by Thalia Viveros Uehara and Alicia Ely Yamin
Conclusion of the Digital Symposium Climate Change and Health:
Mobilizing Public International Law into Action
COP29 in Baku underscored what many had feared — a summit defined by missed opportunities. Perhaps this was to be expected, given that it was the second COP in a row held in a petro-state, with more fossil fuel lobbyists in attendance than climate and environmental activists. The pitiful outcome of $300 billion pledged (by 2035) felt more like an insult than a compromise, particularly when compared to Africa’s $163 billion annual expenditure on debt servicing.
But the disappointment surrounding financing outcomes was merely a symptom of deeper power imbalances, what critical legal scholar Martti Koskenniemi describes as the “structural biases” of global governance institutions. COP29 marked yet another shift in the fragile equilibrium of the underlying logic of the United Nations Framework Convention on Climate Change (UNFCCC), steering it further toward the ultimate commodification of climate action. What does this mean for the “health turn” that the UNFCCC has recently begun to witness?
The Health Turn: An Opportunity Co-opted?
The Health Pavilion at COP29 represented the momentum that has been building since COP16 to acknowledge the climate-health nexus within the UNFCCC. A diverse constellation of stakeholders from the global health community — including the World Health Organization, charitable foundations, NGOs, and private entities — came together to address the inextricable links between planetary health and human health.
Yet this progress was not abstracted from the structural bias shaping the broader climate governance regime. The World Bank presented a staggering estimate: climate change impacts on health could cost the world $21 trillion by 2050. To put this into perspective, this figure represents 1.3% of the GDP of 69 low- and middle-income countries.
The sheer scale of this projection, startling at first glance, seamlessly paved the way for an argument that investments of this magnitude are feasible only through a concerted effort — one that blends public funding with substantial contributions from private sector actors and commercial investors.
While an “all-hands-on-deck” approach holds promise for addressing the monumental challenges of the climate-health nexus, it risks, if left unchecked, entrenching the logic of what legal scholar Carmen Gonzalez aptly terms “racial capitalism.” Within the health turn of the UNFCCC, and particularly during COP29, this risk manifested in three critical ways.
First, while private sector and commercial investors’ involvement has been presented as a way to address critical funding gaps, their entry into health financing without a concerted effort by global health actors to prioritize alternative and more equitable mechanisms raises concerns. This approach risks normalizing measures such as the already well-documented and problematic privatization of health care systems, which is often accepted without sufficient scrutiny as part of a “necessary” solution package. Proposals such as going after tax heavens or implementing wealth taxes on the global rich — championed by the Brazil at the G20, Nobel Laureate Esther Duflo, and the Bridgetown Initiative on the Reform of International Development and Climate Finance Architecture — warrant far greater attention and debate in these contexts.
Second, the prominence of private and commercial actors in the climate-health nexus allows major country contributors to climate change to sidestep their commitments under principles like Common but Differentiated Responsibilities and Respective Capabilities (CBDR-RC). Instead, they lean on debt-inducing mechanisms that risk entrenching vulnerable countries in cycles of dependency, ultimately undermining the efficacy of climate finance. Data show that similar dynamics in development assistance have perpetuated dependencies, limiting the capacity of affected nations to build autonomous and sustainable systems.
Third, the policy prescriptions intended to safeguard the transparency and accountability of public-private investments are themselves deeply embedded in the logics of racial capitalism. For instance, while evidence-based interventions were highlighted during COP29 as a cornerstone of the action roadmap, the process of knowledge production remains steeped in colonial logics, as well as racialized and gendered biases. Women and other marginalized groups have long been rendered invisible in clinical trials and health studies, their experiences systematically excluded from the data and frameworks that inform policy decisions.
Navigating Structural Bias through Human Rights
The six contributions to this digital symposium underscore stark health vulnerabilities in the face of climate change, which disproportionately affect marginalized populations worldwide — vulnerabilities stemming from the invisibilities perpetuated by racial capitalism. They also reveal how these populations are frequently overlooked within the UNFCCC framework.
In South Africa, for example, informal workers are excluded from the country’s National Adaptation Plan, despite facing heightened exposure to extreme weather. In Latin America, pesticide toxicity disproportionately impacts rural women, yet scientific research continues to overlook its specific effects on women’s bodies, reflecting a persistent, gendered blind spot.
At the same time, these contributions emphasize how communities and their partner NGOs are actively navigating the effects of structural bias working against them. Human rights law has emerged as a vital entry point through which marginalized groups can assert justice and visibility within the climate governance arena.
However, the “health turn” within the UNFCCC has yet to fully integrate this framework. For instance, the UAE Declaration on Climate and Health, signed by 151 countries since its endorsement at COP28, omits any mention of human rights. Similarly, the Guiding Principles for Financing Climate and Health Solutions make no mention of human rights, further highlighting the gap in integrating this critical perspective.
While the human rights framework is far from a panacea, it should serve as a moral compass for a social and international order in which everyone, in all our diversity, can enjoy the rights in the Universal Declaration. Human rights, in turn, can counterbalance the growing influence of private and commercial actors in climate governance.
Without meaningful integration of human rights principles, including above all equality of diverse people on this planet, the UNFCCC’s “health turn” risks being caught off guard, allowing the logic of racialized and financialized capitalism to seep further into its foundations. If upcoming COPs – especially the next one in Brazil, which raises high hopes – pave unchecked pathways for the commodification of health, the integration of global health into the climate change regime will not be a beacon of progress, but rather a cautionary tale for generations to come.
Thalia Viveros Uehara is Senior Research Fellow at the Max Planck Institute for Comparative Public Law and International Law and Postdoctoral Researcher at Tilburg Law School, Tilburg University.
Alicia Ely Yamin J.D., M.P.H., Ph.D. is a Lecturer on Law and the Director of the Global Health and Rights Project at the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at Harvard Law School and Adjunct Senior Lecturer on Health Policy and Management at the Harvard TH Chan School of Public Health; as well as Visiting Professor of Law at the Universidad Torcuato Di Tella in Buenos Aires, Argentina.