Climate Change Litigation: Guide for Public Health Professionals

By Giovanna Mazzola, WFPHA Environmental Health Working Group

The past several years have seen a significant increase of litigation over actions or inaction related to climate change. The total number of climate change court cases has more than doubled since 2017 and is growing worldwide. While most cases have been brought in the United States (US), Europe, the United Kingdom (UK), and Australia, about 17% of cases are now being reported also in developing countries, including Small Island Developing States. Climate change litigation is thus becoming an integral part of securing climate action and justice, as an effective tool to affect “the outcome and ambition of climate governance”. By using litigation to oblige governments and private sector polluters to address the climate emergency, claimants have been pushing for more ambitious regulations, opposing regulatory steps or new plans and proposed developments, or even requesting compensation measures for human harm. Moreover, climate litigation creates opportunities for public scrutiny and debate, raising awareness around governments’ inaction or harm caused by private sector polluters.

The success of climate litigation mainly relies on compiling a sufficient level of scientific evidence of current and likely future health impacts on populations. Strong cooperation between the legal and scientific communities is thus essential to the successful outcome of climate change litigation when harm to human health is at issue. Yet, public health experts are often unaware of the opportunities offered by litigation and of their crucial role in collecting, securing, and presenting evidence of harm to human health.

To address this gap, the European Public Health Association (EUPHA), the Faculty of Public Health (UK), the Groningen Centre for Health Law, the Aletta Jacobs School of Public Health (Netherlands), and other partners have developed a Guide on climate change litigation for public health professionals. The Guide will be released at the 16th European Public Health Conference in Dublin in November 2023.

With the assistance of the Environmental Health Working Group of the WFPHA, the Guide’s content draws on suggestions made by WFPHA member organizations and public health experts, who were surveyed to ascertain their interest in the proposed Guide and to advise on its content and use. Over 70 completed surveys were received. The survey assessed the level of engagement and interest shared by respondents in climate change issues and their current level of cooperation with local legal expertise. Overall, the results demonstrated that there is a keen interest in the public health community to better understand the importance of climate change litigation in addressing climate-related injustice and the opportunities offered by interdisciplinary collaboration. Yet, while most respondents (79,2%) reported they are already working on issues related to climate change, many of them (57%) declared not to have ready access to legal expertise, either internal or external, for guidance on policy matters.

The Guide will be available from the Faculty of Public Health website, which also contains other useful related resources for public health professionals.

Protecting Healthcare Workers in Low- & Lower-Middle-Income Countries through Vaccination: Barriers, Leverages, & Next Steps

Healthcare workers play a vital role in providing medical care to individuals and communities. Compared to the general public, healthcare workers are at a higher risk of exposure to infectious diseases, including vaccine-preventable ones, due to the nature of their work. The World Health Organization (WHO) recommends healthcare workers be vaccinated against tuberculosis (BCG), hepatitis B, polio, diphtheria, measles, rubella, meningococcal, influenza, varicella, pertussis, and COVID-19; yet, despite clear guidelines, these are not always implemented, especially in less wealthy countries.

Importance of Routine Vaccination of Healthcare Workers

Routine vaccination of healthcare workers not only protects them from contracting infectious diseases but also helps prevent the spread of diseases to their patients, reduce healthcare costs associated with treating infected individuals, and reduce the risk of outbreaks that overburden health systems and increase costs. Moreover, healthcare workers who are protected against vaccine-preventable diseases are less likely to miss work due to illness or infection which can improve confidence and increase overall productivity. This, in turn, is essential for providing quality healthcare and improving the efficiency of the overall healthcare system. Similarly, vaccinated healthcare workers would be more confident in their ability to perform their duties as they are less likely to experience stress and anxiety related to their work.

Despite its importance, the implementation of policies for routine vaccination of healthcare workers in low- and lower-middle-income countries faces several challenges. In a recent article published by the researchers of the WFPHA and its International Immunization Policy Taskforce, they analyzed the barriers and recommendations for policy implementation and the role of partnerships.

Main Barriers to the Implementation of Policies for Routine Vaccination of Healthcare Workers

According to the article, lack of funds, lack of specific schedules for healthcare workers, lack of evidence-based data, hesitancy, beliefs, and low literacy are the main barriers to the implementation of policies for routine vaccination of healthcare workers in low- and lower-middle-income countries.

Recommendations for the Implementation of Policies for Routine Vaccination of Healthcare Workers

Expanding the COVAX initiative to cover healthcare workers, building partnerships with WHO, GAVI, governments, universities, and communities, mandatory insurance for healthcare workers, including vaccination, utilizing COVID vaccination infrastructures to vaccinate healthcare workers, collecting national data focusing on healthcare workers vaccination, increasing awareness and literacy from the university partnering with health-related student organizations, advocacy at different levels, providing specific schedules and funds addressed to healthcare workers (as done for children and pregnant women), and considering healthcare workers vaccination as part of the Occupational Safety Plan are the main recommendations for the implementation of policies for routine vaccination of healthcare workers in low- and lower-middle-income countries.

