The Bartlett


Code red for a healthy future: Lancet Countdown 2021

21 October 2021

Urgent action needed to integrate climate change mitigation into COVID-19 recovery plans to address global inequities in health and build a sustainable future.

Rain pouring on trees

Key findings

  • In 2020, up to of 19% of the global land surface was affected by extreme drought in any given month, a value that had not exceeded 13% between 1950 and 1999.
  • Climate change is driving an increase in the frequency, intensity, and duration of drought events, threatening water security, sanitation, and food productivity, and increasing the risk of wildfires and exposure to pollutants. The 5 years with the most areas affected by extreme drought have all occurred since 2015. The Horn of Africa, a region impacted by recurrent extreme droughts and food insecurity, was one of the most affected areas in 2020.
  • Climate change threatens to accelerate food insecurity, which affected 2 billion people in 2019. Rising temperatures shorten the time in which plants reach maturity, meaning smaller yields and an increased strain on our food systems. Maize has seen a 6% decrease in crop yield potential, wheat a 3% decrease and rice a 1.8% decrease, compared to 1981 – 2010 levels.
  • Average sea surface temperature has increased in the territorial waters of nearly 70% (95 out of 136) of coastal countries analysed, compared to 2003-2005. This reflects an increasing threat to their marine food security. Worldwide 3.3 billion people depend on marine food.
  • In 2021 the World Health Organisation found just over half of countries that answered to the Health and Climate Change Global Survey (37 out of 70) had a national health and climate change strategy in place, a similar proportion to 2018. Nearly three-quarters of countries surveyed said finances prevented them developing such a strategy, with others citing a lack of skilled people, being restricted by COVID-19 and lacking research and evidence.
  • Globally, climate change adaptation funding directed at health systems represents just 0.3% of total climate change adaptation funding.

The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future outlines the growing risks to health and climate. These risks exacerbate the health hazards already faced by many, particularly in communities exposed to food and water insecurity, heatwaves, and the spread of infectious diseases. The authors call for urgent, globally coordinated action to mitigate climate change and build a healthier, sustainable future for all.

The COVID-19 pandemic has demonstrated the need for increased international co-operation in the face of global crises. Politicians must show leadership by moving beyond rhetoric and take action a the upcoming UN Climate Change Conference (COP26), which will start on Sunday 31 October 2021 in Glasgow, Scotland. Carbon emissions must be rapidly reduced to improve health and to provide a more equitable, sustainable future.

As countries commit trillions of dollars to restart their economies in the midst of the COVID-19 pandemic, the report urges political leaders and policy makers to use this public spending to reduce inequities. Promoting a green recovery by creating new and green jobs, and safeguarding health, will build healthier populations now and in the future.

The report shows that many countries are under-prepared for the health effects of climate change. In a 2021 World Health Organisation survey of health and climate change, only 45 of 91 countries surveyed (49%) say they have a national health and climate change plan or strategy. Only 8 out of those 45 countries in the analysis reported that their assessments of the effects of climate change on their citizens’ health had influenced the allocation of human and financial resources. The survey found 69% of countries in this analysis reported insufficient financing was a barrier to implementing these plans.

Just as the world is failing to deliver an equitable supply of COVID-19 vaccines, the data in this report exposes similar inequities in the global response to climate change. In general, it is the countries lowest on the human development index that are often least responsible for rising greenhouse gas emissions and are lagging behind in climate change adaptation and mitigation efforts and in realising the associated health benefits of accelerated decarbonisation.

Executive Director of the Lancet Countdown Prof Ian Hamilton said:

“This year’s 2021 report continues to track the health implications of the changing climate and the actions needed to address climate change. This year’s report shows the systemic levels of inequality across countries in terms of how they contribute to climate change through their Greenhouse Gas emissions, but also how the impacts to health are greatest among those who are most vulnerable and least able to protect themselves.

"Understanding climate change as health crises gives urgency to the need to protect ourselves now and in the future through dramatic treatment to decarbonise our global economy, and alongside this address health and social inequalities. This report provides the evidence base needed for policymakers and governments to take urgent action on climate change and to prioritize health in all climate policies.”

Authors from the Bartlett School of Environment, Energy and Resources 

Institute for Sustainable Resources:

UCL Energy Institute:

Institute for Environmental Design and Engineering:

Read the report

(Photo by Lola Guti via Unsplash)