An open letter from the Pan-European Commission on Climate and Health
To the governments and health authorities of the WHO European Region’s 53 Member States,
We, the undersigned Commissioners of the Pan-European Commission on Climate and Health, write with urgency regarding the escalating health crisis caused by extreme weather events across Europe and central Asia. This is no longer a distant threat or seasonal nuisance. It is a public health emergency unfolding in real time.
The crisis we face
The European Region is experiencing record-breaking heatwaves, growing more frequent, more intense and more deadly. These events are not merely inconvenient – they are silent killers. Their toll is often hidden in death records as strokes, heart attacks or respiratory failure. But the cause is clear.
Older adults, people with disabilities and those living in poor-quality housing are especially at risk. So too are pregnant women, young children and outdoor workers exposed to dangerously high temperatures. The effects are not just immediate: they ripple through lives and livelihoods, harming mental health and well-being, lowering productivity, damaging crops, raising energy bills and straining vital infrastructure.
Heat-related mortality has increased by 30% in the past two decades, with more than 100 000 deaths recorded across 35 European countries in 2022 and 2023 combined. This death toll is expected to rise in the years ahead. June 2025 was the hottest month on record in western Europe, with two severe heatwaves before summer even peaked. Meanwhile, climate change is fuelling the spread of diseases once rare in the Region – cases of locally transmitted dengue in the European Union/European Economic Area soared 368% between 2022 and 2024.
Health systems under siege
Hospitals are feeling the heat. Emergency departments see a surge in admissions during heatwaves, especially for heart, lung and kidney conditions. Mental health suffers too: sleep worsens, anxiety deepens and cognitive function declines. Meanwhile, people with mental health conditions face higher risks of heat stroke and hospitalization, as some prescription drugs reduce the body’s ability to regulate its temperature. Furthermore, health workers are at risk of heat exhaustion and burnout, while the systems they rely on – from cooling to information technology – buckle under pressure. During the 2022 heatwave in the United Kingdom, Guy’s and St Thomas’ hospitals in London experienced such critical infrastructure failures. These vulnerabilities are not isolated – they are systemic and growing.
All of this underscores the urgent need for better preparedness across all levels of the health system and across sectors. Heat-health action plans save lives by triggering early action, protecting the most vulnerable and easing pressure on hospitals. Accelerating the adoption of these plans must be a priority – not in a few years, but now.
Health, climate and economics
The climate crisis is a health crisis, and climate action is therefore health action. Air pollution causes over 500 000 premature deaths annually in the European Region, many of which are attributable to fossil fuel burning.
The good news is that many climate solutions are also solutions that protect and promote health. First and foremost, cutting emissions means cleaner air and fewer deaths – potentially saving over 5 million lives globally from reduced air pollution. Expanding green spaces in cities reduces heat exposure, improves mental health, lowers energy bills and absorbs carbon. Increasing urban greenery by 30% could cut heat-related deaths by up to 40%. These are all wins for health, equity and the economy.
These solutions are not just effective – they are smart investments. But to truly unlock their potential, we must shift how we define and measure progress. Yet our economic systems don’t reward prevention. Traditional indicators like gross domestic product miss what matters: the value of healthy people and healthy ecosystems. Gross domestic product might go up when hospitals treat wildfire victims, but it does not capture the cost of those fires or the suffering they cause. Nor does it count the benefits of climate action.
We need new measures of progress that put health, well-being, equity and sustainability at their core. Some countries are already redefining success by including health and climate in economic policy. Others must follow because we cannot outsource health – not our own and not the planet’s. Both are priceless. And both are at stake.
As Commissioners of the Pan-European Commission on Climate and Health, we are committed – individually and together – to pushing for affordable, practical and just solutions. Over the coming months, we will put forward a set of bold yet achievable cross-sectoral recommendations to address the climate crisis and safeguard health. This is not a time for half-measures. This is a time for extraordinary action.
Signed by:
H.E. Katrín Jakobsdóttir, former Prime Minister of Iceland, Chair of the Pan-European Commission on Climate and Health
Professor Sir Andrew Haines, Chief Scientific Advisor
Dr Majlinda Bregu, former Secretary General of the Regional Cooperation Council
Professor Hans Bruyninckx, former Executive Director at the European Environment Agency
Professor Sandrine Dixson-Declève, Honorary President, Club of Rome and Executive Chair, Earth4All
Dr Omnia El Omrani, Climate Change and Health Policy Fellow, Imperial College London, United Kingdom
Professor Enrico Giovannini, former Minister for Infrastructure and Sustainable Mobility, Italy
Ms Khatuna Gogaladze, former Minister of Environment and Natural Resources Protection, Georgia
Ms Connie Hedegaard, former European Union Commissioner for Climate Action
Professor Ernst Kuipers, former Minister of Health, Welfare and Sport, Netherlands (Kingdom of the)
Dr Karl Lauterbach, former Minister of Health, Germany
Mr Sulton Rahimzoda, Chairman of the State Committee on Investment and State Property Management, Tajikistan
Dr Hülya Şirin, Associate Professor, University of Health Sciences, Türkiye