---
title: "Phase out fossil fuels to protect health and national security"
id: "bmj-4-for-the-sake-of-both-health-and-security-phase-out-fossil-fuels"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-4-for-the-sake-of-both-health-and-security-phase-out-fossil-fuels"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "BMJ"
source_url: "http://www.bmj.com/content/395/bmj-2026-101202.short?rss=1"
published_at: "2026-10-22T13:16:11.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Phase out fossil fuels to protect health and national security
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-4-for-the-sake-of-both-health-and-security-phase-out-fossil-fuels
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** BMJ
- **Source URL:** [Original Journal Publication](http://www.bmj.com/content/395/bmj-2026-101202.short?rss=1)
- **Published At:** 2026-10-22T13:16:11.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- The editorial argues that the extraction and use of **fossil fuels** drive both the climate emergency and security threats, and calls for accelerated phase-out at COP31. - Investigators reported record heat signals: the World Meteorological Organization predicts one year between 2026 and 2030 may surpass 2024 as the hottest on record. - The 2024 heat burden cost an estimated 639 billion working hours and $1.09tn in lost income globally, while wildfires in Canada burned more than four million hectares in August. - Health systems face a new “twin crisis” of summer and winter demand; NHS emergency departments recorded 7.3 million attendances this summer, 7.5% higher than last winter. - Climate-driven disasters have quintupled in the last 50 years; glacier melt and flooding in Nepal produced more than 1400 deaths and over 6000 missing persons, despite Nepal contributing under 0.1% of global greenhouse gas emissions. - Conflict amplifies climate harms: analysis cited shows early-phase climate pollution from the Iran war exceeded Iceland’s 2024 emissions; wars also damage food and water systems with downstream health effects such as increased stunting. - Media attention to the climate emergency has fallen 38% since 2021, even as climate-related mortality exceeds deaths from armed conflict. - Fiscal data reported that from 2015–2019, every dollar on fossil fuel subsidies displaced $0.35 of health spending; global military spending reached about $3tn in 2025 while development assistance was about $174bn. - The editorial urges redirecting fossil fuel subsidies and mineral revenues to health, centering communities most harmed—especially women, children, and adolescents—and addressing climate anxiety and coping mechanisms. - The authors frame the arms industry as a commercial determinant of health and call for rebalancing spending priorities; COP31 must accelerate the phasing-out of **fossil fuels**.
## Clinical Analysis & Structured Key Points
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[News & Views](https://www.bmj.com/us/news) 2. For the sake of both... 3. For the sake of both health and security: phase out fossil fuels Editor's Choice # For the sake of both health and security: phase out fossil fuels BMJ 2026; 395 doi: (Published 22 October 2026) Cite this as: BMJ 2026;395:e101202 * [Article](https://www.bmj.com/content/395/bmj-2026-101202 "Article Tab - Article")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_art/node:1129240/1 "Article Tab - Article") * [Related content](https://www.bmj.com/content/395/bmj-2026-101202/related "Article Tab - Related Articles")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_related_art/node:1129240/1 "Article Tab - Related Articles") * [Metrics](https://www.bmj.com/content/395/bmj-2026-101202/article-info "Article Tab - Info & Metrics")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_info/node:1129240/1 "Article Tab - Info & Metrics") * [Responses](https://www.bmj.com/content/395/bmj-2026-101202/rapid-responses "BMJ Article Related Rapid Responses")[](https://www.bmj.com/panels_ajax_tab/bmj_related_rapid_responses/node:1129240/1 "BMJ Article Related Rapid Responses") * [Peer review](https://www.bmj.com/content/395/bmj-2026-101202/peer-review "Article Tab - Peer review")[](https://www.bmj.com/panels_ajax_tab/jnl_bmj_tab_peer_review/node:1129240/1 "Article Tab - Peer review") * [](https://www.bmj.com/content/395/bmj-2026-101202/submit-a-rapid-response "BMJ Rapid Responses Form")[](https://www.bmj.com/panels_ajax_tab/bmj_rapid_responses_form/node:1129240/1 "BMJ Rapid Responses Form") ![Loading](https://www.