by Dr Seán Owens, Chair, Sustainability Working Group of the Irish College of General Practitioners
Every 5 years the Intergovernmental Panel on Climate Change (IPCC), the UN body for assessing the science relating to climate change, convene and report on the current state of climate related affairs.
The IPCC consists of 195 members and relies on thousands of volunteer expert scientists across the world to appraise thousands of scientific papers each year. They provide an evidence based and contemporary summary of the drivers of climate change, as well as future risks and adaptation and mitigation measures that may be used. Historically their reports, predictions and advice have erred on cautious given the myriad of uncertainties of how to report on such complex natural systems. However in the previous two reports, the fifth report in 2013 and now the sixth in 2022, the language from these reports has become more resolute, the findings damning and the advice unwavering.1,2 Human activities are causing continued carbon emissions, they are rapidly eroding the natural systems upon which we depend, we must decarbonise to ensure a habitable planet in the near future and the time to do so is now.
What did the most recent IPCC report say?
Such is the spectrum of evidence collected from these IPCC reports, they are split into three parts.
The first part of the sixth report (also known as AR6) was released in 2021 and it took the pulse of the planet as it were; it was a scientific assessment of where we are from a physical point of view. Preceding COP26, this was a damning indictment of our failure to act on the known evidence to date.
The second part of AR6 was an adaptation assessment which disturbingly asked how we might live with the likely consequences of extreme weather events, mass displacement, increased rates of chronic and infectious disease and more.
However the third and final section of AR6, published in April 2022, was remarkable as it offered an evidence- based roadmap back from the brink. For the first time, there has been scientific consensus not only that climate change is a real and present crisis, but that there are measures that we can take now to keep warming to a level that may mitigate some of the worst predictions.
While the IPCC AR6 reports have become more definite in their conclusions, the language remains stiff and often laborious to read. In contrast the commentary on their findings has become much inflammatory.
The UN secretary General Antonio Guterres described the report as a ”litany of broken climate promises…a file of shame, cataloguing the empty pledges that put us firmly on track towards an unliveable world.” The reason for this change of language is that these AR6 reports truly represent our final chance to limit warming to 1.5 degrees (which is thought to be the best chance of a liveable future as we recognise it).
As these reports are only published every 5 years, there is a strong likelihood that without widespread societal change, the next AR7 report will mark the planet’s warming beyond safe levels and the crossing of many other planetary tipping points.
A Cause for Hope
The IPCC AR6 reports tell us in no uncertain terms that we will have marked societal change either way.
We can elect for a happier, safer and healthier future by following evidence based cleaner energy systems, sustainable diets, active transport systems and other emerging technologies. Or we can continue to rely on fossil fuels for energy, transport and agriculture, and live in an increasingly unstable and inhospitable world not just for future generations but for our own lifetimes.
The AR6 report asks not only for decarbonisation, but for decarbonisation at speed and at scale. Furthermore a commonality in the report was that many countries have demonstrated sustained emissions reductions. Of note these were as the result of evidence -based sustainable policies.
If there was one takeaway from this report it is that only petitioning for and achieving policy change is the key to reducing emissions. The other major takeaway was that the cost of mitigating emissions will easily be paid through the health savings of same.
What does the AR6 report mean for General Practice in Ireland?
While the NHS has already published a roadmap to net zero, Irish healthcare does not yet count its own carbon emissions, much less publish a road map to net zero.
As one of the first colleges to endorse planetary health (2019 AGM), the ICGP has not shirked its duties. To mark Earth Day 2021, the ICGP published an infographic for how planetary health relates to our everyday practice. The nub is as follows; healthcare has a marked carbon footprint of its own to recognise, and the bulk of our emissions can be found in our prescribing, particularly inhalers.
Many of the chronic diseases we diagnose and manage are the result of unhealthy lifestyle behaviours and unhealthy environments. The trusted roles of doctors and nurses in our communities and frequent patient contacts make GPs and practice nurses ideally situated to deliver lifestyle advice that will not only prevent chronic disease but markedly reduce emissions outside of healthcare. Active transport and plant based diets are two good examples of triple wins; patient, planet and economy.
The even better news is that with Chronic Disease Management GPs are already doing this. Medication reviews are a great way to not only prevent unnecessary medication related harms, but also reduce medication related emissions and pollution. We now have time to talk to our patients about realistic exercise, sleep and diet goals and more, without having to cram these questions into a 10 minute slot.
The ICGP Sustainability Working Group has now developed a toolkit, awaiting approval, to show GPs where further efficiencies in the consultation and in the office and practice can be made.
The IPCC reports have now been published and we will not see another until 2027 or later. It is now over to us to follow the evidence and petition for the change that is urgently needed.
With COVID, general practice took a seat at the top table and agitated for changes to policy in the interests of their patients and in line with incontrovertible evidence, despite this meaning marked disruptions to our activities of daily living.
The IPPC reports offers us incontrovertible evidence once again; however the stakes are this time even higher. The challenge for Irish General Practice at every place and every level, from trainer and trainee, from Lincoln Place to Lifford town, from local CME meeting to WONCA conference, is to follow this evidence and do what it does best: Advocate and agitate in the interests of their patients and communities for a happy, healthier and sustainable tomorrow.
- IPCC, 2013: Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Stocker, T.F., D. Qin, G.-K. Plattner, M. Tignor, S.K. Allen, J. Boschung, A. Nauels, Y. Xia, V. Bex and P.M. Midgley (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, 1535 pp.
- IPCC, 2022: Summary for Policymakers. In: Climate Change 2022: Mitigation of Climate Change. Contribution of Working Group III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change [P.R. Shukla, J. Skea, R. Slade, A. Al Khourdajie, R. van Diemen, D. McCollum, M. Pathak, S. Some, P. Vyas, R. Fradera, M. Belkacemi, A. Hasija, G. Lisboa, S. Luz, J. Malley, (eds.)]. Cambridge University Press, Cambridge, UK and New York, NY, USA. doi: 10.1017/9781009157926.001
This blog was published for World Earth Day 2022 (22nd April).