

Dr. María del Carmen Calle Dávila, Executive Secretary, Organismo Andino du Salud (Andean Health Organization)

Dr. Vanessa Kerry, CEO, Seed Global Health

Prof. Luis Eugenio de Souza, President, World Federation for Public Health Associations

Dr. Lujain Alqodmani, President, World Medical Association

Regional Leaders in Health (alphabetical by surname)

Dr. Mary T. Bassett, Director, FXB Center for Health and Human Rights, Harvard University

Dr. Fiona Godlee, Former Editor-in-chief of the British Medical Journal

Prof. (Dr.) Arvind Kumar, Chairman, Institute of Chest Surgery, Chest Onco Surgery and Lung Transplantation, Medanta Hospital, India

Dame Parveen Kumar, Emeritus Professor of Medicine and Education, Barts and The London School of Medicine and Dentistry

Dr. Lwando Maki, Secretary, Public Health Association of South Africa

Dr. Jemilah Mahmood, Executive Director, Sunway Center for Planetary Health – Malaysia

Dr. Kari C. Nadeau, MD, PhD, Chair of the Department of Environmental Health at Harvard School of Public Health

Prof. (Dr.) K Srinath Reddy, Past President of Public Health Foundation of India

This letter supported and endorsed by health leaders and organizations from around the world:


Climate And Health Foundation

Climate Mental Health Network

Health Care Without Harm

International Society for Neglected Tropical Diseases

International Society of Doctors for The Environment

International Youth Health Organization

Ride For Their Lives

Vital Strategies

World Health Innovation Summit


Dr. Agonafer Tekalenge, President, Ethiopian Public Health Association

Dr. Adeline Kimambo, Executive Secretary, Tanzania Public Health Association

Ong Zéro Décès En Donnant La Vie, Burkina Faso

Maison Des Organisations De La Société Civile (Mosc) Anjouan – Comores, Comoros

New Hope for The Poor, Congo

The Youth Cafe, Kenya

African Journal of Gastroenterology and Hepatology, Egypt

Afro-Egyptian Journal of Infectious and Endemic Diseases (Ajied), Egypt

Community And Family Aid Foundation, Ghana

Center Of Education and Research on Health and Climate Change (Cerscc-Magaria), Niger

Peal Medical Ltd, Nigeria

Mental Health Rebuilding and Restoring Initiative, Nigeria

Annals Of Health Research (The Journal of The Medical and Dental Consultants Association of Nigeria) Nigeria

Nurses Across the Borders Humanitarian Initiative, Nigeria

Santé En Transition, Reunion Island

Groundwork, Friends of The Earth South Africa, South Africa

Energy Safe Water And Environmental Preservation For Community Development Foundation (Esawep-Cod Foundation), Tanzania

Csym Huduma Mbuenet, Tanzania

Health For Children Organization, Tanzania

Give A Hand Foundation, Uganda

Kabarole Ngos &Cbos Association (Kanca), Uganda

Tree Adoption Uganda, Uganda

Centre For Peace and Conflict Mitigation, Uganda

Youth Advocacy and Development Network-Uganda, Uganda

Corporacion Hvq Sa, Zimbabwe


Aihms-Global, India

Global Journal of Medicine and Public Health, India

Green Practice Japan, Japan

Health And Global Policy Institute, Japan

Khyber Medical University Journal, Pakistan

Radiological Students’ Association of Pakistan, Pakistan

Planetary And Global Health Program, St. Luke’s Medical Center College of Medicine, Philippines

St. Paul’s Hospital of Iloilo Inc., Philippines

Aga Khan Health Services-Syria, Syria


Dr. Vital Ribeiro, Chair, Associação Civil Projeto Hospitais Saudáveis, Brazil

Dr. Rosana Teresa Onocko Campos, President, Associação Brasileira de Saúde Coletiva, Brazil

