The 2026 Europe report of the Lancet Countdown on health and climate change: narrowing window for decisive health action

The current health risks and impacts of climate change

Indicators reveal a marked increase in both direct and indirect negative health impacts of heat exposure in Europe. Nearly all European regions monitored (823 [99·6%]) saw increased numbers of deaths attributable to heat during 2015–24 compared with 1991–2000, with an overall mean annual increase of 52 (95% CI 43–59) deaths per million inhabitants (indicator 1.1.3). Daily health warnings of extreme heat increased by 3·2 (318%) in 2015–24 compared with 1991–2000. Comparing 2015–24 with 1991–2000, exposure to heat increased by 1·17 billion (254%) person-days among infants and older people (≥65 years; indicator 1.1.1), and the average annual number of hours when heat exposure made light or moderate physical activity unsafe increased by 60 (88%). More than 1 million additional people were affected by moderate or severe food insecurity across Europe in 2023 compared with the annual average for the period 1981–2010, due to increased heatwaves and drought exposure. The increased annual mean temperature is estimated to have reduced the labour supply by approximately 24 h per worker per year across Europe in 2000–23, compared with 1965–94.
The climatic suitability of emerging and re-emerging infectious diseases has increased rapidly over the past decade due to climate change, manifested by a geographical range expansion of some disease vectors, accompanied by more frequent outbreaks in Europe. For example, the annual transmission suitability for dengue virus increased by 297% in Europe in 2015–24, compared with 1981–2010, likely contributing to the rising number of local outbreaks of Aedes-borne arboviruses in Europe. Additionally, climate change has prolonged the pollen season by 1–2 weeks, increasing the duration of exposure for people with allergic rhinitis.
Climate change risks, vulnerabilities, and impacts are unevenly distributed across population groups and regions. Low-income households in Europe are 10·9 percentage points more likely to experience food insecurity due to an increase in heatwave and drought events compared with middle-income households. Outdoor workers in construction and agriculture are at particular risk of heat-related injuries due to increased heat exposure. People living in the poorest regions experience increased wildfire risks and less access to green space compared with those living in less deprived regions. Although we observe an increasing number of countries that have established national health adaptation plans and offer climate services to the health sector, it is important to ensure that adaptation strategies consider differences in risks to protect groups most vulnerable to the effects of climate change.

An integrated approach to climate change mitigation is needed

In Europe, carbon intensity and coal use declined in 2023 compared with 2022. Conversely, annual fossil fuel subsidies reached a new high in 2023 compared with 2010, reaching €444 billion in 2023, reflecting government responses to soaring energy prices after Russia's invasion of Ukraine. At the same time, the share of renewable energy in the total European electricity supply increased to 21·5% in 2023, compared with 8·4% in 2016. Investment trends also point in a positive direction; clean energy investment was €427 billion compared with €229 billion in 2015 (86% higher) and fossil fuel investment was €76 billion in 2024, compared with €112 billion 2015 (32% lower) Although governments increased support for fossil fuels, particularly in response to geopolitical instability, upward trends in clean energy investment and renewable expansion were evident but need to be accelerated.
Progress towards the transition to renewable energy is underway; however, solid biomass, a major contributor to air pollution, accounted for 31% of total renewable energy consumption in 2023. Air pollution-attributable deaths from residential biomass burning increased by 1 per 100 000 (4%) in 2022 compared with 2000. The use of biomass for residential heating contributes to net tree cover loss, which increased by 80% in 2014–23, compared with 2001–10. Shifting away from combustion-based residential heating towards cleaner alternatives such as heat pumps should be a priority.
Air pollution-attributable deaths from the power and transport sectors continued to decline, despite the minimal decline in greenhouse gas emissions in the transport sector. Health-care sector greenhouse gas emissions declined slightly in 2022; however, the negative health effects attributable to health-care induced air pollution have increased by 24%, compared with 2010. Integrated approaches to climate mitigation and adaptation are essential to maximise both climate and health co-benefits, the latter of which refers to improvements in human health that arise directly or indirectly from climate action.

Declining engagement with the climate change and health nexus

Despite increasing numbers of scientific studies published on the nexus of climate change and health, individual, political, corporate, and media engagement with the nexus showed a concerning decline in 2023, compared with previous years. Encouragingly, climate litigation has emerged as a powerful platform for elevating the health argument within the broader climate agenda. The International Court of Justice determined that states have a binding legal obligation to act against climate change and recognise its effects on human wellbeing and planetary health.
In many respects, Europe is leading the transition to a healthier and safer future among world regions, notably by reducing its greenhouse gas emissions. However, increasing momentum is needed, particularly in the implementation of adaptation and mitigation policy at the local and national level, where the health co-benefits of climate action are expected to realise.