Climate action appears a long-term challenge, but but when it comes to health, improvements arrive immediately. Across the WHO European Region, just 21 of 53 countries have heat–health action plans. These plans save lives. The gap is now a credibility test ahead of COP30 in Belém, where health will be in the spotlight.

“Accelerating the development and implementation of these plans is not just smart policy. It’s a life-saving necessity,” it was stressed at the Pan-European Commission on Climate and Health hearing on September 1.

This urgency coincides with growing global attention on the health–climate nexus. In August, EU Perspectives reported that heat-related deaths have risen 30 per cent in two decades. In 2022–23 alone, 35 countries recorded more than 100,000 heat-related deaths between them.

Climate change is straining health systems

At the same time, health is moving up the international climate agenda. The July Global Conference on Climate and Health in Brasília laid the groundwork for the Belém Health Action Plan. The UN will launch it at COP30 in November.

Climate action delivers vast measurable health benefits. It improves lives within months to years. — Lorna Benton, Research Fellow in Planetary Health at the London School of Hygiene and Tropical Medicine

“Climate action delivers vast measurable health benefits. It improves lives within months to years,” said Lorna Benton, Research Fellow in Planetary Health at the London School of Hygiene and Tropical Medicine. “These benefits arise not just from cuts in carbon dioxide emissions. They come from reductions in methane, nitrogen oxides, ozone precursors, PM2.5 and black carbon.”

Hans Kluge, WHO Regional Director for Europe, underscored the urgency. He linked the climate crisis directly to a health system strain.

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“We endured record-breaking heatwaves. They resulted in significant rise in heat-related fatalities, catastrophic wildfires and increased mental health issues,” he told the Pan-European Commission. “Rare vector-borne diseases kept expanding off their footholds, and the health and emergency systems are struggling.”

From southern Europe to the Nordic countries, the evidence is mounting. Climate change is not a future health threat but a present-day burden.

Co-benefits of mitigation

For Katrín Jakobsdóttir, Prime Minister of Iceland and chair of the Pan-European Commission, the task is to convince policymakers that climate action is also a public health intervention.

We have reached the point where climate action can be a powerful driver of population health. — Katrín Jakobsdóttir, Prime Minister of Iceland

“We have reached the point where climate action can be a powerful driver of population health,” Ms Jakobsdóttir said. Policies that cut emissions, from active transport to food security and renewable energy can deliver immediate health gains while reducing pollution. 

Progress is already visible. “Across the WHO European region, steps are increasingly taken to integrate health into national climate action,” Iceland’s PM noted. “Good practices are demonstrating measurable benefits. What we need to do, and what I hope this Pan-European Commission will deliver, is to assemble those best practices, share that knowledge more widely, and scale them up. Because the urgency is great.”

The evidence gap

Despite the scale of opportunity, Ms Benton highlighted a critical weakness: most of the evidence base is still modelled. “About 90 per cent of evidence we rely on is modelled, not observed,” she noted. “Models can’t tell us what actually happens when policies are implemented in real-world conditions.” That gap, she argued, is where the Commission can make a difference. Mainstreaming a culture of evaluation, embedding routine health and equity metrics into every climate action, and reporting multi-pollutant, multi-benefit outcomes may be helpful.

One risk is that policy proliferation creates an illusion of progress. Ms Benton pointed to a landmark study of 1,500 climate policies over two decades: “Only about 10 per cent of those proved effective, but they explain most of the real-world emission cuts.”

The examples that worked offer lessons for Europe. Urban road pricing schemes in London, Stockholm and Milan cut pollutants, reduced traffic injuries, and generated revenue. Once benefits became visible, the initial public opposition turned into support. Case studies like these demonstrate that evaluation and communication can make climate policies politically sustainable.

Learning from practice: Europe and beyond

Practical examples came from both Europe and abroad. In North Macedonia, Professor Igor Spiroski described the country’s updated Heat–Health Action Plan, first adopted in 2011 and extended to 2030. It integrates health, education, social care and urban planning, with a focus on vulnerable groups such as outdoor workers and the elderly.

“Presence and partnerships are crucial… the population is talking about this action plan because they know their government is doing and thinking about heat as a health problem,”he said. Partnerships with the Red Cross and media were essential in building trust and broadening audience reach.

In Spain, Madrid’s La Paz Hospital cut nitrous oxide emissions from 2,500 tonnes in 2022 to just two tonnes in 2025, a dramatic climate win from a single change in clinical practice. And in Victoria, Australia, retrofitting 1,000 low-income households reduced nearly 6,000 tonnes of CO₂-equivalent emissions in one winter, while improving indoor air quality and household well-being.

The health sector’s footprint

But health systems are not just victims of climate change, they are also contributors. Maria Gaden, Chief of Development at the Centre for Sustainable Hospitals in Denmark, reminded the Commission that health care is responsible for about 4.4 per cent of global emissions. “Should it be legal to use single-use surgical steel every day in millions, when we may not use single-use plastic straws?” Ms Gaden asked. She called for mandatory national resilience strategies, procurement reforms to address supply-chain emissions, and education for health professionals to change practices.

For too long, this was not core business for the European Union or for the Commission. — Margot Wallström, Sweden’s ex-foreign minister

For Margot Wallström, former Swedish foreign minister and EU commissioner, the missing ingredient is communication. “For too long, this was not core business for the European Union or for the Commission,” she recalled. “It was maybe introduced sort of too early, before people really had a proper understanding, and political leaders had a proper understanding, of what these links consisted of.”

That has changed. With the European Green Deal, the Zero Pollution Action Plan, the Environmental Action Programme, and the Chemicals Strategy, the EU now has a strong normative framework. “All of these elements, if used correctly, can really change things around,” Ms Wallström said. “But we need member states to implement this.”

The pathway forward

The message from the Commission’s hearing was clear. Europe must act not just for the planet, but for people’s immediate health. Proven solutions exist — from transport reform to energy retrofits and heat–health action plans. The challenge is to scale them up, evaluate their impact, and embed equity at every step.

With COP30 in Belém fast approaching, Europe faces a choice. Arrive with a record of fragmented national efforts, or with a coherent agenda that treats climate action as a health intervention. Scaling up best practices, embedding routine health metrics into climate policy, and closing the gap between commitments and implementation will be key to Europe’s credibility on the global stage.