- Between 2000-2016, there has been a 46% increase in the number of weather-related disasters, and 125 million adults aged over 65 were exposed to heatwaves
- Increasing temperatures have led to around 5.3% loss in labour productivity, and economic losses linked to climate-related extreme weather events were estimated at US$129 billion in 2016
- Vectoral capacity of just one type of dengue-carrying mosquito has increased by 9.4% since 1950 as a result of rising temperatures
- Global exposure to dangerous levels of air pollution has increased by 11.2% since 1990, with 71% of 2971 cities exceeding recommended levels of PM2.5
- Increase in electric cars, generation of renewable energy, and health adaptation spending show that momentum is building, but further progress is urgently needed
Climate change is already having an impact on health, impacting on labour productivity, the spread of infectious disease and exposure to air pollution and heatwaves, and affecting countries worldwide, according to the first report of The Lancet Countdown on Health and Climate Change.
While there is some evidence of early adaptation and mitigation strategies being implemented in some areas, the authors warn that further progress is urgently needed.
The Lancet Countdown on Health and Climate Change is a comprehensive annual analysis tracking progress on climate change on 40 key indicators . The project is a collaboration between 24 academic institutions and intergovernmental organisations including the World Health Organisation and World Meteorological Organisation.
By combining multiple data sources, undertaking new analysis and devising new indicators, the report tracks progress in five areas: climate change impacts, exposures and vulnerabilities; adaptation planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and political and public engagement.
Health impacts of climate change already felt today
Between 2000 and 2016, an estimated 125 million adults over 65 were exposed to heatwaves (fig 2), with possible health impacts ranging from heat stress or heat stroke to exacerbations of pre-existing heart failure or increased risk of kidney injury from dehydration.
Increasing temperatures have also resulted in an estimated reduction of 5.3% in labour productivity (fig 4) for people doing manual, outdoor labour in rural areas (fig 5), impacting the livelihoods of individuals, families and communities.
The total value of economic losses (linked to physical assets rather than ill health) resulting from climate-related extreme weather events was estimated at US$129 billion in 2016 (fig 33 &34). Losses account for a much higher proportion of GDP in low income compared to high income countries, and 99% of losses in low-income countries are uninsured.
The rate of transmission of some mosquito-borne infectious diseases has also increased, with the vectoral capacity for the transmission of dengue fever by the Aedes Agypti mosquito increasing by 9.4% since 1950 (fig 9). The number of cases of dengue fever has nearly doubled every decade.
The number of people with undernutrition in 30 countries in Asia and Africa has increased from 398 to 422 million since 1990. Climate change is expected to have an impact on crop production, with a 1?C rise in temperatures associated with a 6% decline in global wheat yields and a 10% decrease in rice grain yields.
Professor Anthony Costello, Co-Chair of The Lancet Countdown and a Director at the World Health Organization says: "Climate change is happening and it's a health issue today for millions worldwide. The outlook is challenging, but we still have an opportunity to turn a looming medical emergency into the most significant advance for public health this century. As we move in the right direction, we hope for a step-change from governments to tackle the cause and impacts of climate change. We need urgent action to cut greenhouse gas emissions. The health and economic benefits on offer are huge. The cost of inaction will be counted in preventable loss of life, on a large scale." 
Between 2007 and 2016, there were on average 306 weather-related disasters (mainly floods and storms) per year, representing a 46% increase since 2000 (fig 6). As events worsen over time, the authors warn that current levels of adaptation will quickly become insufficient.
Adaption and mitigation: prevention is better than cure
An increasing number of countries and cities are developing preparedness plans to mitigate the impact of climate change. In 2016, 449 cities worldwide reported having undertaken a risk assessment (fig 12). However, the majority were in high income countries, with 83% of European cities surveyed, compared to 28% of African cities.
Climate-related events, such as storms or floods, can impact on the capacity to provide medical care, for example by interrupting electricity supply, transport, communications or IT. Adaption spending for health accounts for 4.6% of total global adaptation spending, and the authors call for scale-up of financing for climate resilient health systems.
Professor Hugh Montgomery, Co-Chair of The Lancet Countdown and Director of the Institute for Human Health and Performance, University College London, adds: "We are only just beginning to feel the impacts of climate change. Any small amount of resilience we may take for granted today will be stretched to breaking point sooner than we may imagine. We cannot simply adapt our way out of this, but need to treat both the cause and the symptoms of climate change. There are many ways to do both that make better use of overstretched healthcare budgets and improve lives in the process."
Some evidence suggests a decline in the use of private motorised vehicles in cities in the USA and Australia, but there has been little improvement for cities in emerging economies (fig 27 & 28). While transport is still heavily dominated by gasoline and diesel, non-conventional fuels (eg biofuels, and natural gas) and electric vehicles are gaining traction, particularly in Europe and the USA (fig 26). However, these figures remain modest when comparing the overall sales of electric cars per year (77 million) and the global total fleet of 1.2 billion cars. Electric vehicles are expected to reach cost-parity with traditional cars by 2018.
In 2015, more energy from renewable sources (solar, wind, hydroelectric) was added to the global energy mix, compared to fossil fuels. However, to remain on the pathway to reaching the Paris Agreement by 2050, this needs to increase by 2.5 times the current levels. In 2016, employment in the renewable energy sector reached 9.8 million people, 1 million more than are employed in the fossil fuel extraction sector.
However, global exposure to air pollution (fine particulate matter PM2.5) has increased by 11.2% since 1990, and about 71% of 2971 cities monitored by WHO exceed the recommended levels of PM2.5. The report concludes that momentum is building across a number of sectors, but that further progress is urgently needed.
Christiana Figueres, Chair of The Lancet Countdown's High-Level Advisory Board and former Executive Secretary of the UN Framework Convention on Climate Change, explains: "The Lancet Countdown's report lays bare the impact that climate change is having on our health today. It also shows that tackling climate change directly, unequivocally and immediately improves global health. It's as simple as that. Most countries did not embrace these opportunities when they developed their climate plans for the Paris Agreement. We must do better. When a doctor tells us we need to take better care of our health we pay attention and it's important that governments do the same." 
NOTES TO EDITORS
The Lancet Countdown is funded by the Wellcome Trust. Organisations involved are: Centre Virchow-Villermé, European Centre for Environment and Human Health, Imperial College London's Grantham Institute, International Livestock Research Institute, Iranian Fisheries Research Organization, London School of Hygiene & Tropical Medicine, NHS Sustainable Development Unit, The Centre for Climate & Security, Tehran University of Medical Sciences, Tsinghua University, Umea University, United Nations University, Universidad Peruana Cayetano Heredia, University College London, University Colorado-Boulder, University of Birmingham, University of Essex, University of Exeter, University of Reading, University of Sussex, University of Washington, University of York, World Bank, World Health Organization and World Meteorological Organization.
 Full list of indicators available in panel 2 of the report.
 Quotes direct from authors and cannot be found in the text of the report.
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