Intended for healthcare professionals


The dangers of “health washing” the fossil fuel industry

BMJ 2023; 381 doi: (Published 19 April 2023) Cite this as: BMJ 2023;381:p843
  1. Giulia Loffreda, researcher12,
  2. Rhiannon Osborne, medical student, researcher and organiser34,
  3. Erika Arteaga-Cruz, co-coordinator, professor5,
  4. Fran Baum, professor and director67
  1. 1People’s Health Movement Scotland
  2. 2Institute for Global Health and Development, Queen Margaret University
  3. 3People’s Health Movement UK and Ecosystems and Health Circle
  4. 4Health for a Green New Deal
  5. 5People’s Health Movement Ecosystems and Health Circle, Universidad San Francisco de Quito
  6. 6Stretton Health Equity, Stretton Institute, University of Adelaide
  7. 7Advisory Committee, People’s Health Movement

The Prince Mahidol Award Conference took place in Bangkok, Thailand, at the end of January 2023. It featured five days of policy, politics, and social movement inspired discussions on the intersection between climate change and health. While the conference was attended predominantly by global and public health specialists, the presence of the fossil fuel industry at two panel sessions sparked criticism and heated discussion, continuing an ongoing debate on the issue of “multi-stakeholderism.”

The fossil fuel industry has known for decades that their operations are causing the climate crisis and they hid it.1 The industry is continuing to expand oil and gas infrastructure, contrary to the aim of keeping warming to 1.5 degrees and to the Fossil Fuel Non-Proliferation Treaty, signed by many organisations including the World Health Organization (WHO).2 The fossil fuel industry’s practices have involved extreme violence towards communities, mainly in the global South, but also towards Indigenous Peoples, poorer people and racialised people in the global North. Fossil fuel companies need to be dismantled and held accountable for the destruction they have caused. For example, communities in the Niger Delta are demanding a full clean-up and restoration instead of the companies’ attempted “Cut and Run.”3

The inclusion of the fossil fuel industry in international climate negotiations, national policy making, and wider discourse has systematically prevented real progress on climate change and health. Their lobbying and interference prevents the phase out of fossil fuels and proposes dangerous false solutions such as carbon offsetting, and hydrogen and carbon capture. Those most affected by extractivism and climate change are still side-lined. At COP27 there were almost twice as many fossil fuel lobbyists as Indigenous Peoples delegates.4 Conflicts of interest are rife—the COP28 president is also CEO of a national oil company and has already started a speaking tour defending fossil fuels.5

The WHO has previously recognised how industry prevents progress in international negotiations with the exclusion of tobacco companies from health forums, which not only enabled effective action on tobacco, but helped to delegitimise the tobacco industry globally. This decision resulted from the evidence of how the industry obstructed health policies using political influence, manipulation of information, and false narratives, among other strategies— the exact same strategies used by the fossil fuel industry. The global health community could be a powerful force for fighting the fossil fuel industry, but not if it remains deluded about their power and intentions. Demands to remove the fossil fuel industry from COP negotiations, and from climate policy making in general, are mainstream in the climate justice movement, who have frequently drawn lessons from the WHO Framework Convention on Tobacco Control (FCTC). Over 450 civil society organisations have called for fossil fuel lobbyists to be excluded from COP28.6

In recent years the field of the commercial determinants of health has highlighted how corporate power is negatively influencing the global public health agenda. Despite significant evidence of bad faith interference by alcohol, diet, gambling, arms, milk formula, agribusiness and pharmaceutical companies, these actors are still welcomed in health fora as part of “multi-stakeholderism.”7 In 2016, the World Health Assembly reached a consensus in a resolution known as FENSA (Framework of engagement with non-State actors). While this recognised the risk of conflicts of interest, public health advocates denounced the shortcoming of this framework as a missed opportunity for WHO to put people’s health above commercial interests.8

The fossil fuel industry's tactics are well documented, part of a classic corporate playbook that extends far beyond international negotiations, and crucially includes appearing alongside respected actors in “dialogue.” Hosting their speeches, talks, sponsorships, and panels legitimises their violence and greenwashing and spreads the misconception that they are just another “stakeholder.”

We don’t need the fossil fuel industry in order to implement climate action. A transition to renewables could be managed through nationalisation. It could be funded by corporate taxation and ending the trillions of dollars of subsidies for the fossil fuel industry. Governments, such as the new government of Colombia, can ban new oil and gas exploration—an essential policy that the industry will never agree to willingly. Indigenous resistance has averted 25% of the US and Canada’s emissions.9

This can only be achieved through the power of social movements. If the global health community joins forces with the climate justice movement, there could be a powerful alliance to support communities on the ground, fight the investor state dispute settlements preventing fossil fuel phase out, challenge the extractive policies of the International Monetary Fund and The World Bank, and resist the legislation criminalising climate protestors and environmental defenders.1011

It’s not just the fossil fuel industry undermining action on the climate and ecological crisis and putting corporate interests over health. A corporate-led “green transition” will only further entrench the existing injustices of the colonial capitalist system, which extracts resources for corporations, the rich, and the global North at the expense of the global majority and the planet. We need an end to the domination of corporations, and real solutions such as community control over resources and Indigenous land rights. Any transition must include reparations by global North countries to restore the health, soil and water of communities in “sacrifice zones,” mostly in the global South, devastated by extractive industries.12

People’s Health Movement calls on the global health community to support the calls for the exclusion of fossil fuel companies from COP negotiations; commit to excluding fossil fuel companies from health events; endorse the proposed Joint Civil Society Submission on a UNFCCC accountability framework; and advocate for an energy transition rooted in global justice, such as the Manifesto for an Ecosocial Transition from the Peoples of the South.13

Systems for health require all of us to focus on the structures that determine health, in particular challenging the corporate determination of health. We must support building the power of communities, uplift the social movements fighting for justice, and fight for a world built on social and ecological justice, as envisioned in the People’s Charter for Health.


  • Competing interests: All the authors were sponsored to attend the PMAC Conference in 2023 (airfare, hotel, per diem). FB was also sponsored to attend the 2020 PMAC conference (airfare, hotel, per diem). FB was sponsored to give keynote/plenary addresses in last three years: Royal Australian College of General Practitioners (airfare, hotel and speaker fee paid to University of Adelaide); Global Health and Welfare Forum, Taipei (Taiwan Department of Health Promotion (airfare and hotel); Australian Academy of Health and Medical Sciences Annual Meeting, 2022 (airfare and hotel). FB is also a board member of Australia 21 (Home | Australia21 | Think Tank for the Public Good). BMJ was part of the international organising committee of PMAC for this conference.

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

  • Correction: The competing interests statement on this piece was updated on 2 June 2023