At Dubai climate talks, the world notices one of Kenya’s best and brightest

The United Nations’ 28^th edition of the Conference of Parties on Climate, or COP28, summit that opened on November 30 will continue through December 12, in Dubai, the United Arab Emirates, and brings together dignitaries from 197 signatory countries to draft a plan to jumpstart the global transition away from polluting fossil fuels since burning them is heating the Earth.

The planet has already warmed by 1.2 degrees Celsius above preindustrial levels, below the cap of 1.5 degrees agreed to five years ago in Paris, and greenhouse emissions, which are gases in the atmosphere that trap heat and cause temperatures to rise, are trending higher. If the trend continues, scientists say it will be so hard for humans to cope with the severe storms, drought, heatwaves, and sea level rise.

Over the past several days, as negotiations in Dubai’s Expo City Blue Zone have focused on money for mitigation and resilience—finalising the loss and damage fund agreed to last year in Egypt, with contributions from rich nations that are responsible for most of the pollution—one issue that has dominated the first few days of the conference is how to integrate health into climate change decisions, thanks to the efforts of Dr Patrick Osewe, a Kenyan scientist and diplomat who is playing a starring role at the conference as a policy and technical expert.

With fellow epidemiologists who have studied the link between health and the environment, Dr Osewe connected climate change risks to health risks as moderator of a key panel that included Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, and eight health ministers and technical experts from key countries across the globe.

The Dubai summit is the first COP edition to dedicate a full day of official discussions to health. At the talks this weekend, Dr Ghebreyesus said the climate crisis was a present and imminent danger to human health, requiring immediate action by oil producers that have for long resisted doing anything. This time, oil companies agreed to cut pollution to net-zero from their operations by 2050. Net zero means there is no additional pollution because release of greenhouse gases is balanced by corresponding removal of others from the atmosphere.

Dr Ghebreyesus of WHO, Asian Development Bank President Masatsugu Asakawa, and health ministers from both India and Brazil were among the dignitaries attending the launch of Climate and Health Initiative (CHI)—a G20 endorsed initiative designed to accelerate knowledge, capacity building, partnership and investment in climate and health, and provide a platform for governments and partners for bold actions.

“The Climate and Health Initiative launch at COP28 marks a pivotal moment in aligning climate and health agendas,” said Dr Osewe. “This is the best attended and organized summit and I was pleased to be at the opening plenary session with Bill Gates.” Gates, an American billionaire, is a philanthropist who funds many health projects around the world.

For Dr Osewe, this is the latest in a line of global initiatives he has undertaken over a 30-year career to deal with challenges involving public health. He argues that the climate crisis is a healthcare crisis, and, thus, swift, synergistic action to address the climate-health nexus is key. Evidence shows the health sector, which is often the first responder to climate-related crises, is also a contributor to climate change—healthcare’s climate footprint accounts for about five per cent of net global emissions—equivalent to emissions of 514 coal-fired power plants. Put another way, if the health sector were a country, it would be the fifth largest emitter of greenhouse gases on the planet after the United States, China, the European Union, and Japan.

The consequences of climate change on human health are severe. For instance, it amplifies existing health threats and fuels new ones, potentially dwarfing those of the Covid-19 pandemic. Extreme weather events like heatwaves, floods, wildfires, drought, and air pollution expose millions of people worldwide to respiratory diseases, food and water insecurity, and increased stomach and intestinal illnesses. They also disrupt and delay access to medical care or leave populations vulnerable to forced displacement. These are problems that could devastate any industry, but health is so intertwined with the climate crisis that its impact on human well-being is magnified.

These climate health risks do not affect everyone equally. They disproportionately hurt the poorest and the most vulnerable people, including women, children, the elderly and disabled, agricultural workers, migrants, and the urban poor. Think of the recent flooding that caused so much damage to neighborhoods that were already facing public health challenges in the coastal and lake regions of Somalia, Kenya, and Tanzania.

In the Pakistani floods of 2022, a single extreme weather event damaged 2,000 health facilities, disrupted food and water supplies, and affected 33 million people. In Bangladesh, erratic rainfall and high temperatures provided a breeding environment for mosquitos, causing deadly outbreaks of dengue and other infectious diseases. In Australia, the 2019-20 bushfires killed 33 people and 56,000 livestock, while in India heat stress caused more than 11,000 deaths between 2012 and 2021, and elevated levels of respiratory and heat-related illness such as dehydration, cramps, and strokes. Thus, as part of the remedy, health systems must prepare for and build resilience to the impacts of extreme weather on health infrastructure.

