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Conference, conscience and climate
  1. Hugh Montgomery
  1. Correspondence to Professor Hugh Montgomery, UCL Institute for Human Health and Performance, 4th Floor, Rockefeller Institute, 21 University Street, London WC1E 6DE, UK; h.montgomery{at}

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Climate change due to the emission of greenhouse gases (GHGs) represents a grave threat to human health and survival. But will abandoning the international conference make a difference?

Climate change and impacts on human health

The physical properties of some atmospheric gases to ‘trap heat’ was first described by John Tindall in 1863. Since then—in a little <150 years—human activity has increased the concentration of such GHGs to the highest the earth has experienced in 15 million years.1 In response, political efforts have focused on efforts to limit GHG emissions such that the earth's global mean temperature rises by no more than 2°C. However, far from reducing, GHG emissions are accelerating, their annual rate climbing by nearly 50% since 1990, and by 5.9% in 2010 alone. The International Energy Authority warns that “the door to 2°C is closing.”2 Such warming will prove catastrophic to human health and survival in our time and that of our children,3 the ‘2°C barrier’ now recognised to represent the threshold “between dangerous and extremely dangerous climate change.”4

Steady rises in temperature (with altered rainfall patterns) can be harmful, and may increase exposure to allergens such as those from ragweed. Meanwhile, the occurrence of recent extreme weather events can now be confidently ascribed to climate change5 and severe storms, coastal surges, floods and droughts will become increasingly frequent and severe.6 Intense precipitation causes surface runoff and increased contamination of water with particulate and microbial materials, including sewerage.7 Extreme temperatures, such as those seen in the European and Russian heat waves of the last decade, are intrinsically lethal—but also through the reduction of food availability. Flooding in July 2010 left a fifth of Pakistan's land mass submerged while, in the same year, Russia's hottest summer for 130 years was similarly devastating to crop production. Rising temperatures reduce rice production, which peaked a decade ago. Such impacts of climate change on food production are likely to extend worldwide, and to be compounded by other effects: warm water holds less oxygen and this, with acidification due to CO2, threatens marine ecosystems. The associated rise in food prices further limits food intake, and leads to civil unrest (below).

Climate change influences pathogen maturation and multiplication, and vector density and behaviour, expanding risk related to diverse diseases including schistosomiasis, dengue fever, salmonella infection, leishmaniasis, Lyme disease, trypanosomiasis and onchocerciasis.8 Such impacts are already seen.9

Climate change will also drive conflict through drought, disease, flood, famine, loss of natural habitats and of human habitation, insolvency and loss of infrastructure. These effects have long been recognised: wars in Africa peak in the hottest and driest years, while the risk of civil war rises over large and varied land masses during the warmer phases of the (natural) El Niño-Southern Oscillation: such cyclical warming has contributed to one-fifth of such civil conflicts since 1950.10

The moral imperative for urgent action to deal with climate change is thus clear and is not restricted to healthcare professionals. All citizens must recognise their responsibilities and take action in the personal (home, community, friends and family), professional (place of work, societies, national bodies) and political aspects of their lives. That said, given their role in promoting health and preventing suffering, healthcare workers perhaps have a special responsibility to act.

International conference: is abstinence an answer?

There is no doubt that international travel is associated with a substantial cost in GHG emissions. The carbon burden of flying delegates to and from the 2006 American Thoracic Society conference in San Diego was estimated to be 10 800 tonnes, representing some 100 million person air miles.11 Large international medical conferences thus have a very significant ‘carbon footprint’—estimated to be some 600 000 tonnes of carbon30—a staggering 0.3 trillion litres of CO2, well over 60 billion litres of which will still be warming our atmosphere in 33 000 years time. This represents the sustainable carbon emissions for around half a million people in India or the carbon dioxide absorbed by 120 million mature trees covering 120 000 hectares of rainforest.12 In addition, there is the cost of bus and taxi ground transport, and of the vast energy costs of hotels and conference centres.

These conferences can, of course, be profitable for health-sector technology and pharmaceutical companies, and for the many businesses (such as hotels and airlines) whose services are engaged. They help build the reputation of ‘the great and good’.13 They may also be fun and stimulating for delegates. But while enjoyable for many, the real academic value of such meetings has recently been called into question.14 The value of ‘the scientific congress abstract’ is certainly doubtful, while results from ‘the big breaking studies’ will be disseminated (and critically evaluated) through conventional routes.

Only the most nihilistic, however, would not see that conferences abroad do have some value. Scientific collaboration is often harder to nurture without social interaction. Great ideas are often stumbled upon or explored in hotel bars. However, it seems that these increasingly represent the main values of such meetings: conventional information can be obtained and scrutinised from the desk, and meetings held via the internet. Even conference presentations can now be given without substantial detriment in the same way: I recently delivered a lecture ‘in Dublin’ but, instead of facing a 2-day trip, was back at my desk in under 70 min. My life was enriched as were the coffers of the society which had invited me.

All of this said, “to go or not to go” has to be a decision made after balanced consideration of one's personal carbon footprint (See What action will make the biggest difference most readily? Turning down the thermostat by 1°C in the winter can reduce heating-related emissions by 7–11%. Attending to the unglamorous issues of wall and loft insulation and condensing boilers may have substantial benefits, while also saving money. Moving an electricity account to a ‘100% renewable’ supplier ( is simple and easy. Moving a bank account to a bank which does not invest in fossil fuel (for instance, the Cooperative Bank- (,)) will make a disproportionate difference. But, that said, restricting travel to international conferences can make a big difference too: not taking a return flight to Los Angeles will save GHG emissions equivalent to nearly 1 million litres of CO2.

But does this mean missing out on academic contact? Not necessarily. Our societies have an obligation to act, too, making local and national meetings worthwhile substitutes. Perhaps, rather than 5000 UK delegates flying to a conference in the USA, our societies might (where strictly necessary) fly 10 key speakers to a UK conference? Or, better still, arrange excellent videoconferencing presentations? James Moon and colleagues have offered an excellent guide.15 Using technology frees time—time which might then be gainfully used in other academic activity, or even in social recreation (a football match at the weekend) without great loss. Finally, taking the Eurostar to Geneva does take longer but emissions are much lower, and one can work on the train.


Climate change poses a clear, grave and immediate threat to human health and survival. We all have a responsibility to act, and to act fast. What actions each individual takes will depend upon their own lifestyles and what is “most amenable to impact”—an issue readily resolved by use of an online carbon calculator. However, limiting travel to international conferences seems both sensible and feasible. Doing so may benefit our pockets and those of our societies, while enriching our lives. But one thing is clear. It will save lives.


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  • HM is a member of the UK Climate and Health Council.

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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