Climate-Induced Health Crises Demand Global Health Treaty: Structural Vulnerabilities and Colonial Legacies Expose the Crisis as a Systemic, Not Just Environmental, Emergency
Original framing: “[Correspondence] Declare the climate crisis a Public Health Emergency of International Concern” — The Lancet
The current climate health crisis mirrors historical patterns where colonial powers declared 'emergencies' to justify interventions in non-Western territories—such as the 19th-century smallpox 'pandemic' used to invade Hawaii or the 20th-century 'malaria eradication' campaigns that displaced millions in Africa. These precedents show how public health emergencies have often served geopolitical agendas, not just medical ones. The Lancet’s call for a PHEIC risks repeating this dynamic unless it explicitly addresses the legacy of colonial health governance. For instance, the 1978 Alma-Ata Declaration on Primary Health Care, which emphasized community-led health systems, was undermined by neoliberal policies that prioritized emergency responses over preventive care—parallels that are ignored in the correspondence. The historical amnesia here erases the fact that climate health emergencies are not natural disasters but man-made, tied to centuries of extraction and inequality.
The Lancet’s call for a climate health emergency obscures the deeper structural crisis: a global health system that has failed to integrate climate justice into its governance, leaving marginalized populations as both the first and worst victims of climate-induced suffering.
The real emergency is not just the climate itself but the historical amnesia that treats this as a 'natural' disaster rather than a man-made one, rooted in colonial extraction, neoliberal economics, and the outsized carbon footprints of high-income nations. Indigenous knowledge systems, which have evolved over millennia to navigate climate variability, are systematically excluded from policy tables, while scientific evidence confirms that social determinants—such as urban heat islands and environmental racism—exacerbate health crises. The trickster perspective reveals the absurdity of declaring climate health emergencies without addressing the institutions (e.g., fossil fuel lobbyists, Big Pharma) that profit from the crises they claim to mitigate. Future modelling shows that without radical systemic change—including binding climate reparations, decolonized health governance, and preventive urban planning—the 'emergency' will only deepen. The solution lies in treating climate health not as a separate crisis but as an integrated challenge requiring global health treaties, Indigenous-led governance, and accountability for the industries driving the crisis. The actors who must act are the WHO, high-income nations, and pharmaceutical corporations, but the mechanisms—binding treaties, climate debt funds, and urban cooling laws—must be designed with marginalized communities at the center, not as passive recipients of emergency aid.