More than 1,000 health workers and 200 organizations have demanded that governments worldwide create and enact a legally binding nonproliferation treaty to end the global dependence on fossil fuels, which are known to be harmful to human health.

"The modern addiction to fossil fuels is not just an act of environmental vandalism. From the health perspective, it is an act of self-sabotage," said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, which backed the initiative along with the Global Climate and Health Alliance, Physicians for Social Responsibility, Health Care Without Harm and other groups.

In a public letter released Wednesday, they called for an immediate end to new fossil fuel exploration, production and infrastructure. Existing production should be phased out in a "fair and equitable manner" to meet the 1.5 degrees Celsius (2.7 Fahrenheit) climate goal set out in the 2015 Paris Agreement, with "financial, technological and other support" for low- and middle-income countries to ensure a"just transition"to a sustainable future.

"The proposal for a treaty aims to support what the international community has been pushing on for years but focusing on the supply side," Jeni Miller, executive director of the Global Climate and Health Alliance, told DW. "A treaty will allow the Paris Agreement to be stronger by creating a legally binding international mechanism that focuses on the heart of the problem: extracting fossil fuels. If we do not end extraction, it will be much more difficult to end use of these fuels."

"While everybody is aware that we need to end fossil fuel production and use in order to limit climate change, there is less awareness about the huge health bill that has come with decades of coal, oil and gas use," said Anne Stauffer, deputy director at the Brussels-based Health and Environment Alliance. 

"With the pandemic, policy makers have placed health protection to the top of their agendas. Now, they need to bring their commitment to preventing ill-health to the area of fossil fuels."

Poor air quality causes millions of deaths each year

Air pollution linked to fossil fuel use causes more than 6.5 million deaths around the world each year, according to a May 2022 study in The Lancet Planetary Health journal. More than 90% of these deaths are happening in rapidly developing countries in Africa and Asia. Almost no one on Earth is spared. According to the latest WHO figures, 99% of the world's population lives in places where the air they breathe exceeds quality limits set by the global body.

The link between fossil fuel emissions and health was made clearer during the first wave of the COVID-19 pandemic, when cities across the world essentially shut down. With businesses closed, roads empty and many people staying home, carbon emissions decreased and air quality improved in many major centers, if only for a short time.

A recent study comparing 46 European cities during those months estimated that 800 deaths linked to air pollution in those cities may have been prevented in the first half of 2020. While just a snapshot of an unprecedented moment in time, the results do reflect how better air quality could improve the health of billions of people worldwide. 

The results of the study are backed by moves to phase out coal in other parts of the world over the last 20 years. After the closure of coal-fired power plants in California and Ontario, Canada, for example, surrounding communities saw significant decreases in premature deaths, preterm births and hospital admissions.

Exiting fossil fuels to protect human and ecosystem health

The proposed treaty, to be negotiated by participating countries, would follow the example set by the WHO Framework Convention on Tobacco Control. The international accord, which entered into force in 2005, aims to raise awareness of the dangers of tobacco and limit its use.

A fossil fuel treaty would seek to do the same for the use of coal, oil and gas, which are known to be harmful to human and ecosystem health. The letter points out the numerous health effects of fossil fuel use that go beyond the direct impact of air pollution. A warming climate, for example, also increases the risk of heat-related illness and death and favors the spread of food and waterborne illnesses. At the same time, health care systems and medical supply chains are also coming under increasing strain.

"Communities around the world have been paying the health price for our dependence on fossil fuels for far too long," said Miller. "Every stage of the fossil fuel cycle puts people's health at risk, from mining and fracking to transport through pipelines, to processing and finally to burning fossil fuels for transport, electricity, and industrial use," she said.

New treaty would be a 'tangible sign' that governments are serious 

Stauffer of the Health and Environment Alliance told DW the call for a new treaty comes at a crucial time, pointing out that despite increased commitments in recent years from entities like the G20 and the European Union, progress on cutting back on fossil fuels has been too slow. The current geopolitical crisis in Europe isn't helping matters, with countries scrambling to find oil and gas from sources other than Russia rather than strengthening renewables.

"With the many short-term measures to deal with the implications from the war in Ukraine, we're risking a fossil fuel lock-in in Europe, despite all commitments to climate neutrality and energy transition," Stauffer said.

"A fossil fuel nonproliferation treaty would be a tangible sign and commitment by governments that they're serious about protecting our health and tackling a top cause of ill health," she added. 

Miller said clean energy alternatives to fossil fuels are readily available, but remain out of reach for many. Developed countries, which have profited from decades of growth based on polluting power, now "have the resources and moral responsibility not only to make the clean energy transition, but to support developing countries to do the same," she said.

"For decades we've depended on the capacity of fossil fuels to provide energy, but we now have alternatives that are cleaner and more sustainable — and compatible with the healthier future we want," she added.

Edited by: Jennifer Collins