The fallout of COP30

In this episode Jessamy talks to Iris Blom, a medical doctor and researcher with the London School of Hygiene & Tropical Medicine and co-chair on The Lancet Commission on Sustainable Healthcare.

Iris details her role at the recent COP30 in the Brazil Amazon, translating research for negotiators and advancing evaluation frameworks for sustainable healthcare, tells her takeaways from the conference and also explains why multilateralism still matters, how city-led co-benefits can drive measurable action, and what to expect from the upcoming Just Transition away from fossil fuels conference that  will take place on 28-29 April 2026 in Santa-Marta, Colombia.

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Transcript

This transcript was automatically generated using speech recognition technology and may differ from the original audio. In citing or otherwise referring to the contents of this podcast, please ensure that you are quoting the recorded audio rather than this transcript.

The fall out of COP30

Jessamy: Hello and welcome to The Lancet Voice. My name is Jess Bagenal, and until very recently, I've been a senior Executive Editor at The Lancet. I'm joined today by Dr. Iris Blom, who is a medical doctor and climate health researcher, and a policy expert who's recently completed her PhD at the London School of Hygiene and Tropical Medicine.

She focuses on greenhouse gas mitigation in healthcare systems, and its intersection with climate change adaptation. Today we're gonna be talking about the fallout of COP 30.

Um, Iris, thank you so much for joining us. Just tell us a little bit about how you have been involved with The Lancet. You've been working with us in various different capacities, um, and also what your role was at COP 30. Uh, I know that you had a sort of ship role in shaping some of the agenda. So Overachieved.

Iris: Sure. Thanks very much and thanks for having me. Very glad to be here. Um, I'm a medical doctor by background and I'm a researcher that's working on really intersection of climate change and health, um, and with a particular focus also on healthcare systems and how they can reduce emissions whilst also building resilience.

So I recently completed my PhD at the London School of Hygiene and Tropical Medicine, where I looked at that. Um. And, uh, thanks. And I also during this time have been working, uh, with the Lancet, including on the Lancet Commission, on on sustainable Healthcare. So I've been a working group co-chair and resilience on that commission, and I'm now helping with, with the writeup.

And, and this commission really focuses on how healthcare systems can. Uh, provide quality, remain safe, equitable, and functionable. While we are considering climate change, while we're being sustainable, not contributing further, but also, um, uh, responding to and preparing for the further impact of climate change on health.

Um, and within that, I've worked specifically also on a paper around accountability and evaluation of global commitments towards sustainable healthcare that many countries have done over a hundred now with the World Health Organization. Sorry. Published that work in the lens at Planetary Health and presented that at COP 29 and at COP 30.

I've been trying to follow up on that. So are we doing what we promised, um, does this matter for health and how, um, and um, yeah, in COP 30, my role really span sort of research translation into that space, engaging, uh, with the negotiators, but also convening with the health community that's there, um, to, to try and make sure that.

As health community, we're contributing to the ambition, um, around climate change and around the negotiations that are, that are ongoing there. 

Jessamy: Cop 30, obviously it occurred in quite a strange, you know, far out place. I know that some people were traveling 51 hours to get there. There were some concerns about, um, wifi and hybrid sessions.

I, I didn't attend, but you were, you were there. I mean, give us a flavor of the, of what it, what it was like, uh, hotels running out. I, you know, no one, no one could find anywhere to stay. 

Iris: Right, right. Yeah. No, I think it was very interesting, um, that we had Cop 30 in Palam in the Amazon, um, of Brazil. Um, interesting location.

It was the first time that I, I was in the Amazon myself. Uh, and I personally, um, had a great time being in Beem. I think, um, the context really made. The urgency even more palpable. Um, of course we are in the current real moment of, of real urgency. We see that climate impacts are increasingly visible. Heat flooding, food insecurity, disruptions to healthcare as well that we're seeing all over the globe.

Um, and I. Did see that health had a stronger presence, um, at this cop compared to to, to earlier. We've seen in the past couple of years a real increase in, in how seriously health is being taken in these spaces. We saw, for example, at COP 28, we saw the first health day that was, uh, themed around health. Um, during cop, we saw the first declaration on climate change and health.

Um, we've seen health and voice now, um, during cops. Um, and I I did see a, a real visibility of health and at the same time a very strong visibility, I would say, of civil society. Um, we saw protests that were happening in Berlin, and we haven't seen those in the past year. So this was really also the setting that lent itself, um, to that.

