‍What’s happening? Fossil fuel projects are exposing over two billion people to potential health risks, with nearly half a billion – including 124 million children – living within 1 km of operational sites, warns an Amnesty International report. The analysis mapped 18,300 oil, gas and coal facilities across 170 countries and found that pollution hotspots are forming in low-income and Indigenous communities, many of which lie close to critical ecosystems. One-third of fossil fuel sites overlap with biodiverse regions essential for climate stability. Approximately 3,500 new sites are in the planning or development stage, which could place an additional 135 million individuals in harm’s way. (The Guardian)

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Why does this matter? The entire fossil fuel lifecycle – extraction, processing, transportation, combustion and disposal – has been linked to negative health outcomes at all life stages. Recent research by the Global Climate & Health Alliance (GCHA), which brought together peer-reviewed studies, case studies and community testimonies, highlights that fossil fuel pollutants ranging from benzene and heavy metals to volatile organic compounds (VOCs) and particulate matter 2.5 (PM2.5) drive up risk of cancer, cardiovascular disease, respiratory illness, adverse birth outcomes, neurological disorders and premature mortality, among others. A separate report published in November by leading US health experts, including Physicians for Social Responsibility, echoed these findings, further demonstrating the dire impact of fossil fuels on the human body.

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Transition urgency – Amnesty’s report is the first to estimate the number of people living in close proximity to fossil fuel infrastructure, although the two billion figure is likely higher due to discrepancies in project documentation and areas with limited census data. With Indigenous populations and low-income disproportionately affected in so-called “sacrifice zones”, not just in terms of health but also livelihoods, safety and security, the evidence adds urgency to the need for a human-rights-based just transition, which provides green jobs, promotes social inclusion and eliminates poverty. According to Amnesty, policies should not only consider a fair and funded phase-out of fossil fuels, which still account for around 80% of the global energy supply,  but also the renewables sector and other growth sectors, so no one is left behind.

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Advertising ban – GCHA made a range of policy recommendations, including ceasing new fossil fuel exploration and development, ending subsidies and finance, cleaning up existing production, meeting health costs linked to fossil fuels via “polluter pays” principles and initiating community-led health research and action for those living in areas impacted by fossil fuels. Another proposal put forward was a ban on fossil fuel advertising, a call made by UN Secretary-General Antonio Guterres in 2024. Encouragingly, ACT Climate Labs launched a UN-backed roadmap to end such advertising during the first week of COP30 in Belem, Brazil, which provides a viable path for media firms to disengage with fossil fuel clients. While this directly targets climate change, such a policy will undeniably deliver health benefits, as seen with tobacco advertising bans.

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Broader approach – The Belem Health Action plan was also launched at COP30, which seeks to place climate adaptation in the health sector at the core of climate action and monitoring it as part of the global stocktaking process. Brazil’s Minister of Health, Alexandre Padilha, warned that 3.3 to 3.6 billion people live in areas exposed to the most extreme impacts of climate change and health services in these locations must adapt to prevent deaths. In tandem, a group of 35 leading global philanthropic organisations, including the Rockefeller Foundation, the Wellcome Trust and the Gates Foundation, announced the formation of the Climate and Health Funders Coalition. An initial $300m investment will support the Belem Health Action plan via on-the-ground projects, such as extreme heat adaptation and tackling the air pollution that is claiming lives and warming the planet – a double win.