Published annually, the Lancet Countdown on health and climate change is an international, multidisciplinary collaboration, dedicated to monitoring the evolving health profile of climate change, and providing an independent assessment of the delivery of commitments made by governments worldwide under the Paris Agreement. All content on this page is either Open Access or has been made free to read with registration.

The Lancet Countdown: tracking progress on health and climate change was established to provide an independent, global monitoring system dedicated to tracking the health dimensions of the impacts of, and the response to, climate change.

The 2020 report presents 43 indicators across five sections: climate change impacts, exposures, and vulnerabilities; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. This report represents the findings and consensus of the 35 leading academic institutions and UN agencies that make up The Lancet Countdown, and draws on the expertise of climate scientists, geographers, engineers, experts in energy, food, and transport, economists, social, and political scientists, data scientists, public health professionals, and doctors.

The emerging health profile of the changing climate
5 years ago, countries committed to limit global warming to “well below 2°C” as part of the landmark Paris Agreement. 5 years on, global carbon dioxide (CO2) emissions continue to rise steadily, with no convincing or sustained abatement, resulting in a rise in the global average temperature of 1·2°C. Indeed, the five hottest years on record have occurred since 2015.

The changing climate has already produced considerable shifts in the underlying social and environmental determinants of health at the global level. Indicators in all domains of section 1 (climate change impacts, exposures, and vulnerabilities) are worsening. Concerning, and often accelerating, trends were seen for each of the human symptoms of climate change monitored, with the 2020 indicators presenting the most worrying outlook reported since The Lancet Countdown was first established.
These effects are often unequal, disproportionately impacting populations who have contributed the least to the problem. This fact reveals a deeper question of justice, whereby climate change interacts with existing social and economic inequalities and exacerbates longstanding trends within and between countries. An examination of the causes of climate change revealed similar issues, and many carbon-intensive practices and policies lead to poor air quality, poor food quality, and poor housing quality, which disproportionately harm the health of disadvantaged populations.

Vulnerable populations were exposed to an additional 475 million heatwave events globally in 2019, which was, in turn, reflected in excess morbidity and mortality (indicator 1.1.2). During the past 20 years, there has been a 53·7% increase in heat-related mortality in people older than 65 years, reaching a total of 296 000 deaths in 2018 (indicator 1.1.3). The high cost in terms of human lives and suffering is associated with effects on economic output, with 302 billion h of potential labour capacity lost in 2019 (indicator 1.1.4). India and Indonesia were among the worst affected countries, seeing losses of potential labour capacity equivalent to 4–6% of their annual gross domestic product (indicator 4.1.3). In Europe in 2018, the monetised cost of heat-related mortality was equivalent to 1·2% of regional gross national income, or the average income of 11 million European citizens (indicator 4.1.2).

The focus is on:
*Health and climate change: policy responses to protect public health
*Human health: impacts, adaptation, and co-benefits.
*Better growth, better climate: the new climate economy report. The synthesis report
*Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health.
*The Lancet Countdown: tracking progress on health and climate change.
*Managing vulnerability to drought and enhancing livelihood resilience in sub-Saharan Africa: technological, institutional and policy options.
*Understanding: the drought phenomenon: the role of definitions

Prolonged drought remains one of the most dangerous environmental determinants of premature mortality, resulting in reduced crop yields, food insecurity, an malnutrition (which in turn leads to life-long stunting, wasting, and eventually death when experienced by young children).3 The spread of water-borne disease, reduced availability of potable water, and migration as a result of reductions in arable and habitable land often compound to further wear away at the resilient capacity of populations.

Indicator 1.2.2: drought—headline finding: in 2020, up to 19% of the global land surface was affected by extreme drought in any given month
Climate change is increasing the frequency, intensity, and duration of drought events. These changes pose threats to water security, sanitation, and food productivity and increase the risk of wildfires and exposure of the environment to pollutants.