And, and luckily, I, I had the. The, yeah, the luck to be able to be welcomed by, by a host family. Uh, so I could stay in Baam, uh, with them. Had a wonderful time, uh, very, very, very can to, to welcome you there so that I could, uh, be able to participate, um, during Cop Cop 30. And in terms of health, yeah, maybe just to mention.

What I, what I felt like it was, um, and the discussions were around is, is kind of a transition point where we've seen the past few years, and this started at the Paris Agreement where health was integrated into the agreement. That was the first time health was mentioned in that agreement. Uh, and we've seen the, the, the years following a steady increase of health in this space, but mostly around, um, visibility.

And now I I, I did see kind of a transition point that instead of only talking about visibility and making sure that health is mentioned, how can we translate that into actual sustained measurable action? I think those discussions were starting at COP 30, so that's exciting to see. 

Jessamy: Was that. So when you think about your major kind of takeaways from your time at Cop 30.

What, so, you know, some of the major wins where you felt like, actually this is progress, this is year on year, I'm seeing improvements. What, what? Tell us about those. What, what were they? 

Iris: Yeah, definitely I think they're start, give, 

Jessamy: give us hope. Yeah. 

Iris: Give us hope, 

Jessamy: Iris. 

Iris: Yeah, yeah. There are definitely some challenges which I can speak to too.

But, but let me start with those successes. The really, um, the hope that I saw. So first of all, more mainstreaming of health. So we saw a lot of parties or countries that were there. Mentioning the health impacts that they're experiencing in the discussion. So I think, um, that is something important and that hopefully, um, uh, mobilizes us all to, to be more ambitious in the outcomes.

Then we saw, um, champion by the Ministry of Health of Brazil, the Bellin Health Action Plan that was launched um, at COP 30. So this focused mostly around adaptation of, of health systems, but in general adaptation to protect health. And this was endorsed by over 30 countries and 50 organizations as well.

So we saw that, um, during week one on Health Day. Uh, and then what I think was an interesting one is that we saw the launch of the Climate and Health Funders Coalition, and they pledged, uh. 300 million US dollars, uh, to support really implementation around climate and health. Uh, so I think that signals a bit of a growing confidence amongst funders, um, that health, uh, delivers maybe climate and also development returns, hopefully.

Um, and uh, specifically in the text we saw around the just transition text. Including, uh, the recognition of the right to health and the health co benefits of, of certain actions such as clean energy, clean cooking, and so on, uh, discuss. So I think that's an important normative shift. Um, and a very important discussion that was being held at COP 30 was around the global go adaptation and specifically the indicators that.

Parties are hopefully going to use to, to see how it's going in terms of adaptation in the world, how we're doing, um, how progress is in terms of adaptation. So they've been discussing those indicators and there is a set of indicators that's specifically relevant to health. So I see that as a positive as well, um, of this cup dirty.

Jessamy: And that 300 million, can you give us more details about how that, you know, how that's gonna be kind of distributed? What, what the sort of scope of that, of that 300 million is for besides just adaptation? 

Iris: That's a good question and a great question. And indeed, I, I am not entirely sure what the details of that will be, uh, and how that's 300 million will be used.

We see large funders that are engaged in that. We see, for example, welcome Rockefeller and so on. So one is of course that it's already increased the visibility again, of climate and health. I think, um, when these big actors come into the space and make pledges like this, we see an increase in of visibility.

We also see them engaged with the high level people that are present at COP 30 that are part of these types of announcements. So I see that as a positive now exactly how, um, that money is going to be used. I am, at this moment, unsure, but I hope that we'll hear, uh, soon more about this. Yeah, 

Jessamy: thanks Iris.

And kind of just building on that, thinking about the private sector and some of the criticisms that we've heard about, uh, you know, what copper's become in terms of uh, you know, a little bit of a jamboree, lots of kind of private sector people coming over, uh. Conflicts of interests, commercial determinants of health, what was that like this year?

Uh, particularly related to to, to health and climate? 

Iris: Yeah. Yeah. I think that's such a good point and such an important one. And we saw again, that s Society has done assessments of how many fossil fuel lobbyists, for example, there were in this space. And, and those numbers are, are quite shocking. Um, and we've seen that every year.

