This Guiding Principles Consensus Statement is the first in a series of documents linked to the Global Climate and Health Summit 2025. It sets out a shared commitment from participants to accelerate urgent action at the intersection of climate change and health. 

A future where people and planet thrive is within reach. But only if we act with urgency, unity and resolve. Now is the moment to protect people, transform systems, and ensure that everyone can thrive in a climate-resilient, low-carbon world. 

PROTECT: PRIORITISE HEALTH AND PREVENT HARM 

1. Climate change is a health crisis for everyone, everywhere.

Climate change is dangerous for the lives and livelihoods of everyone, everywhere. It is already driving excess deaths from extreme heat, worsening air pollution, and undermining nutrition through disrupted food systems. It threatens food, air, water, housing, livelihoods, and health systems across all countries, regions and income levels. No one and nowhere is safe. Climate policies must protect and promote health across mitigation, adaptation, finance, and planning.

2. Recognise the physiological limits to adaptation.

There are hard limits to how much the body can adapt to climate stressors such as extreme heat, air pollution, undernutrition, and disease. These thresholds must shape how we assess risk, set mitigation ambition, and plan for adaptation. No amount of technical innovation or policy response can fully adapt us out of the escalating harms of an overheating planet. Without urgent, large-scale emission reductions, these physiological limits will be increasingly and irreversibly breached.

3. Reducing emissions delivers direct health co-benefits.

Actions to cut emissions, such as tackling air pollution, improving food systems, and designing healthier cities, can also deliver immediate health gains. These benefits must be better recognised and reflected in policy across all contexts, from urban centres to vulnerable rural areas.

TRANSFORM: REDESIGN SYSTEMS TO BUILD RESILIENCE

4. We need transformational adaptation.

We cannot adapt our way out of crisis with small, incremental steps. Rising climate threats demand a fundamental redesign of the systems that shape exposure, vulnerability and health: from how we build cities and deliver care, to how we work, eat and live. This transformation must be long-term, systemic, and guided by physiological science so that it is grounded in an understanding of how the body responds to multiple, compounding stressors.

5. Adaptation and mitigation must go hand in hand.

High-income countries must lead in cutting emissions, while low- and middle-income countries must be supported to pursue low-carbon development. At the same time, all countries must invest in adaptation to protect people from the climate impacts already underway. Climate and health strategies must reflect this dual urgency: reducing emissions while strengthening physiological, social, economic, and infrastructure resilience.

6. Support adaptation by building physiological resilience.

While we must act to avoid breaching the limits of human tolerance, adaptation depends on strengthening the body’s capacity to cope with climate stress. Within these boundaries, physiological resilience means better enabling people to withstand and recover from climate shocks without lasting harm. This requires improving conditions that support health – including housing, nutrition, rest, decent work and access to care – and applying physiological science to design effective, targeted interventions that reduce vulnerability and protect lives. 

7. Translate knowledge into action and identify what is still needed.

We already know enough to take stronger, more targeted action to protect health. Strategies must use existing physiological and public health evidence to drive real-world interventions. But we must also be clear about where knowledge gaps remain – particularly around how best to adapt to a changing climate. While the need to reduce emissions is unequivocal, further research is needed to understand how to protect health in the face of multiple, coincidental compounding climate stressors.  

THRIVE: WORK FOR A HEALTHIER, FAIRER AND CLIMATE SAFE FUTURE

8. Act now to secure a healthier, safer future.

A positive future is still possible – but only if we act now and urgently. The worst impacts of climate change are not inevitable. By protecting health, cutting emissions, and adapting our systems, we can create more liveable cities, fairer societies, and stronger economies. Climate–health action can deliver a climate-resilient, low-carbon world with cleaner air, better housing, healthier diets, and safer working conditions. These are not trade-offs – they are opportunities.  

9. Cross-sector, transdisciplinary collaboration is essential.

No single discipline, sector or country can address these challenges alone. We must forge new alliances and bring together physiologists, health professionals, engineers, policymakers, funders and communities to deliver integrated solutions that reflect diverse experiences and needs.

10. Equity and justice must underpin all action.

Climate change deepens existing health inequalities. Action must be guided by the needs and voices of those most affected – including people in low-income countries, disadvantaged communities, children, older people, and outdoor workers. We must tackle the systemic barriers that drive unequal exposure, vulnerability, and access to protection.