Editorial

The 21st session of the UN Framework Convention on

Climate Change (Nov 30Dec 11, 2015; Paris, France)
marked the 11th meeting of those countries who
endorsed the Kyoto Protocolan agreement that
set binding greenhouse gas reduction targets, in an
attempt to mitigate the eects of such emissions on
climate change. The Protocol, drawn up in 1997 and
ocially enforced from 2005, required 37 industrialised
nations, plus the European Community, to reduce
their greenhouse gas emissions by 2012, to achieve
a worldwide decrease of 52% compared with
concentrations in 1990. Although 192 countries ratied
the Protocol (the USA being a notable exception), many
countries that were classed as rapidly developing at
the time of its draftingincluding India and China
were exempt.
The need for countries to act on climate change is
enshrined in one of the UNs Sustainable Development
Goals (SDG 13), which calls on countries to take urgent
action to combat climate change and its impact.
However, the need for action on climate change is
intrinsic to almost all SDGs, not least those addressing
health. Incidence of non-communicable disease is
rising rapidly in high-income and low-to-middle
income countries alike. Such incidence will increase
further with a changing climate. As global patterns
of weather change, the number and type of extreme
weather events, some precipitating natural disasters,
will increase. Unexpected or unseasonally heavy rain
can lead to ooding, which can release potentially
carcinogenic chemicals into the environment
from contaminated groundwater by washing over
industrial sites or through overow of sewage.
Additionally, a warmer planet alters biogeochemical
cycles, potentially exposing human populations to
otherwise inert chemicals that are more volatile, or
more soluble, at higher temperatures. For example,
persistent organic pollutants are toxic and some, such
as dichlorodiphenyltrichloroethane [DDT] and lindane,
are possibly carcinogenic. Such pollutants can travel far
from their source due to a slow rate of decomposition.
Data are already showing that those that had been
locked into cold water and Arctic ice are now coming
out of solution, and are being released into the air as
the oceans warm and polar ice melts.
www.thelancet.com/oncology Vol 17 January 2016

Climate change will have immediate human

costs. Changing weather patterns could increase
food instability (eg, through drought, or spoiled or
contaminated crops) and in turn, food security concerns
might precipitate the increased use of more intensive
farming practices, including greater use of carcinogenic
pesticides and preservatives. Finally, climate change
risks increasing the numbers of dispossessed peoples
in the world, with people eeing either from natural
encroachment on their homes by ooding, or from
uninhabitable conditions. Such climate refugees would
not fall under any jurisdiction for health care and there
is clear evidence of the extremely poor health care,
including cancer services, such migrants receive.
Implementation of the reductions in greenhouse gas
emissions would thus not only protect against future
burdens, but could also have an immediate bystander
eect by inuencing the activities of heavy polluting
industries. For example, greenhouse emissions from
industry are often released in combination with other
carcinogenic pollutantseg, particulate matter between
25 m and 10 m in size, which is signicantly associated
with an increased risk of developing lung cancer. Such
pollution is actually worsening in some low-to-middle
income countries. On Dec 7, 2015, authorities in Beijing,
China, declared a red smog alert for the rst time. This
highest level of alert required schools to close and
outdoor construction to cease. The 25 m particulate
matter concentration, as recorded by the US Embassy
in Beijing, was reported to be 256 g/m3more than
ten times higher than the UNs safe limit of 25 g/m3.
Climate change is a global problem that needs a
global solution. Rising incidence of non-communicable
diseases, especially cancer, will only be worsened
if nations do not act. The Lancet Commission on
planetary health identied poor governance (dened
as implementation failures) as an issue that must be
addressed if we are to maintain or improve human
health in the face of harmful environmental change.
The aim of the 2015 Paris talksencouraging countries
to agree to reduce emissions to the extent that global
temperatures increase by no more than 2Cneeds all
countries to accept responsibility without self-interest:
our health, and that of future generations, depends
on it. The Lancet Oncology

Mitsuru Tamura/Associated Press

Climate change and non-communicable diseases

For more on the UNFCCC Paris

talks see http://unfccc.
int/2860.php
For more on the UNs
Sustainable Development
Goals see https://
sustainabledevelopment.
un.org/?menu=1300
For more on cancer health care
for migrants see Policy Review
Lancet Oncol 2014; 15: e29097
For more on the risks of air
pollution and developing lung
cancer see Articles Lancet Oncol
2013; 14: 81322
For more on The Lancet
Commission on planetary
health see The Lancet
Commissions Lancet 2015;
386: 19732028