Um, and we've also seen in the past year, of course, that the countries that have. Have been had, having the presidency of cos might have certain interests in oil and gas. Um, so all those interests are, are, uh, competing with climate ambition and I'm really important to consider, um, whilst we cons, we are considering the role of, of COP 30, um, uh, and also critically think we need to critically think about that.

Um, I do still see COP 30 important in the sense of, um, convening, uh, people. At this political level. So health, climate, finance, equity, all, all kinds of different sectors are coming together there. Um, and also building around, uh, that and, and signaling direction building coalition, we still see cops, of course, of course, shaping norms as well, but I, I mostly see that value.

Bringing people together. Uh, and one exciting outcome from that disc cop, I think was the announcement that there will be a conference on the, just transition away from fossil fuels next year in Colombia. They announced this co-hosting with the Netherlands. Um, so I, I see that as a result of that coalition building that's also happening in this space.

I think we're currently in a very difficult geopolitical climate. We're currently in a difficult, um. Uh, situation when it comes to the progress in terms of, of climate change, which we are not, where we, where we want to be. Uh, so the negotiations are incredibly challenging and, and we see that, uh, at cops.

Um, but we still see outcomes in terms of the outcome document. Uh, we, and we see results of the people that are coming together in that space. However, when it comes to those competing interests, I think we need to take it very seriously. I hope that this conference on the just transition away from fossil fuels will hopefully do some thinking around fossil fuel lobbyists as well.

Um, and I think as health community, this is where we have. Uh, something to offer because we have a large experience around tobacco. Um, and, uh, in, in fact in in the World Health Organization, there's a lot of regulation around the fact that there are no tobacco lobbyists in that space. Um, uh, and there's a, around that this is a result of the treaty, uh, on tobacco.

So, so I think that is where the health commun can use that experience to hopefully also contribute to, to that ops. 

Jessamy: Yeah. So let's talk a bit about the challenges, um, and some of the maybe negative things or things that you were disappointed by or that you hope might happen, but, but didn't happen. 

Iris: Um, I think there was a strong rhetoric and a strong narrative coming from the COP 30 presidency in Brazil, but I do believe that there was a weak link around implementation.

Um, so we see commitments, but we don't really see clear timelines, baselines, accountability, uh. Particularly means of implementation for those parties that need it the most. Um, so this includes adaptation finance. Um, uh, we saw that finance timelines were actually postponed. Um, and I think that is not, um.

A positive in my sense. We also saw at this cop, um, that the final decision decisions did not explicitly reference fossil fuels. I think that's a huge, uh, missed opportunity to really clear, clearly connect, um, these actions that, that parties want to do with, with fossil fuel phase out. Um, which of course is strongly connected to, to health protection.

We have strong evidence for that. We have strong advocacy around that. We had a large number of parties that were in support of that, I think around 80 of, uh, at least. Um, and we see a, we have a president because this was in the texts at COP 28, so I think it was a big loss to not see that fossil fuel phase out language.

At COP 30, um, and one other loss, which is specifically around that, those adaptation indicators, which I mentioned before that were negotiated during COP 30. There was a very late stage sort of political change, uh, done to those indicators. So those indicators have been developed by experts, um, for a, a period of two years.

Um, those experts have works on developing those indicators. They've been discussed, um, at may point in time. But, um, a lot of, uh, challenges came up during COP 30 around those indicators, including, again, discussion on means of implementation. Because if we have these indicators, how can countries actually measure them?

Uh, and what does it mean if countries don't have the resources to measure them? Uh, for, for. Uh, for their access to finance and, and for their access to actual adaptation. So there, there were some difficult discussion around discussions around those adaptation indicators, and we did see large changes around two days before the end of COP 30 to those indicators that had been developed by experts without.

The consultation of those experts. So that risks for me, um, really reduce usefulness, um, of those indicators. And I think also a reduced, um, opportunity for real world implementation and accountability around those indicators. So I look forward to seeing how we can still hopefully take those forward. Also looking at COP 31.

Um, but that late stage change, um, to the indicators, I think it was a big challenge as well that I saw. 

Jessamy: Iris. So I wanna ask this next question carefully with the sort of caveat or, or the preface that I strongly believe in multilateralism and I believe in the way that we do things. I believe in negotiators sitting down and hashing things out in the governance model that we've developed over many years.

