Rx for Climate & Health Equity: The Fossil Fuel Non-Proliferation Treaty

Rx for Climate & Health equity: The Fossil Fuel Non-Proliferation Treaty

I first saw her in the emergency room on a hot summer day: doubled over in the bed, gasping for air, barely able to speak. My patient, a working mom who lived next to a busy highway, was having an asthma attack. Her room was a flurry of activity -- oxygen, nebulizers, medications, bloodwork, and X-rays -- as various members of our medical team tried to help her breathe. Once the medications kicked in and her breathing eased, so did mine.

My patient is not alone. Today, 4 in 10 Americans breathe polluted air. Worldwide, seven million lives are lost prematurely to polluted air each year. Caring for patients and communities suffering the health effects of fossil fuel-related pollution and climate change is a rapidly growing part of our clinical practice. We prescribe inhalers, treat heart attacks, and tend to those suffering from extreme heat. But as health professionals, we also know that our patients need more than medical care to stay healthy. They need clean air, clean water, and a livable climate.

NBC: New Study Finds Pollution Caused Nearly Nine Million Deaths Worldwide In 2019, May 18, 2022.

CNBC: Why Air Quality In The US Is So Bad, April 22, 2021.

The Lancet: Pollution | A global public health crisis, October 19, 2017.

DW: Air pollution and what can be done to reduce it, June 6, 2022.

That is why yesterday, hundreds of health professionals across the world are demanding that our governments implement the Fossil Fuel Non-Proliferation Treaty, which calls for no new fossil fuel development, a rapid phase-out of existing dependence on fossil fuels, and a just transition to a clean energy future.

Grounded in principles proposed by the Pacific Island Nations and Least Developed Countries, the Treaty is now supported by 101 Nobel laureates, roughly 3000 scientists, health institutions representing more than 100,000 health professionals, parents, faith communities, youth, and most recently, the World Health Organization.

Yes, a legally binding international climate treaty already exists. The 196 signatories of the 2015 Paris Climate Agreement pledged to limit global heating to 1.5 degrees C (2.7 F) compared to pre-industrial times. But the words “fossil fuels,” “coal,” “oil,” or “gas” never even appear in the Paris Agreement, and new fossil fuel infrastructure is still being greenlit across the world, locking us into future warming. Countries are already on track to produce 110% more fossil fuels by 2030 than would be compatible with a 1.5 degrees C warming scenario. The Fossil-Fuel Non-Proliferation Treaty targets the root cause of global climate change: fossil fuels. Its three foundational pillars also promise public health co-benefits.

Fossil Fuel Non-Proliferation Treaty Initiative: Introducing the Fossil Fuel Non-Proliferation Treaty, September 25, 2020.

DW: Time is running out | WMO warns 1.5 degree threshold could be topped by 2026, May 18, 2022.

EuroNews: UN Secretary-General says the climate crisis is placing half of humanity in 'the danger zone,' June 14, 2022.

IISD: Cutting Emissions Through Fossil Fuel Subsidy Reform and Taxation, April 22, 2022.

TED: Fossil fuel companies know how to stop global warming. Why don't they? | Myles Allen, December 4, 2020.

The first pillar calls on countries to stop new fossil fuel development. Climate change, caused by burning fossil fuels, is the biggest global public health threat of the 21st century. Just this summer, climate-attributed extreme heat claimed lives across the world. Wildfires fueled by climate change threaten air quality, and a hotter climate is increasing conditions suitable for the transmission of infectious diseases. Considering these impacts are from just a 1.1 degrees C of temperature rise, the only common-sense public health response is to leave fossil fuels in the ground where they belong.

The second pillar is a rapid phase-out of existing dependence on fossil fuels, which will carry health benefits beyond limiting the damage to our climate. Our health is threatened by all phases of the fossil fuel “lifecycle” -- the mining, drilling, transporting, refining, burning, and disposing of fossil fuels and their toxic waste products. Fossil fuel-related air pollution is linked to asthma, heart attacks, strokes, lung cancer, and 1 in 5 deaths worldwide.

Communities of color are disproportionately impacted by the fossil fuel lifecycle. In the US, oil and gas drilling sites are twice as likely to be in historically redlined neighborhoods. Living close to drilling sites is associated with congenital heart defects, childhood leukemia, respiratory ailments, higher rates of kidney disease, and hospitalizations for heart failure. Communities next to petrochemical refineries are exposed to toxic levels of cancer-causing chemicals such as benzene and are left to bear the burden of toxic coal ash. The costs of phasing out fossil fuels are easily outweighed by the advantages, such as projections for global public health benefits in air quality improvements alone saving trillions of dollars annually.

BBC: Past seven years hottest on record, EU satellite data shows, January 10, 2022.

Francis Crick Institute: Researchers discuss link between air pollution and lung cancer, September 13, 2022.

Arirang News: Air pollution causes 40,000 premature deaths in S. Korea each year | Greenpeace, February 12, 2020.

MSNBC: New EPA Plan Cracks Down On Pollution In Communities Of Color, January 27, 2022.

TED: End fossil fuels to protect human health | Carolyn Orr, March 1, 2022.

Still, this rapid phase-out of fossil fuels must be undertaken through a just and equitable transition. This is addressed in the Treaty’s third pillar, and it means supporting workers and families dependent on the fossil fuel economy, revitalizing fenceline communities, and ensuring that decarbonization ends extractive processes and doesn’t merely transfer the health burdens of building a green economy onto other frontline communities.

Across the world, over 230 legislators are already upholding the principles of the Fossil Fuel Non-Proliferation Treaty. Hawaii’s state legislature, as well as Los Angeles, London, Toronto, and 60 other cities worldwide, have endorsed the Treaty and are taking concrete local actions to fulfill its mandate -- such as Los Angeles City Council’s recent vote to ban new oil well development and London’s pledge to electrify their Tube network by 2030.

The first step toward recovery is to identify and address the root cause of the illness. For our planet’s health and our own, we must eliminate our dependence on fossil fuels. Just as clean air is essential for my patient, it is medicine for us all, and the Fossil Fuel Non-Proliferation Treaty is the prescription.


If you are a health professional, you can add your name to the Fossil Fuel Non-Proliferation Treaty letter here.


TED: Tzeporah Berman | The bad math of the fossil fuel industry, January 17, 2022.

MSNBC: Climate Change Is Our Greatest Existential Threat, January 3, 2022.

Grantham Imperial: Dr Friederike Otto speaks to CNN's Connect the World about the extreme heat, 18 July 2022, July 19, 2022.

UNEP: How to claim your right for clean air, March 24, 2021.

IEA: A 10-Point Plan to Cut Oil Use, March 18, 2022.

WW0: ​​Climate and Health Are Connected, January 26, 2021.

World War Zero: A Conversation on Health and Climate, August 6, 2020.