Intended for healthcare professionals


Join the fight against fossil fuels

BMJ 2022; 379 doi: (Published 12 October 2022) Cite this as: BMJ 2022;379:o2414

Read our special issue on the climate emergency

  1. Rhiannon Osborne, medical student
  1. University of Cambridge, UK
  1. Follow Rhiannon Osborne on Twitter: @rhiannon_osborn

In September, the World Health Organization, along with hundreds of other health organisations, signed a call for a Fossil Fuel Non-Proliferation Treaty (FFNPT)—a proposed framework for a legally binding transition away from fossil fuels in line with keeping global warming below 1.5°C. The proposed treaty calls for action along three pillars: non-proliferation of any new fossil fuel projects; a fair phase out of existing production, with responsibility for the greatest work falling to the most on wealthy countries; and the fast tracking of a global just transition for workers, communities, and countries.

A rapid phase out of fossil fuels is essential. The world is on track to produce more than twice as much coal, oil, and gas by 2030 than is consistent with limiting the rise in global temperature to below 1.5°C of global warming, both from new fossil fuel extraction and existing projects. Even if we exceed 1.5°C, we must not give up. Fossil fuel companies intend on going after every last drop of oil and gas, even as we hurtle towards ecological collapse. As we go deeper into the climate crisis, we must fight them over every drop.

The fossil fuel industry is built on harm, violence, and pollution across the entire lifecycle, killing millions of people each year. In the UK, there will be record numbers of people in fuel poverty this winter and record profits for energy companies. The health letter highlights the dangers of false solutions which avoid a fossil fuel phase out, such as carbon capture (neither proven nor affordable).

The forces working against us are phenomenal. Jacob Rees-Mogg, secretary of state for business, energy, and industrial strategy, and a known climate denier, has said he wants to drill “every last drop” of North Sea oil and gas. Prime Minister Liz Truss has pledged to “clamp down” on climate activists. The international Energy Charter Treaty is being used to block climate action, banks continue to finance the fossil fuel industry, and the military and police are regularly deployed across the world to protect fossil fuel “assets.”

The health community must use its large membership and public interface to bring more people into organising and campaigning spaces. In particular, those of us based in the global North must target the expansion of oil, fracking, and gas in countries like Canada, the EU, the UK, and the US. The UK has just announced plans for a new oil and gas licensing round. This includes the largest undeveloped oil field in the North Sea, Rosebank, which would create more CO2 than the combined emissions of all 28 low income countries in the world. Wins from the climate justice movement teach us that taking on this industry requires a diversity of tactics, including civil disobedience, protest, legal action, and local community organisation, among others.

Violent colonial capture of land and resources to feed to wealth of the rich in the global North is the core of the fossil fuel industry. Those on the frontlines of fossil fuel expansion face violence, criminalisation, and militarisation. Nine students were arrested in Uganda this week for protesting the East African Crude Oil Pipeline.1 Despite the violence used against them is estimated that indigenous resistance has averted 25% of Canadian and US emissions.2 The health community must provide direct support, financial and political, to the communities who have been most effective at resisting fossil fuels and whose lives are most at risk.

Much like the health community’s fight against the lies of the tobacco industry, we can work to remove the social licence that holds up the fossil fuel industry. We can call out their false claims, highlight their health harming practices, and support calls to exclude them from negotiations. In particular, we must reject including the industry as part of the “solution” to a problem they created, as recently seen at the TED Countdown conference in London.3

Beyond phasing out existing supply and non-proliferation, the FFNPT calls for a just transition away from fossil fuels. This term usually refers to retraining for fossil fuel workers and the protection of consumers from high energy prices. In a global context it puts the onus on wealthy, high emitting countries to phase out more rapidly and provide financial and technical support to low and middle income countries to support their move away from fossil fuels. At the moment, rich countries and the companies themselves have almost completely ignored this demand. And it is nowhere near their true responsibility. To achieve global justice for the harms of climate colonialism, our demands must go further.

Ending the expansion of fossil fuels is not enough for the communities whose water, air, and soil has been polluted, resulting in death, ill health, collapse of farming infrastructure, and poverty. Pollution, risk of spills, and irreparable damages stay in ecosystems and communities for decades after an oil field has closed. New research analysing the “slow violence” of pollution across 3033 environmental conflicts around the globe found that “mobilising groups are reluctant to consider the closure of a polluting project a successful outcome because of the persistence of toxic pollution across time.”4

Ken Henshaw, of We The People Nigeria, writes in the New Internationalist that “the definition of just transition has to include repairing the damage occasioned by oil pollution, an audit of the health of the people, and a plan to respond to the threats posed by climate change. A just transition must also provide justice for the countless victims of oil company-inspired and state-sanctioned abuses, and reparations to the people of the Niger Delta for decades of expropriation. Anything short of these is injustice.”5

Rich countries must not be allowed to provide crumbs of “climate financing” through loans which are only likely to strengthen the cycles of debt injustice. They owe reparations. A third of Pakistan is underwater, despite contributing only a miniscule amount of global emissions—the case for reparations is indisputable. Rich countries owe reparations for the climate crisis and its root cause—colonialism. Those of us in the health community who are based in the global North must make climate reparations a mainstream priority.

Climate justice goes beyond fossil fuels. As highlighted by the film Powerlands,6 and by many activists including the People’s Health Movement,7 there is nothing “green” about mining. Governments and corporations are using the same tactics as the fossil fuel industry to oppress communities in the name of a “green transition.” In many cases, it’s the same companies. Changing the inputs into an energy system based on corporate profit, endless “economic growth,” and resource colonialism cannot be the end goal. We must demand an energy system run by and for communities, where no one’s land is stolen for the profits of shareholders

A socially just ecological future is possible, and dismantling the fossil fuel industry is an essential step towards this.

Sign the Fossil Fuel Non-Proliferation Treaty and then join a movement such as Health for a Green New Deal, Doctors for XR or Stop Cambo.


  • Competing interests: RO is a global health researcher and a campaigner for health and climate justice. She is a member of the #StopCambo campaign, Health for a Green New Deal, and the People’s Health Movement. She is on the executive for the UK Health Alliance for Climate Change.

  • Provenance and peer review: commissioned, not peer reviewed.