But at the moment, there are questions geopolitically when there are, um, populists moving fast and, you know, euphemistically being disruptive or ignoring certain ways that we do things. About whether we need to move some of those processes into the 21st century and, um, what that looks like. So I wanted to ask you, particularly with your experience having been at COP 30 while you're bringing the research to the negotiators, working with them directly, um, and because of where you are in your career, which is you've just done your PhD, you've got this sparkling career ahead of you, or lots of energy, lots of passion and a vision for what this space could be, can.

The way that we do things now you're sitting with a negotiator typing different things out, going point by point, looking at the wording. Can this keep up with the type of landscape and environment that we are all living in, where things are rapidly changing? Uh, and there are lots of different external forces pushing us to go in different directions and when there is a need to actually move fast.

Iris: I think such an important question, and I'll start by saying those, um, cup is an, is an exhausting space. Um, the venue is incredibly large, so, so getting steps in daily is very easy to do, just going from one place to another. Um, but it makes it very physically, physically exhausting. Uh, you can imagine it's to be a huge sort of tent.

There's not really daylight anywhere, just pavilion sounds, noises, people everywhere. Um, and trying to find the right people to talk to at the right moment. Um, at all times. It, it can be exhausting and at the same time, negotiations sometimes go very slowly, uh, don't move at all or, or move backwards. Um, which can also be mentally very exhausting.

So those things come together during, during cops, um, and I definitely experienced that as well. This cop, uh, in Brazil, what I get my energy and hope from is, is connecting to the other people that. We're all trying to do this together with, um, so to the other people that are, for example, part of the health community that are bringing in ambition from that health perspective, especially students, medical students, pharmacy students, nursing students that are, that are coming there with a lot of energy, creative ideas, um, and that are usually very great connecting with negotiators.

Um, I'm bringing that energy every day, um, stemming from experience at that local level, bringing that into, into these spaces. So that's where I get energy. I also get energy from the negotiators that I've been engaging with. These negotiators are usually speaking. Oftentimes until midnight and then start again very early.

Um, and they're bringing a lot of, um, their energy as well to these spaces, and they're really there to bring this to a successful end, even though it is difficult to sometimes navigate these extremely large geopolitical challenges, um, at, at the same time we see that at cop, not all parties are are there because we see, for example, that the United States, um, was not present this year in negotiations.

Um, that is challenging. I very much agree with you and still very much believe in the system of bringing everyone together. Um, I see the United Nations as the most inclusive platform that we have at the global level. Uh, and if that doesn't function, I am afraid that we will move towards. More exclusive, um, global mechanism.

So I am a very big supporter of, of the United Nations and bringing all these parties together, um, towards this ambitious agreement that they've all, uh, at, at some point been part of. So I still see a lot of hope there, but, uh, the current geopolitical situation does make it very challenging. Where I then see a very important role is also action really at the local and regional level, whilst let's say the global and some countries are, are trying to push in the other direction.

Let's see that leadership, um, at the other levels, because I think it's happening, we see a lot of incredible city initiatives around climate and health. Where cities are thinking through what the co-benefits are, for example, um, uh, stimulating more active transports and how that can benefit the climates and health, uh, of food systems, having school meals that are sustainable and healthy, uh, so that young people and actually school, uh, those school children are, are educated on this.

So we see a lot of those initiatives, which also bring me hope and I hope that that local and regional. Action that's still very much ongoing can then hopefully push the global as well to more ambition as we're ongoing and, and try to keep bringing everyone together, uh, towards that. 

Jessamy: I feel like it's very easy to end on a low point with this type of conversation.

So I think we should end on a high point and that seems like a good one. Is there anything else that you wanna say, Iris, um, or that you wanna discuss? 

Iris: Yeah, no, this has been a super interesting conversation. So thanks so much for having me. Um, I look forward very much in the next year, um, to sort of the outcomes and how some of these outcomes are going to be further discussed at COP 31, I think we see a lot of ambition from Australia and Turkey.

Um, that are going to be hosting the next one in hopefully bringing this to, to even more ambition as. So I look forward to that and I want to mention again that I look forward to that conference on the, just transition away from fossil fuels. I think we have some hope points there also on that global level whilst we keep going on the local and the original level as well.

Jessamy: And when is that conference of the just transition away from fossil fuels Ira? 

Iris: That's in April, so it's, it'll be coming up quite soon. 

Jessamy: Okay. Alright, well maybe we'll have to have you back on after that. 

Iris: Sounds good. 

Jessamy: Alright, great. Thank you so much. I really appreciate your.