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif) 1. Kamran Abbasi, editor in chief [Author affiliations](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1) 1. The BMJ 1. kabbasi@bmj.com Summer is coming. While superpowers engage in forever wars; while nation states, rogue states, and failed states flex their weaponry; while old alliances are abandoned and new ones forged; while our thoughts are consumed by security threats and our leaders dream of building military might; while the elite pray to new gods and dream of new worlds; while the growing ranks of undeserved and underserved poor people are too distracted, disempowered, or disinformed to contemplate a better future; while the people tasked with securing our existence are conflicted by personal, corporate, and national interests; and while we banish our greatest threat, the threat we must unite against, from our collective conscience, the forces of summer are breaching our planetary walls (doi:[10.1136/bmj-2026-101184](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101184))[1](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-1)—and they bring annihilation. As we squabble over power, politics, and pride, the world burns. The World Meteorological Organization predicts that one of the years 2026-30 will exceed 2024 to become the hottest on record.[2](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-2) More than 500 wildfires burned more than four million hectares of Canada in August (doi:[10.1136/bmj-2026-101071](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101071)).[3](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-3) Being rich is no protection. Melting and collapsing glaciers caused catastrophic flooding in Nepal (doi:[10.1136/bmj-2026-101101](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101101))[4](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-4): more than 1400 people died, and more than 6000 are missing. Being poor makes you more vulnerable. Nepal generates under 0.1% of global greenhouse gas emissions. “We did not create this crisis,” Nepal’s prime minister told the United Nations—“yet we are paying a colossal price for it.” British summers could reach 45°C by 2056 (doi:[10.1136/bmj-2026-101151](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101151)).[5](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-5) Temperatures inside health facilities tend to be higher than outside. The UK requires a radical overhaul of its health infrastructure, which isn’t fit for purpose, and it needs new ways to deliver health and care services. The NHS, which struggles to respond to an annual winter crisis of demand, now faces a “twin crisis” in summer and winter (doi:[10.1136/bmj-2026-101149](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101149)).[6](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-6) This summer was the “busiest ever” and exceeded winter demand. A record 7.3 million people attended emergency departments, 7.5% higher than an equivalent period last winter. Globally, the impact of heat in 2024 was an estimated loss of 639 billion working hours and $1.09tn (£810bn; €970bn) in lost income (doi:[10.1136/bmj-2026-101095](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101095)).[7](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-7) Weather related disasters, driven by climate change, increased fivefold in the last half century. A practical guide for clinicians, who are often the first to be consulted or to respond, might help here (doi:[10.1136/bmj-2026-100635](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-100635))[8](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-8)—as might compassionate listening skills (doi:[10.1136/bmj-2026-100913](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-100913)).[9](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-9) Unfortunately, much of the harm is ignored by the media. Print and online coverage of the climate emergency has dropped 38% since 2021 (doi:[10.1136/bmj-2026-101050](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101050)),[10](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-10) when it was competing with covid-19 for headlines. Even as the climate emergency deepens, today’s media coverage is dominated by conflict. Yet the climate emergency kills more people each year than armed conflict (doi:[10.1136/bmj-2026-101055](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101055)).[11](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-11) Militarists see climate change as a “threat multiplier” that increases national security risks and demands greater military spending. Alternatively, we might see the arms industry and armed conflict as “climate change multipliers.” The Iran war produced more climate pollution in its first 14 days than Iceland did in 2024 (doi:[10.1136/bmj-2026-101023](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101023)).[12](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-12) The climate impact of conflict extends to the food system, which produces more calories per capita than ever but contends with localised food shortages—primarily in conflict settings, with immediate and long term harms to health, such as a rise in prevalence of stunting (doi:[10.1136/bmj-2026-101113](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101113)).[13](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-13) Wars also damage water systems. “Without water there is neither health nor durable peace,” say Rohit Ramchandani and colleagues (doi:[10.1136/bmj-2026-101168](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101168)); “Without peace, water is never secure.”