Table of Contents INTRODUCTION I. CLIMATE CHANGE AND GLOBAL PUBLIC HEALTH A. Climate Change Impacts on Human Health B. The Global Health Community's Recognition of the Problems Caused by Climate Change C. Why Global Health Should Be a Leading Concern Within International Climate Change Law II. USING CLIMATE CHANGE LAW TO ADDRESS HEALTH IMPACTS A. Climate Change Litigation: A Slow and Narrow Option for Global Health Advocacy B. The International Climate Change Regime: A Better Way to Address Global Health 1. UNFCCC: A Framework Structure for Addressing Global Health Concerns 2. The Mitigation Regime and the Failure to Capitalize on Global Health Co-Benefits III. THE ADAPTATION REGIME: A SHIFT AWAY FROM THE MITIGATION-APPROACH A. Language Leading to Adaptation Action B. Adaptation Endorsed Through COP Decisions IV. THE ADAPTATION REGIME'S RESPONSE TO GLOBAL HEALTH CONCERNS A. The Gradual Progression of Health Adaptation During the COPs B. Party Reporting on Health Adaptation Strategies and Needs 1. Nationally Determined Contributions 2. National Adaptation Programs of Action 3. National Adaptation Plans C. Adaptation Regime's Work Programmes and Funding Mechanisms as a Resource for Health Adaptation 1. Nairobi Work Programme on Impacts, Vulnerability, and Adaptation 2. Other UNFCCC Working Groups That Contribute to Health Adaptation 3. Adaptation Funding Mechanisms V. INCREASING EFFORTS TOWARDS HEALTH ADAPTATION ACTION A. Benefits of Incorporating the Global Health Community Within the Adaptation Regime B. Shortcomings Within the Regime in Addressing Global Health Problems CONCLUSION INTRODUCTION
Since climate change action has been on the international agenda, policies have focused on climate change mitigation. (1) Unfortunately, it is becoming more and more unlikely that mitigation alone will work quickly enough to prevent devastating impacts, especially in the global health context. (2) In October 2018, the Intergovernmental Panel on Climate Change (IPCC) released a report warning that, without drastic reductions in greenhouse gases (GHGs), global warming will reach catastrophic levels in just over a decade from now. (3) In recognition of this problem, the international climate change regime (4) has increased its focus on climate adaptation as a method of addressing global health problems, encouraging capacity-building measures that help communities face climate change impacts and strengthen their resilience. (5)
The World Health Organization has estimated that between 2030 and 2050, climate change could cause approximately 250,000 deaths per year. (6) Severe weather events, worsening air pollution, malnutrition, and a rise in infectious diseases are all but guaranteed as temperatures continue to rise. (7) It is clear that protection against global health problems like these requires international cooperation and governance. (8)
The international climate change regime has the potential to make significant advancements in addressing global health problems through its institutions, work programmes, and reporting commitments, particularly those being developed under its adaptation regime. (9) Adaptation to climate change requires many of the same strategies as traditional health initiatives, such as disease monitoring and surveillance. (10) Utilizing the adaptation regime is the most feasible option for alleviating climate change impacts on global public health as quickly and effectively as possible.
This Article evaluates legal efforts to respond to public health problems arising from climate change. Part I will provide a brief overview on climate change's impacts on health, how the health community has already responded, and why it is important for international law and policy makers to address this problem. Part II will discuss how advocates have used climate change law as a way to address global health problems through climate change litigation and the mitigation regime, ultimately concluding that those methods cannot tackle the issue alone. Part III will provide a detailed description of the adaptation regime as a precursor for showing why this is the most efficient option for addressing global health problems. Part IV will then illustrate how the adaptation regime is working to respond to climate change impacts on health. Finally, Part V will discuss the benefits of incorporating the health community into the adaptation regime, as well as the barriers preventing advancements in health adaptation.