It is crucial to remember that the primary requirement for implementing the recommendations is the genuine commitment of governments to protect healthcare workers. Regrettably, numerous governments are yet to prioritize the protection of healthcare workers as essential for the well-being and prosperity of their nations. Consequently, this lack of prioritization hinders the successful implementation of the proposed recommendations, despite their potential for positive outcomes.

IC2PerMed: Roadmap

Integrating China in the International Consortium for Personalized Medicine (IC2PerMed) project aims to support the European Union (EU)-China collaboration over the developments of personalized medicine research, innovations, and policies through the International Consortium for Personalized Medicine (ICPerMed) initiative, providing people with access to personalized, smart, and inclusive healthcare solutions in the near future.

Over the past 4 years, the IC2PerMed project has developed a roadmap that aims to promote consistent approaches to personalized medicine research, development, innovation, and policies between the People’s Republic of China and the EU.

The roadmap proposes, through the actions listed below, items to deepen and promote alignment and creation of a common ground for European and Chinese collaborations on personalized medicine.

Improving: Empowered and Responsible Citizens

• Health Literacy
• Research
• Public Trust
• Ethical Challenges

Promoting: Trained and Up-to-Date Healthcare Workforce

• Education and Ethics
• Collaborations
• Policies

Fostering: Healthcare Systems’ Sustainability

• Resources
• Ethical, Legal, and Social Implications (ELSI) and Costs
• Evaluation
• Networks

Bringing: Innovation to Market

• Cost Effectiveness
• Needs Assessments
• Principles and Guidelines
• Perspectives

Adopting: Big Data and ICT Solutions

• Data Exchange
• Privacy, Security, and Trust
• Standards

Fostering: Research funding

• Patient Needs
• Value Chain
• Synergies

Translating: Basic Clinical Research and Beyond

• Omics Sciences
• Data and Standards
• Collaborations

The roadmap was presented during the High-Level Symposium on Health Policy and Personalized Medicine for Cancer: Projecting Europe-China Collaboration in the Global Arena, organized by the WFPHA in Geneva, Switzerland, on May 26, 2023.

Integrating China in the International Consortium for Personalized Medicine Project: A Glance

Cancer is one of the leading causes of death worldwide, and its prevalence continues to rise. Traditional cancer treatments such as chemotherapy and radiation therapy can have significant side effects, and they may not be effective for all patients. The field of personalized medicine has the potential to revolutionize cancer prevention and treatment by tailoring therapies to an individual patient’s specific genetic and molecular profile.

Despite the potential benefits of personalized medicine for cancer, there are still significant challenges to its widespread implementation. One of these challenges is the lack of alignment between policies in different regions of the world. To address this issue, the Integrating China in the International Consortium for Personalized Medicine (IC2PerMed) consortium, of which the World Federation of Public Health Associations (WFPHA) is a partner, has developed a common roadmap for personalized medicine for cancer to foster common approaches between the People’s Republic of China and the European Union (EU) on personalized medicine research, development, innovation, and policies.

The IC2PerMed consortium is an EU initiative that aims to promote the implementation of personalized medicine in prevention and care. The consortium brings together organizations, researchers, policymakers, and healthcare professionals to work towards a common goal of improving patients’ outcomes.

The IC2PerMed consortium’s roadmap for personalized medicine for cancer has been finalized and is being presented at a series of events, including WFPHA webinars, a dedicated workshop at the 17th World Congress on Public Health, and a high-level symposium held in Geneva, Switzerland, in conjunction with the World Health Assembly.

The high-level symposium brings together high-level policymakers, scientists, and Chief Executive Officers from international health-related organizations to discuss the importance of personalized medicine for cancer and beyond and the need for international collaboration to promote its implementation. The meeting also provides an opportunity to showcase the work of the IC2PerMed consortium.

Thank You to Outgoing Governing Council Member

The WFPHA recognizes the outstanding contributions and unwavering commitment of its Outgoing Governing Council (GC) member, Dr Jesus Gonzalez.

Dr Gonzalez, a surgeon from the Faculty of Medicine of the National Autonomous University of Mexico (UNAM), served the GC as a representative of the Americas region.

Dr Gonzalez’s tenure as a member of our GC has been marked by his exceptional dedication, expertise, and relentless efforts to promote global public health. The WFPHA expresses its sincere gratitude to him for his invaluable contributions, which have undoubtedly advanced the organization’s mission to promote and protect public health worldwide. His exceptional leadership, vision, and dedication have been a source of inspiration for colleagues and peers alike.

As Dr Gonzalez embarks on new endeavors, the WFPHA extends its heartfelt appreciation and wishes him a fruitful journey ahead, confident in his ability to continue making a significant difference in the field of public health.