Fundación Ética Climática Y Desarrollo, Argentina

Act Health Promotion, Brazil

Health Hospitals Project, Brazil

São Leopoldo Mandic Medical School, Brazil

Instituto De Medicina, Estudos E Desenvolvimento – Imed, Brazil

Hospital Das Clínicas da Faculdade De Medicina De Botucatu, Brazil

Aguas Libres Villarrica, Chile

Departamento Comunal De Salud, I. Municipalidad De Talca, Chile

Clinica De Alta Complejidad De Aguachica, Colombia

Clinica De Cirugia Ambulatoria Conquistadores, Colombia

Clinica Esperanza Sas, Colombia

Clinica Pajonal Sas, Colombia

Cooperativa De Profesionales De La Salud De Donmatias Prosalco Ips, Colombia

Ese Hospital San Rafael De Pacho, Colombia

Fundación Amigos De La Salud, Colombia

Fundación Colombiana Del Corazón, Colombia

Hospital Regional De Zipaquirá, Colombia

E.S.E Hospital San Vicente De Paúl, Colombia

Hospital Francisco De Paula Santander – Santander De Quilichao Departamento Del Cauca, Colombia

Alc Eco Solutions De Costa Rica Limitada, Costa Rica

Fundacion Plenitud, Dominican Republic

Corporacion Hvq Sa. (Hospital Vozandes Quito), Ecuador

Alergiamx, Mexico

Centro Estatal De Vigilancia Epidemiologica Y Control De Enfermedades (Cevece), Mexico

Hospital Comunitario Abasolo, Mexico

Hospital Comunitario Moroleón, Mexico

Hospital General Salvatierra, Mexico

Hospital Materno Perinatal “Monica Pretelini Saenz”, Mexico

Observatorio Ciudadano De La Calidad Del Aire Del Área Metropolitana De Monterrey, Mexico

Celtimedic Sa De Cv, Mexico

Centro Estatal De Vigilancia Epidemiologica Y Control De Enfermedades (Cevece), Mexico

Hospital Materno Perinatal “Monica Pretelini Saenz”, Mexico

Secretaría De Salud Del Estado De México-Red Mexiquense De Hospitales Verdes Y Saludables, Mexico

Salud Sin Daño Panama, Panama

Circulo Laudato Si De Tacna, Peru

Instituto Nacional De Salud Del Niño, Peru

Asociación Latinoamericana De Pediatría (Alape), Uruguay

Sanatorio Semm Mautone, Uruguay


Dr. Sara Cerdas, Member Of the European Parliament, Portugal

Diederik Aarendonk, Forum Coordinator Global Health Organization Leadership, European Forum for Primary Care

Dr. Ansgar Gerhardus, Board Chair, German Public Health Association

Prof. Kevin Fenton, President, UK Faculty of Public Health

Dr Latifa Patel, Representative Body Chair, British Medical Association

Kamran Abassi, Editor-in-Chief, British Medical Journal

Dr. Richard Smith, Chair, UK Health Alliance on Climate Change

Sheila Sobrany, President, Royal College of Nursing

Diana Zeballos, Executive Secretary, Sustainable Health Equity Movement

Health For Future Austria, Austria

Eurohealthnet, Belgium

European Union of Medical Specialists, Belgium

Health Care Without Harm Europe, Belgium

Observatoire De L’anthropocène, Belgium

Pharmadvance, Belgium

Résiliænces Métamorphoses, Belgium

Association Of Basic Medical Sciences of Federation of Bosnia and Herzegovina, Bosnia and Herzegovina

Collectif Je Suis Infirmière Puéricultrice, France

Danish Family Planning Associaiton, Denmark

Société Française De Santé Publique (Sfsp) / French Society of Public Health, France

Comité Pour Le Développement Durable En Santé (C2ds), France

Eco Veto, France

Société Française De Santé Publique (Sfsp) / French Society of Public Health, France

