Intended for healthcare professionals

Rapid response to:


Doctors and climate change

BMJ 2010; 341 doi: (Published 18 November 2010) Cite this as: BMJ 2010;341:c6357

Rapid Response:

The climate bandwagon and public health don't mix

There is something about jumping on a bandwagon that erodes the
critical facilities. I realise the the medical community feels a bit left
out by the climate change bandwagon, but that is no excuse for leaping
onto it with arguments that range from ridiculous to weak.

Start with the assertion that global warming will have (or already
has had) major effects on health. None of the quoted effects (heat
related, malaria, diarrhoea, malnutrition etc.) are clearly related to
increasing temperature and the reported relationships have all been
strongly challenged and some can only be sustained by systematically
misquoting the actual evidence (while heat stress kills, so does cold and
more lives are currently lost from cold; the only way we get net deaths
from warming is to ignore the gains from fewer deaths from cold). Take
malaria as an example. Finland had malaria during the second world war. It
didn't stop because Finland got colder: it stopped because of improved
public health. Warming is irrelevant to the control of malaria.

The authors (Roberts and Stott) seem to want us to focus our public
health attention on climate lobbying ("Responding to climate change could
be the most important challenge that health professionals face"). This is
where being part of a bandwagon starts to damage public health. Every good
measure they propose (eat less meat, walk more, drive less) is irrelevant
to global warming. We should lobby for those anyway, and might be more
effective if we didn't pretend that the climate was involved.

Even if you believe the link between major world diseases and health
problems and warming (and these links are regarded by many experts as
tenuous), spending money to avoid climate change is the least effective
way to do something about it. We could guarantee to eliminate malaria and
infected drinking water for a tiny fraction of the cost of Kyoto, for
example. The major consequence of being on the climate bandwagon is to
divert effort and money from cheap, effective public health measures to
ridiculously expensive and highly ineffective ones.

The trouble with medics being on the bandwagon is it seems to fog
their sense of truth and divert effort away from what works. The medical
community should get off the climate change bandwagon and lobby for what
is known to work in public health.

Competing interests: No competing interests

22 November 2010
stephen black
management consultant
pa consulting, london sw1w 9sr