The planet is in intensive care by Paula Bartlett

The next climate summit should have fewer politicians discussing carbon targets and considerably more doctors explaining what happens when the patient stops breathing.

Somewhere between another diplomatic handshake, another beautifully worded declaration and another promise to achieve net zero several decades from now, reality has been abandoned in the waiting room. The patient is deteriorating, the emergency department is overcrowded, and the politicians are still arguing about who should pay for the ambulance.

The climate crisis is no longer simply an environmental emergency. It is a global health crisis, potentially of pandemic proportions, and the medical profession should stop being an invited supporting act in climate discussions and become one of their principal voices.

For years, climate change has been presented through the language of environmental accounting: degrees Celsius, atmospheric carbon concentrations, emissions targets, industrial transitions and economic projections. Important, certainly, but also wonderfully convenient for politicians who prefer discussing numbers rather than human consequences. A temperature graph does not scream. A statistical projection does not arrive at an emergency department gasping for breath. A carbon budget does not bury a child. People do.

Extreme heat is already turning ordinary summer days into medical emergencies. Cardiovascular and respiratory patients face increased risks. Older people, outdoor workers, infants and those living in poorly insulated housing are particularly vulnerable. Air pollution aggravates existing illnesses, while droughts, floods and changing weather patterns threaten food security, sanitation and access to clean water. Meanwhile, warming conditions expand the geographical reach and seasonal opportunities of disease-carrying mosquitoes and ticks.

The consequences are not waiting for some distant environmental apocalypse. They are entering clinics, operating theatres, maternity wards and intensive care units.

And then there is the psychological damage. Climate anxiety, displacement, trauma following extreme weather events and the destruction of communities are not footnotes to an environmental report. They are human suffering, requiring professional attention and long-term care. When a flood destroys somebody's home, the damage does not disappear when the television cameras leave. When an entire community loses its livelihood, the consequences do not fit neatly into a government spreadsheet.

Yet climate negotiations continue to operate as though the principal stakeholders are energy companies, finance ministers, industrial lobbyists and diplomats with an impressive collection of carefully rehearsed adjectives.

Where are the doctors? Where are the nurses, epidemiologists, public-health specialists, emergency physicians and hospital administrators? They should be sitting at the negotiating table, not waiting outside it.

The next climate summit must place health professionals at its centre. Not as ceremonial speakers delivering five minutes of compassionate warning before the delegates return to discussing economic competitiveness, but as participants shaping binding priorities and measurable commitments.

Every national climate strategy should include health impact assessments. Hospitals must become climate-resilient infrastructure, equipped to withstand heatwaves, floods, power failures and supply-chain disruptions. Public-health surveillance must anticipate emerging infectious diseases. Urban planning must prioritise breathable air, accessible green spaces, shade and protection for vulnerable populations. Climate adaptation funding must include the financial resources necessary to protect healthcare systems, particularly in poorer countries that contributed least to the problem but frequently suffer its harshest consequences. And perhaps most importantly, governments must stop treating prevention as an optional expenditure.

There is a brutal economic absurdity in refusing to invest in prevention while spending billions treating the consequences. It is the equivalent of setting fire to a hospital and then proudly announcing an increase in the emergency services budget. The inequality is equally unforgivable. Wealthier societies possess greater resources to protect themselves, while poorer communities face greater exposure and weaker healthcare infrastructure. Climate injustice is therefore also health injustice. Any summit that ignores this relationship is not negotiating a solution; it is negotiating the distribution of suffering.

Medical professionals understand something that political negotiators frequently forget: emergencies do not negotiate with election calendars. Viruses do not respect diplomatic protocol. Heatwaves do not wait for parliamentary majorities. Human biology has no patience for political compromise.

The medical profession cannot solve the climate crisis alone. But it can expose its consequences with an authority that no government public-relations department can manufacture. Doctors understand prevention, risk, evidence and the terrible cost of delayed intervention. They also understand that when a patient is critically ill, pretending everything is under control is not optimism. It is malpractice.

The next climate summit needs fewer speeches about saving the planet and more serious discussions about saving the people living on it. The planet will survive another political conference. Humanity, particularly its most vulnerable populations, cannot afford another exercise in diplomatic procrastination. Perhaps it is time to stop treating climate change as a problem for the environment ministry and start treating it as an emergency for the entire medical profession.

The planet is running a fever. The waiting room is full. The doctors are ready. The question is whether the politicians are finally prepared to listen before somebody has to pronounce the patient dead.