Berufsverband Der Präventologen E.V., Germany

Deutsche Gesellschaft Für Epidemiolgie E. V., Germany

German Public Health Association, Germany

Klug – German Alliance on Climate Change and Health, Germany

Un Sustainable Development Solutions Network (Sdsn) Youth Black Sea, Greece

Irish Doctors for The Environment, Ireland

Irish Society of Specialists in Public Health Medicine, Ireland

Italian Assciation of Epidemiology, Italy

European Forum for Primary Care, Netherlands

Huisartsenpraktijk Rietkampen, Netherlands

The Green Health Alliance, Netherlands

Zorg Voor Klimaat, Netherlands

Centre For Sustainable Healthcare Education, Norway

Alianza Médica Contra El Cambio Climático, Spain

Fundación Ecología Y Desarrollo (Ecodes), Spain

Galician Health Service, Spain

Ifmsa-Sweden, Sweden

Medical Alliance Against Climate Change, Spain

Medicus Mundi Spain, Spain

Salud Por Derecho, Spain

Spanish General Medical Council, Spain

Fundación Ecología Y Desarrollo (Ecodes), Spain

Swedish Doctors for The Environment, Sweden

Doctors For the Environment Switzerland, Switzerland

Faculty Of Medicine, University of Geneva, Switzerland

Consortium Suisse Pour La Santé Durable Et La Transition Écologique Du Système De Santé, Switzerland

Swiss Malaria Group, Switzerland

Health For Future Switzerland, Switzerland

Public Health Schweiz, Switzerland

Doctors In Unite the Union, UK

Green Health Wales, UK

Greener Practice, UK

Institute Of Health Visiting (Ihv), UK

Palliative Care Sustainability Network, UK

Royal College of Nursing, UK

The British Psychological Society, UK

The Centre for Sustainable Healthcare, UK

Royal College of Paediatrics And Child Health, United Kingdom

The British Psychological Society, United Kingdom


Dr. Kate Wylie, Executive Director, Doctors for the Environment Australia

Dr. Frances Peart, President & Board Chair, Climate and Health Alliance Australia

Veterinarians for Climate Action, Australia

Institute For Climate & Peace, United States Minor Outlying Islands


Katie Huffling, DNP, Executive Director, Alliance of Nurses for Healthy Environments

Canadian Association of Nurses for The Environment, Canada

Canadian Association of Physicians for The Environment, Canada

Canadian Health Assoc. For Sustainability and Equity (Chase), Canada

Canadian Medical Association, Canada

Canadian Public Health Association, Canada

Registered Nurses’ Association of Ontario (Rnao),

Ifmsa-Québec, Canada


Boston College Global Observatory on Planetary Health, US

Carolina Advocates for Climate, Health, And Equity, US

Climate Health Now, US

Climate Psychiatry Alliance, US

Clinicians For Climate Action New Jersey, US

Florida Clinicians for Climate Action, US

Georgia Clinicians for Climate Action, US

Greater Boston Physicians for Social Responsibility, US

Healthy Climate Wisconsin, US

Idaho Clinicians for Climate and Health, US

Medical Society Consortium on Climate and Health, US

Michigan Clinicians for Climate Action, US

Montana Health Professionals for A Healthy Climate, US

Physicians For Social Responsibility, US

Physicians For Social Responsibility, US

Physicians For Social Responsibility – Florida Chapter, US

Physicians For Social Responsibility Arizona, US

Physicians For Social Responsibility Maine, US

Physicians For Social Responsibility Pennsylvania, US

Physicians For Social Responsibility, Arizona Chapter, US

Physicians For Social Responsibility/Sacramento, US

Public Health Institute, US

San Francisco Bay Physicians for Social Responsibility, US

Solavida, US

Texas Physicians for Social Responsibility, US

Vermont Climate and Health Alliance, US

Virginia Clinicians for Climate Action, US

Washington Physicians for Social Responsibility, US

Yale Center On Climate Change and Health, US

Please refer to this detailed background note for evidence on each of the demands. 

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This letter was coordinated by Health Care Without Harm and Global Climate and Health Alliance on behalf of the health community.