The healthcare sector, Dr Osewe said, must reduce its own contribution to the crisis through adoption of climate mitigation strategies. As director of human and social development at the Asian Development Bank (ADB), Dr Osewe spearheaded the efforts earlier this year—strategic and technical deliberations—that birthed CHI, in partnership with the with the Government of India, which had the presidency of the Group of 20 rich nations or G20. CHI is not only a policy and technical outfit but also a mechanism for raising funds among rich nations for climate mitigation and resiliency in the health sector in poor countries.

Housed at the ADB, which will commit at least 15 per cent of its annual health budget to support climate-focused projects and mobilise resources for climate and health actions, CHI should be a model for other regional initiatives.   

This is the kind of initiative East African leaders should pursue. Given his concern about climate change matters, President William Ruto and East African leaders have a chance to lean on home-grown experts like Dr Osewe who are transforming other regions. President Ruto’s recent trip to India extends his admirably sharp focus on the political front of the climate change agenda, which should benefit Kenya if he couples the political with local technical expertise.

The India trip was an opportunity for Ruto to learn more about this health and climate integration. CHI was at the core of India’s recent presidency of the G20. The G20 Leaders’ Summit in New Delhi on September 9-10 approved High-Level Principles for Sustainable Health Emissions Reduction and Resilience Opportunity (SHERO Principles). These principles were a catalyst for the G20 to drive health sector climate action while simultaneously striving to meet global health goals. Elaborated through a concerted global effort—involving experts from WHO, ADB, and others—these principles provide a means to improving health and minimising the negative environmental impacts of delivering healthcare. The principles are based on a cross-cutting approach that recognizes a close link between human health and the health of animals, as well as our shared environment.

Dr Osewe’s role in the CHI has roots in the pandemic. He led the response efforts to the health crisis in Asia in his capacity as the director of human and social development at ADB, working closely with health ministers across Asia and the Pacific when the Delta variant of Covid-19 emerged and started spreading around the world, including to Kenya. It provided invaluable insights into how to respond rapidly to a looming threat.

One lesson learned from the pandemic response was that the path to an equitable and sustainable world rests on collective action.

“We learned that the health sector can lead a comprehensive, multisector response to a pressing global challenge that cuts across all segments of society,” he said. “That is how in India, for example, what happened there and the work we at ADB did with the health ministry laid the foundation and the process that led to the birth of CHI. It was established to support low and middle-income countries.”

Drawing on these and other lessons, he said, health leaders in all countries must lead the way in aligning climate and health goals. Their actions are critical not only for meeting the combined ambitions of the Paris Agreement, Universal Health Coverage, and the Sustainable Development Goals 2030, but also for safeguarding overall health and prosperity over the long term.

In recent months, at the UN General Assembly in New York City last September, Dr Osewe moderated a panel that included Japanese Prime Minister Kishida Fumio and former British Prime Minister Tony Blair, and he was able to consult with political and corporate leaders on the need to bolster health systems against climate change risks.

During the Covid-19 crisis, as vaccination efforts lagged in Africa, Dr Osewe joined a six-member global vaccine advisory council of health experts that sought to improve universal, equitable, and sustainable protection through vaccination. The Economist Group, the widely respected London-based global magazine, established Vaccine Ecosystem Initiative (VEI), which aimed to promote a sustainable vaccine ecosystem by reimagining elements critical for vaccine development, deployment, and adoption. To support the initiative, the Economist appointed a team of experts with diverse insights and perspectives to its Advisory Council. Dr Osewe was attractive to them due to his vast experience in public health and finance. Aside from his leadership role at ADB, he had previously held senior roles at the World Bank and USAID, working across Africa, Asia, the US, and Europe.

After graduating from the University of Nairobi Medical School and Harvard University School of Public Health, Dr Osewe trained in epidemiology at the US Centers for Disease Control and Prevention in Atlanta and taught at Emory University School of Public Health in Atlanta together with former US President Carter. At ADB he oversaw a health budget of about Sh1 trillion to respond to Covid-19 prevention and mitigation efforts in the entire Asian continent and Pacific island nations. His work won plaudits, including in Africa, where he was part of a team that established the Africa CDC and mobilised billions of dollars to compensate ex-mineworkers in southern Africa after exposure to tuberculosis and mining related illnesses in South Africa.

Dr Osewe is now involved in the establishment of ASEAN CDC for the 10-member Association of Southeast Asian Nations, which comprise Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam.