Beyond pledges: promises of carbon-neutrality aren’t enough

Biopharma companies must combat the health effects of climate change via multi-sectoral action

Climate change impacts human health. Warming temperatures, extreme weather, and poor air quality are rapidly changing the patterns of both infectious and non-communicable diseases. Despite this emerging climate health crisis, many seem reluctant to turn their pledges into actions, and pledges alone — however well-meaning — cannot alleviate the disastrous consequences for human health unfolding around the world.

The COP28 Declaration on Climate and Health is a perfect example of this. Supported by 120 countries, this is the first time a climate declaration has focused on the health implications of climate change, and while the declaration includes many promising objectives, there is nothing to hold those who have signed to account or to action.

While policymakers try to find a way forward, hotter and more extreme weather patterns are propelling neglected tropical diseases — and the vectors that carry them — further and faster. Whether dengue-carrying mosquitoes in the Parisian suburbs or flesh-eating leishmania-infected sandflies in the southern states of the U.S., the impact of climate change on health is clear to see as such diseases continue to spread beyond traditional tropical and sub-tropical regions.

Similarly, the toll of non-communicable conditions like heart disease and cancer — which others have quite rightly dubbed a “global emergency of unprecedented proportion” — is only set to worsen due to global warming.

The first-ever Health Day at COP28 generated positive new commitments to support and improve global health in light of the impacts of climate change. However, the response from pharmaceutical companies to this progress appears to be a continued focus on net zero and carbon neutrality. While admirable, this siloed response is not enough.

It is at the interface between climate change and human health — in diseases exacerbated by climate change, which overwhelmingly affect the poorest people on the planet — that we need to come together to do more.

The solution not only involves greater investment in neglected tropical diseases and other conditions affected by climate change but engagement in multi-sector initiatives to ensure access to those therapies.

Acknowledging our impact

With respect to climate change, our industry appears caught in a damaging cycle of causation: the warming climate heightens the demand for medicines, while the production of medicines exacerbates emissions, further perpetuating climate change. As a sector, pharmaceutical companies clearly have a role to play in addressing this challenge.

The pharmaceutical industry emits 55% more CO2 than the automotive industry for every $1 million generated. It is therefore unsurprising that, up to this point, many pharmaceutical companies have focused their green agendas on reducing emissions. While crucial, we must also work to manage the impact climate change is having on global health. Some organizations have started to expand their approach, investing in vaccines and medicines for vector-borne diseases as well as cutting emissions, but we can and must go further.

Incorporating innovative, multi-sectoral partnerships, will be crucial as pharmaceutical companies reconsider the path forward.

Whether we look at the expanding range of cryptosporidiosis, a parasitic diarrhea that is one of the main causes of death for children around the world, or the increasing spread of antimalarial resistance as disease-carrying mosquitos move further and further north, one thing is clear — in a warming world, the global burden of disease is changing. And so, therefore, must we.

Innovation, access, and resilience

Firstly, we need to increase investment, both internally within pharmaceutical companies and globally, in research to develop new medicines to treat neglected tropical diseases (NTDs) that will impact more people as the climate continues to warm.

In a positive move, financial commitments made at the COP28 Health Day seemed to recognize and address this need. A combined $777 million commitment was made by the United Arab Emirates and several charities including the Bill and Melinda Gates Foundation to eradicate NTDs that are expected to worsen as temperatures climb. This includes a $50 million investment to better understand, detect and respond to malaria.

Similarly, pharmaceutical companies are starting to do the same. Novartis has been investing in advancing R&D for new treatments against NTDs and malaria for over two decades, and most recently pledged an additional $250 million at last year’s Kigali Summit on Malaria and NTDs. With more and more companies following suit, we must capitalize on this momentum.

Secondly, we need to make sure medicines reach the people who need them most and address the barriers preventing people in need from accessing healthcare and innovative medicine. Multi-sectoral collaboration will be essential if we are to achieve this.

Addressing the cost of treatment, to ensure affordability and improve availability, is step one. But, often, the physical and social environments in which people live, or the existing healthcare infrastructure they depend on, present an even greater challenge. Overcoming barriers to treatment such as prejudice and stigma, or bridging clinical gaps in training or diagnostics, requires locally tailored approaches.

Lastly, but perhaps most critically, we also need to change the way we approach healthcare and address the imbalance between primary care facilities and hospitals.

Many infants who die from common childhood diseases like malaria or pneumonia will die before they ever reach a hospital. By moving healthcare into the community and investing in and improving local primary care facilities, we can help ensure people can access the care they need, faster and closer to home.

Moreover, while hospitals undoubtedly hold an essential role in caring for individuals and populations at large, they are also one of the biggest polluters. Community health facilities have a smaller environmental footprint and are more resilient to future threats from climate change.

Time to refocus

What the COP28 Health Day made clearer than ever is that for pharmaceutical companies, fighting climate change means more than reducing emissions.

We must make neglected tropical diseases and other conditions affected by climate change higher priorities for drug development, both to save lives in regions most vulnerable to climate change and to give us the best possible chance of staying ahead of the spread of these diseases into broader territories.

Simultaneously, we must acknowledge that developing medicines is not enough, as treatments are of little benefit if patients can’t access them — a lesson that extends beyond the climate change conversation.

Climate change poses an unprecedented threat to global health. As the burden of disease changes, our sector must stand as a crucial ally, both in the pursuit of a greener industry and, most critically, as a relentless force to safeguard lives from the very real consequences of climate change. For this to be possible, we must all work together to transition from pledges and promises to tangible, impactful action.

Lutz Hegemann is president of global health & sustainability at Novartis AG (SIX:NOVN; NYSE:NVS) where he is responsible for integrating ESG matters into the core of the company’s business, with a special emphasis on innovation and access. The unit focuses on transforming health in low- and middle-income countries and represents the company’s business in sub-Saharan Africa.

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