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HEALTH 115Climate also influences the emergence of new diseases. About 75 per cent of all new human pathogens originate in wild or domestic animals. Climate variables, including those that influence the availability of food and water, have a direct impact on wild animal populations, their concentrations, and their incursion into areas inhabited by humans.All these consequences for health make the first global climate change agreement, reached in Paris last December, not just an environmental treaty. It is a health treaty as well. Much is at stake.Human rights obligations, standards, and principles have the power to shape policies for climate change mitigation and adaptation.A human rights approach provides an entry point for holding countries accountable for their international obligations on climate change. This approach also provides the ethical reference point which underscores why we need to take action on climate change.Much of the continuing debate about the climate is talk about money. What will mitigation and adaptation measures cost? Can the world afford them? Who will pay?The focus of this panel on human rights, and specifically the right to health, offers a different perspective. It puts people, their health, their lives, and their livelihoods, at the centre, not money.Holding countries accountable for their climate-related policies is also a matter of fairness. The countries that have historically contributed the least to greenhouse gas emissions are being hit the hardest.As is so often the case, one of the biggest barriers that stand in the way of realizing the right to health is poverty. Poverty is sexist. It burdens women the most.We need fairness. We need justice. And we need global solidarity. All countries need to work together to cut carbon emissions. But let’s look at the reality.The poorest households in the world are forced to rely on the most polluting energy sources just for everyday cooking and heating. Use of these energy sources, which cause heavy indoor air pollution, is associated with more than 3.5 million deaths each year.Half of all health facilities in some African countries do not have reliable access to electricity and clean running water. This was a hazard that came under the spotlight during the Ebola outbreak in West Africa.The Paris agreement, with its central reference to human rights, including the right to health, is a welcome step forward. However, the agreement is largely voluntary and subject to interpretation.What we need now is an agenda for action that doubles as a results-based framework for accountability. Accountability means counting. WHO keeps health statistics documenting both the direct and indirect consequences of climate change.To define an action agenda, WHO will host a second global conference on health and climate this year, hopefully in July.To support accountable action, WHO and the UN Framework Convention on Climate Change will jointly roll out climate and health profiles for individual countries. These profiles focus on the health risks and opportunities for the most vulnerable populations. They also track compliance with the Intended Nationally Determined Contributions in terms of their impact on health.The declaration to the 2030 agenda for sustainable development describes climate change as “one of the greatest challenges of our time.” As noted, “its adverse impacts undermine the ability of all countries to achieve sustainable development.”Without a strong agenda for action on climate change, most of the 17 goals will be utopian. The hard-won gains for health since the start of this century can easily be swept away by the tidal wave of health threats unleased by climate change. A ruined planet cannot sustain human lives in good health. ■ABOUT THE AUTHORDr Margaret Chan joined WHO in 2003 as Director of the Department for Protection of the Human Environment. In June 2005, she was appointed Director, Communicable Diseases Surveillance and Response, as well as Representative of the Director-General for Pandemic Influenza. In September 2005, she was named Assistant Director-General for Communicable Diseases. Dr Chan was elected to the post of the Director-General of WHO on 9 November 2006. The Assembly appointed Dr Chan for a second five-year term at its sixty-fifth session in May 2012. Dr Chan’s new term will begin on 1 July 2012 and continue until 30 June 2017.Above: Dr Margaret Chan