CLIMATE CHANGE AND GLOBAL PUBLIC HEALTH
Climate change not only creates health vulnerabilities, but also magnifies and intensifies existing health hazards. (11) The global health community has acknowledged these health impacts, prompting health advocates and policymakers to develop a relationship between health and climate change law. Still, it is necessary to strengthen the relationship between health advocates and policymakers in order to prepare countries for deteriorating health systems and the transboundary problems that could result.
Climate Change Impacts on Human Health
Climate change will inevitably affect almost all aspects of human health. (12) Anthropogenic activities which have contributed to the rise of GHGs in the atmosphere and climate impacts, have led to problems such as air pollution, soil and water contamination, and ecosystem collapse. (13) These problems, in turn, then cause adverse impacts on health worldwide, including threats to food security, infectious diseases, sea level rise and extreme weather events. (14) In addition, climate change not only creates health problems, but it also exacerbates existing health concerns. (15) For instance, climate change creates irregular irrigation patterns, which could lead to a decline in crop yields and increase strain on regions already facing malnourishment and poverty. (16)
Water-related events provide a clear example of the connection between climate change and health. (17) This was recognized in the UN's Sustainable Development action plan, Agenda (21). (18) Agenda (21) stipulates that "[s]afe water-supplies and environmental sanitation are vital for protecting the environment, improving health and alleviating poverty." (19) Devastating floods in flood-prone regions can destroy homes, crops, and infrastructure. (20) In drier regions, ongoing droughts limit access to water for drinking and sanitation purposes. (21) Scarcity of clean, safe water can be devastating to health due to an increase in water-borne diseases as a result of droughts and inadequate sanitation practices. (22)
Climate change has also been associated with an increase in the frequency and intensity of extreme weather events. (23) Sea level rise, increases in storm surges, and severe storms cause direct injuries to many people, especially those from Small Island Developing States (SIDS). (24) Heat waves in Europe and North America have resulted in the deaths of tens of thousands of people. (25)
But equally concerning as these high-profile events are the "gradually emerging" effects on health. (26) Rising temperatures result in higher levels of pollution, such as smog, which can weaken human lung functions. (27) Intensified air pollution impacts cardiovascular and respiratory health leading to more asthma attacks and heat strokes. (28) These impacts have been felt the most by people in developing countries, and even more disproportionately, by children and the elderly in those countries. (29) Moreover, vulnerable communities typically lack access to regular medication and treatment, so an increase in natural disasters will only further disrupt the healthcare infrastructure in those regions. (30)
The Global Health Community's Recognition of the Problems Caused by Climate Change
The health organizations, advocates, and experts that make up the global health community have recognized the problems caused by climate change and have begun to take necessary steps to integrate the regimes of international climate change and public health. (31) For example, the World Health Assembly (WHA) has sought to obtain a greater role within the United Nations Framework Convention on Climate Change (UNFCCC). (32) In 2008, the organization issued a resolution calling on the Director General to work with member nations and U.N. entities, including the UNFCCC, "to ensure that health impacts are taken into account in the international response to climate change." (33) Moreover, the WHA has urged its member nations to integrate public health measures into their national climate change plans. (34)
The World Health Organization (WHO) has shown the most initiative in strengthening the relationship between health and the procedures and institutions established within the climate change regime. The WHA issued two resolutions requesting WHO to develop the capacity to assess the health risks from climate change, implement response measures, and help member nations strengthen their partnerships and health systems. (35) WHO has advocated for "better integration of health concerns" into climate change policies, stating that "[c]limate change is the defining issue for health systems in the 21st century." (36) The organization refers to the Paris Agreement as a fundamental health agreement and has called it "the most important public health agreement of the century." (37) Although WHO should be leading the fight against climate impacts on global health, it has "shied away" from the politics of international law and taken a more subservient, guiding role. (38) This is likely because the environmental advocacy community has dominated international climate change negotiations. (39) Regardless, while WHO can generally address health problems efficiently, it lacks the ability to comprehensively address climate change on its own. The organization is spread too thin, and cannot focus on climate change impacts since it also needs to work in policy areas outside of climate change, such as trade and...