[14](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-14) Within a few months of Russia’s invasion of Ukraine, six million people experienced water scarcity. Even without conflict, the effects of heat and drought threaten water availability: the UK’s Environment Agency predicts a daily water shortage of five billion litres by the 2050s (doi:[10.1136/bmj-2026-101102](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101102)).[15](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-15) ## Subsidies and spending Solutions exist. We can divert fossil fuel subsidies and critical mineral revenues towards health (doi:[10.1136/bmj-2026-100890](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-100890)).[16](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-16) From 2015 to 2019, each dollar spent on fossil fuel subsidies displaced $0.35 spent on health. We might spend more again on international development: military spending reached about $3tn in 2025, while development assistance fell to a trifling $174bn by comparison (doi:[10.1136/bmj-2026-101040](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101040)).[17](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-17) We should place communities hit hardest by the climate crisis at the heart of the response, especially women, children, and adolescents (doi:[10.1136/bmj-2026-100970](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-100970)).[18](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-18) We might also seek out coping mechanisms to reduce climate anxiety (doi:[10.1136/bmj-2026-101056](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101056)).[19](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-19) How about simply planting more trees? (doi:[10.1136/bmj-2026-100998](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-100998))[20](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-20) At the heart of the issue is a difficult trade-off. Defence is essential, but how can we achieve a balance that provides security while maximising health and wellbeing? The data and our lived experience of the world tell us that a rebalancing is required to de-escalate conflict, spread peace, and invest in the health and wellbeing of people and the planet. But the calculus seems impossible, as we fail to face up to the common driver of the security crisis and the climate disaster: extraction of fossil fuels. Next month’s UN Climate Change Conference (COP31) has a duty to accelerate the phasing-out of fossil fuels (doi:[10.1136/bmj-2026-101167](https://www.bmj.com/lookup/doi/10.1136/bmj-2026-101167)).[21](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-21) We would be wise to consider the arms industry a commercial determinant of health—an industry motivated by profit, delivering injury, displacement, and death (doi:[10.1136/bmj-2025-086166](https://www.bmj.com/lookup/doi/10.1136/bmj-2025-086166)).[22](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#ref-22) A confluence of interests between governments, militaries, and arms companies—now joined by the biohackers and the planetary terraformers—drives the booming military-industrial complex. This is no war game, no fictional _Game of Thrones_. Winter isn’t coming—but summer is. ## References 1. [↵](https://www.bmj.com/content/395/bmj-2026-101202.short?rss=1#xref-ref-1-1 "View reference 1 in text") 1. Dobson J . 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BMJ2026;395:e101184.doi:10.1136/bmj-2026-101184 [OpenUrl](https://www.bmj.com/content/395/{openurl}?query=rft.jtitle%253DBMJ%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj-2026-101184%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx)[FREE Full Text](https://www.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6MzoiYm1qIjtzOjU6InJlc2lkIjtzOjIwOiIzOTUvb2N0MjFfMTIvZTEwMTE4NCI7czo0OiJhdG9tIjtzOjI5OiIvYm1qLzM5NS9ibWotMjAyNi0xMDEyMDIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)[Google Scholar](https://www.bmj.com/lookup/google-scholar?link_type=googlescholar&gs_type=article&author\[0\]=J+Dobson&title=Earth%E2%80%99s+liveable+limits+breached+further+this+year&publication_year=2026&journal=BMJ&volume=395) 2. 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BMJ2026;395:e101101.doi:10.1136/bmj-2026-101101 [OpenUrl](https://www.bmj.com/content/395/{openurl}?query=rft.jtitle%253DBMJ%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj-2026-101101%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx)[FREE Full Text](https://www.bmj.com/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6MzoiYm1qIjtzOjU6InJlc2lkIjtzOjIwOiIzOTUvb2N0MjFfMTEvZTEwMTEwMSI7czo0OiJhdG9tIjtzOjI5OiIvYm1qLzM5NS9ibWotMjAyNi0xMDEyMDIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)[Google Scholar](https://www.bmj.com/lookup/google-scholar?link_type=googlescholar&gs_type=article&author\[0\]=E+Mahase&title=In+South+Asia+the+most+vulnerable+people+are+paying+for+a+climate+crisis+cr
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