Delegates from more than 180 countries agreed to a "roadmap" on global warming in December that is designed to pave the way toward a new international agreement on the issue.

Delegates to the United Nations Conference on Climate Change agreed to a plan that spells out work and issues to be addressed in anticipation of a 2009 conference in Denmark. The Bali Action Plan is expected to culminate in an agreement defining emissions cuts that industrialized countries should achieve between 2012 and 2016, among other goals.

During the conference, developing countries agreed to take significant steps to cut down on greenhouse gas emissions, a main contributor to climate change.

"Bali delivered what it needed to deliver — a very ambitious agenda going forward," said Yvo de Boer, executive secretary of the UN Framework Convention on Climate Change at a Dec. 15 news conference at the close of the meeting. "What I am especially pleased about is the fact that that road forward is ambitious, that it is transparent and that it’s flexible."

Activists speak out in Bali outside of talks being held on global climate change and greenhouse gas emissions in December. Photo by Jewel Samad, courtesy AFP/Getty Images

Many in the public health community saw the conference as a positive beginning, but some were disappointed that the roadmap doesn’t set specific goals for emissions reduction.

"Given the urgency and given the enormity of the problem facing us, there remains a tremendous amount of work to be done between now and 2009," APHA member John Balbus, MD, MPH, chief health scientist for the advocacy group Environmental Defense, told The Nation’s Health. "But as a first step, it is a step in the right direction."

APHA member Kathleen Rest, PhD, MPA, executive director of the Union of Concerned Scientists, said she was pleased to see the issue of adaptation brought into the spotlight during the Bali meeting. Many climate change talks have zeroed in on mitigation strategies to reduce greenhouse gas emissions, but developing countries in particular need help to adapt to the changes already wrought by climate change, she said.

"For the first time, the issue of adaptation came front and center in Bali," Rest told The Nation’s Health. "This has enormous implications for public health."

As for the overall results of the meeting, Rest said that "what it means for public health really depends on what happens with negotiations over the next two years. It’s a call to action."

As important to some as the formal governmental meeting, several adjunct sessions were held in Bali as well, many focusing on the health implications of climate change. After a two-day World Health Organization-sponsored workshop on climate change and health, Maria Neira, WHO’s director for public health and the environment, told those gathered at the official climate conference that more attention is needed on the current and future health effects of global warming.

"There was a clear message from (WHO) that public health is absolutely at stake," said APHA member Jonathan Patz, MD, MPH, of the University of Wisconsin-Madison, who has served as lead author on a number of Intergovernmental Panel on Climate Change reports. "Whenever we talk about adapting to and mitigating climate change, public health is a core area of concern."

Balbus said a great need still exists to help poorer countries find resources to address climate change concerns, something that’s tough to accomplish with so many countries involved.

"There are certainly huge barriers of mutual mistrust," Balbus said. "Agreements to pursue technology transfer at Bali are a good start, but now we need to see strong signs of implementation."

Even before the meeting, public health advocates said they were encouraged that concerns about climate change are gaining more attention. This year, APHA’s National Public Health Week and WHO’s World Health Day both have a climate change theme, and local and state governments as well as health-based organizations are making unprecedented efforts to address the issue.

For example, more than 600 mayors have signed onto a climate protection initiative to reduce emissions in their cities. Nine U.S. governors and the premier of the Canadian province of Manitoba signed the Midwestern Greenhouse Gas Emissions Accord in mid-November, setting up greenhouse gas emissions reduction targets and time frames.

Rest said she hopes the Bali conference serves as a springboard for many more public health advocates to become involved in the climate change debate as the 2009 Denmark meeting nears.

"I really think the public health community here and globally has enormous stakes in this issue," she said. "I would just encourage the public health community to take up a much- needed role post-Bali."

For more on the conference, visit http://unfccc.int/meetings/cop_13/items/4049.php.  

APHA’s National Public Health Week, to be held April 7–13, will focus on "Climate Change: Our Health in the Balance." To download fact sheets and other resources or to access the event’s blog, visit www.nphw.org.