At COP30, we must act to stop fossil fuels destroying our health

Shweta Narayan is Campaign Lead at the Global Climate and Health Alliance and lead author of its Cradle to Grave report.

When delegates walk out of the COP30 conference centre on Nov. 21, the world will be watching to see whether they have achieved what science and ethics demand: a commitment to phasing out fossil fuels and placing health at the heart of climate action.

That outcome would signal a turning point not just for emissions, but for lives.

A future where health systems are resilient, children breathe clean air, and communities no longer face the daily threat of floods, heatwaves, and pollution, is still possible.

But the window is rapidly closing.

Recent climate disasters have laid bare the limits of adaptation. Hurricane Melissa devastated Caribbean communities, destroyed hospitals and left thousands without clean water or electricity.

South Asia has endured record-breaking heat and floods, pushing cities beyond human survivability.

Wildfires across Europe and North America have turned skies orange and choked emergency rooms with smoke. These are not isolated crises; they are symptoms of a planet overheated by fossil fuels.

Human activity, primarily the extraction and burning of coal, oil, and gas, has already warmed the planet by more than 1.5°C since pre-industrial times. Every fraction of a degree further intensifies the burden of disease, poverty, and displacement. The climate crisis is no longer a distant threat; it is a public health emergency.

Life-time health burden

In September, the organisation I work for, the Global Climate and Health Alliance, published Cradle to Grave: The Health Toll of Fossil Fuels and the Imperative for a Just Transition, providing the most comprehensive global overview yet of the health harms caused by fossil fuels.

The report examines impacts across the entire fossil fuel lifecycle, from extraction to waste, and throughout the human life course, from pregnancy to old age.

Its findings are unequivocal: fossil fuels harm human health at every stage. Exposure begins before birth, with increased risks of miscarriage, low birth weight, and developmental disorders.

In childhood, polluted air contributes to asthma and leukaemia. In adulthood, exposure fuels heart disease, cancer, strokes, and mental health crises. Even if carbon emissions were captured tomorrow, the toxic byproducts of fossil fuel operations would continue to poison air, water, soil, food chains and bodies for decades to come.

The report also underscores how fossil fuel pollution deepens inequality and exacerbates vulnerabilities. Marginalised communities, including Indigenous peoples, low-income populations, and those in the low- and middle-income countries, bear the heaviest burdens of exposure and disruption.

The costs are staggering. According to the International Monetary Fund, global fossil fuel subsidies, including both direct financial support and the unpriced damage to health and the environment, reached an estimated $7 trillion in 2023. These are public funds effectively spent to first make people sick and then cover the cost of treating them.

Cradle to Grave calls for bold leadership from governments to swiftly transition away from fossil fuels. That transition, it argues, must be just and health-centred, prioritising the protection of vulnerable communities and the stability of health systems.

COP30 offeres a critical chance for change

The report also provides a roadmap of evidence and action for policy makers. For COP30 to deliver, governments must take three decisive steps.

First, they must commit to halting the expansion of new coal, oil, and gas projects and set binding timelines for phasing out existing ones. Continued investment in fossil fuels is incompatible with both a liveable climate and healthy populations.

Second, the $1.3 trillion currently given in direct fossil fuel subsidies must be redirected toward clean, renewable energy and strengthening health and social infrastructure. Every dollar spent on fossil fuels is a dollar diverted from hospitals, schools, and adaptation efforts.

Third, the conference must confront the influence of fossil fuel interests on global policymaking. Just as governments once curbed the lobbying power of the tobacco industry, they must now insulate climate and health negotiations from fossil fuel disinformation and interference.

The health community is already stepping up. Hospitals are reducing emissions, and medical associations are divesting from fossil fuels and cutting ties with PR and advertising firms that work for polluters.

Protecting health means ending fossil fuel dependence, yet health remains sidelined in global climate talks, treated as an “impact area” rather than a core outcome across policy areas.

COP30 in Belém offers a critical chance to change that. Brazil, a country rich in biodiversity and deeply affected by environmental degradation, is uniquely positioned to champion a health-centred, justice-driven transition.

When delegates leave Belém, success will not be measured by the number of pages in the final declaration or the pledges made, but by the courage to act on what we already know: that fossil fuels are destroying health from cradle to grave. Anything less would be a betrayal of both science and humanity.