European perspective on climate change and health

Introduction

With Europe warming at more than twice the global average over the past 30 years [1], hundreds of thousands of people across the WHO European Region have already experienced the health and material consequences of climate change [2].

Awareness is growing, and momentum is building, yet significant challenges remain. Vulnerable populations — pregnant women, children, older adults, and those facing socioeconomic hardship — are disproportionally affected, especially in countries already grappling with social and health inequalities and are further compounded by gender-based and intergenerational dimensions of vulnerability, perpetuating injustice.

Despite growing evidence, however, not all countries have taken bold, coordinated action to reduce emissions or prepare for the health impacts of climate change [3]. Health systems themselves offer a key opportunity: by reducing emissions, becoming more sustainable, and leading by example in climate adaptation and mitigation.

This paper reflects on the evolution of climate change and health as a political priority in Europe, and highlights WHO’s role in supporting Member States, scientists and civil society in translating evidence into policy and practice.

From academic concerns to a pressing political issue

The recognition that climate change is a public health issue has been a slow but steady evolving journey in the WHO European Region. The first political acknowledgment dates back to the 1989 Frankfurt Charter on Environment and Health [4], which referenced the need to act on “global disturbances to the environment such as the destruction of the ozone layer and climate change” —three years before the adoption of the 1992 United Nations Framework Convention on Climate Change [5]. Since then, the WHO European Centre for Environment and Health, currently hosted by Germany in Bonn, recognized the need to bring this emerging threat into the public health agenda. However, it wasn’t until the heatwave in the summer of 2003, which is estimated to have caused the death of more than 70,000 people across just 16 European countries [6], that the health implications of climate change not only made headlines across Europe, but broke through into public consciousness and political discourse. The tragedy catalyzed a wave of international research collaboration to accelerate the development of adaptive strategies, with a key enabling role played by the European Union Research Programme.

These efforts laid the groundwork for the first guidance on heat—health action plans, published by the WHO Regional Office for Europe in 2008 [7], and contributed to the adoption of the first World Health Assembly Resolution on climate change and health by Member States [8].

Yet, climate change remained relatively peripheral to the political agenda of European ministries of health for much of the following decade. Even the establishment of a Working Group on Climate Change and Health (HIC) in 2010 — consisting of national focal points appointed by Ministries of Health and the Environment [9] — was not enough to fully gain and accelerate political commitment.

That began to change in the early 2020s, driven by three nearly concomitant and reciprocally reinforcing developments:

1. The faster-than-expected acceleration of the climate crisis in Europe, which coincided with the COVID-19 pandemic. This increased pressure exposed the vulnerabilities of health systems and highlighted the urgent need for resilience, preparedness, and adaptation.

2. In July 2023, the WHO Regional Office for Europe declared extreme weather events as a public health emergency [10]. This marked a turning point in framing climate change as a direct and immediate threat to the health of Europeans and the stability of health systems, and in integrating it into the broader health security and emergency agenda.

3. The Declaration of the Seventh Ministerial Conference on Environment and Health in 2023 brought high political momentum with the adoption of a clear actionable roadmap to 2030 [11]. This was reinforced globally by the first-ever Health Day at the 28th UN Conference on Climate Change (COP28) [12], the COP28 Declaration on Climate and Health [13] and the 2024 Resolution on climate change and health adopted by the 77th World Health Assembly, which collectively helped define the scope of the health sector engagement in the climate change agenda [14].

Where from here?

While recent milestones have brought the climate change and health agenda closer to the core of public health policy in European countries, there is a sustained need for the WHO Regional Office for Europe to support countries in their continued work on several fronts:

1. Firstly, maintaining and amplifying political momentum is critical. The establishment of a Pan-European Commission on Climate and Health [15], convened by the WHO Regional Office for Europe, represents a key opportunity to elevate the issue further. As an independent advisory group, the Commission will develop by mid-2026 a high-level “call to action” to raise the political profile, awareness and support for stronger action to address the health impacts of climate change. In parallel, the forthcoming WHO European Programme of Work 2026-2030 [16], expected to be endorsed by the 75th session of WHO Regional Committee for Europe in 2025, identifies action on climate change and health as one of its core priorities for the second term in office of the WHO Regional Director.

2. Secondly, there is a need to continue providing state-of-the art support and evidence-based guidance on policy development at the national level [17]. The upcoming updated WHO guidance for the development of comprehensive heat—health action plans, to be published in 2026, will provide a cutting-edge resource to countries. Strengthening capacities to implement this guidance at the national level will be supported in partnership with the European Commission and its European Climate and Health Observatory [18]. Furthermore, the WHO Regional Office for Europe continues its technical support on climate-resilient, low-carbon and environmentally-sustainable health systems to Member Countries. This work also includes an evidence review on mental health interventions in the face of a changing climate conducted in the Region.

3. Thirdly, there is a need to further expand and strengthen a vibrant community of practice among Member States to facilitate learning, peer exchange and mutual support for the development of climate-resilient, low-carbon and environmentally sustainable health systems. At the Regional level, the Environment and Health Process (EHP) Partnership for Health Sector Climate Action, led by Ireland and launched in 2023, is bringing together an increasing number of countries, including Germany, to make more rapid advances on this agenda [19], aligning with the global WHO Alliance for Transformative Action on Climate and Health (ATACH) [20].

Conclusion

Continued collaboration and evidence-based action are essential to protect health in the face of climate change. As political attention and public trust face competing pressures, it is vital for policymakers, health professionals, researchers, and communities to work together to build resilient, equitable health systems, prioritize vulnerable populations, and counter mis- and disinformation.