Industry Insight

It was encouraging to see this relationship between climate change and health explored on the world stage and as Alan Dangour, director of Climate and Health at the Wellcome Trust, stated: “COP28 has the power to either save lives or cost lives.”4 A key goal of the COP28 Health Day was about showcasing the evidence base and the clear impact pathways between climate change and human health.1 This closely aligns with the work various pharma companies have been undertaking in recent years, for example to better understand the impact of air quality and climate change on those with chronic lung conditions.

It is estimated that around eight million people in the UK have asthma, which amounts to around 12% of the population with a further 1.2 million diagnosed with COPD.5,6 There remains a significant undiagnosed population across both diseases.7,8

Systemic challenges exist in receiving timely and accurate diagnoses and effective treatment to manage conditions, however, the air inhaled by patients is also having a significant impact. For instance, here in the UK, an estimated 43,000 early deaths can be attributed to air pollution every year, and the UK has the highest death rate for asthma in Europe.9,10

People living with lung conditions are experiencing a growing and tangible impact from climate-driven factors such as extreme weather conditions including heatwaves, increased pollen loads and increased duration of pollen seasons, with pollution from traffic and industrialisation presenting daily challenges for those living with chronic lung conditions.

Various companies have been working on reports assessing the impact of climate change on patients with chronic lung conditions such as asthma and COPD, providing a unique patient perspective of the lived experience of climate change.

Reports have showed that climate change factors such as heatwaves and pollen are having an impact on respiratory health and that poor air quality negatively affects symptoms, overall health and quality of life for people with lung conditions.

Of those surveyed, 69% said they believed air quality had worsened in their area in the last five years, and 48% of those living in areas with poor air quality believed that it made their symptoms worse.9

Paradoxically, weather and climate-related effects such as high heat and humidity can be a trigger for asthma, while extreme cold weather can increase respiratory infections in those with COPD, so there are nuances but extremes of weather patterns that are increasing do not support optimal respiratory health.11

Furthermore, reports recognised that those in urban areas feel they face a greater burden of poor air quality and highlighted that the degree and impact vary, citing that ‘any examination of the link between air quality and health has to consider the socio-economic aspect’ and that more research is needed to further explore the intersection of air quality, health inequalities and lung health.

Digging deeper into the issue of health equity, a pivotal report published by Asthma + Lung UK in 2021 provided a stark reminder of the health inequalities that exist, for instance 85% of people living in areas with illegal levels of nitrogen dioxide (NO2) make up the poorest 20% of the UK population.12

In addition to increased public health awareness and continuing research, pharma companies know that we must go beyond rhetoric to make a meaningful difference for people living with chronic respiratory conditions.

Some pharma companies have begun investing heavily in reducing their carbon footprints and working towards a global commitment to become Net Zero by 2035. Furthermore, significant and innovative research and development (R&D) efforts to develop carbon minimal products, such as inhalers, aim to bring solutions that equally serve patients and the planet.

The themes of the COP health day provide further focus on how we can drive change within the pharma industry, such as how we can make R&D more accessible and sustainable. Whether this is clinical trial recruitment from a broader cross section of society to deliver true patient representation, making trials more ethical in terms of who is participating but also ‘greener’ by considering factors such as decentralisation, water and waste reduction, and how we can embrace artificial intelligence and digital technology to drive efficiencies. Crucial to this is how we can reduce the environmental impact of our products – therapy, medicine or device – by investigating alternatives and bringing greener solutions to market as we support the NHS in achieving its Net Zero targets.

It is a significant commitment for our industry, and some pharma companies have invested significantly in facing the challenge head on. We have the potential to drive positive change in the years ahead, but we must also ensure that such innovation and investment is incentivised and rewarded in the UK. No longer can a medicine’s value only be determined by its mechanism of action, it must also be determined by its impact on the planet. We must evolve policy, regulation and reimbursement frameworks to recognise and support this necessary shift.

It is hoped that health will continue to be an enduring focus at future COP conferences and those in the industry should look forward to seeing discussions form into actionable guidance and policies that can support those living with chronic diseases.