Climate Crisis and Health: Education of health professionals for Transformative Action, Germany

Climate change is one of the great challenges to human health and well-being in Europe. Assuming the present vulnerability and no additional adaptation, annual fatalities from extreme heat in Europe could rise from 2,700 deaths/year now to approximately 30,000 and 50,000 by 2050 with 1.5°C and 2°C global warming , respectively. An additional 15 million European living in the proximity of wildland would be exposed to high extreme fire danger for at least 10 days/year and almost half a million people in the EU and UK would be exposed to river flooding each year. In addition, climate change increases the likelihood of occurrence of infectious diseases such as Dengue fever and West Nile fever, increase of allergic diseases and other pulmonary diseases due to longer allergenic exposures and air pollution as well as mental health implications. The health effects are expected to be more severe for elderly people and people with infirmities or pre-existing medical conditions. Climate change already affects all clinical disciplines and its implications for human health need to be addressed at a diagnostic, therapeutic and organizational level. However, there is a lack of information and knowledge within the health care sector regarding the climate-related disease patterns. Climate change is rarely addressed in both education of health professionals and the training of practicing medical and public health staff. This affects the development of preventative health strategies as well as the ability of the health professionals to raise awareness among the general public about the climate change impacts.

The Planetary Health Academy aims to provide the continuing professional education on climate crisis and health and communication training. Further, its lecture series has a focus on transformative action. Planetary Health Academy lectures have the following objectives: To raise awareness among health professionals of the health consequences of the climate crisis and their responsibility to convey the urgency of action to policy makers, patients and the general public, To educate health professionals on climate-related medical challenges, such as adapting medication during heat waves, To enable people to act as multipliers in communicating the connections between climate and health, To encourage socio-political commitment, To motivate sustainable action in the sense of an emission-neutral health sector, To integrate research findings on the health consequences of climate crisis in basicand advanced training for the health professions, To fill the knowledge gaps that exist in medical universities in terms of teaching on these subjects.

In 2020, the German Alliance for Climate Change and Health (KLUG), a network of individuals, organisations and associations from the health sector, launched the Planetary Health Academy , a lecture series on planetary health (i.e. global human health and the state of the natural systems on which it depends) for physicians, trainees, students and employees of all health professions. This series offers practical suggestions for implementation in everyday working life (e.g. working with patients), in order to address the gaps existing in terms of education on these topics in German medical universities. The Planetary Health Academy is aimed at all interested parties from the healthcare sector. During the COVID-19 pandemic, lectures were delivered online due to the impossibility of arranging physical meetings - and with the additional benefit of reaching a larger audience and attracting health professionals worldwide. The lectures are free of charge, open to all interested parties and give participants the opportunity to deal intensively with the topic of health and the environment. Each lecture series involves 6 to 9 events of 1.5 hours each. The contents of all lecture series are subsequently prepared as videos including materials (presentations, background information, etc.) and made permanently available via the Planetary Health Academy website. The first lecture series were delivered in German and focused primarily on students and trainees in the health care professions. The second and third editions, in English, were aimed at an international audience. The fourth edition of the online lecture started in November 2021, including 9 lectures in German by more than 20 renowned experts from various clinical disciplines, including general medicine, paediatrics, anaesthesia, and other. Based on the recently published textbook “ Planetary Health - Climate, Environment and Health in the Anthropocene ", the focus was on clinical content, with particular emphasis on the connection between various medical disciplines and planetary health, to explore the clinical effects of climate crisis for individual specialist fields and areas of action. The Planetary Health Academy continues to broaden its offer including workshops and labs that focus on specific topics, such as heat or psychological impacts of the climate crisis, with smaller groups of approximately 20 people. The lectures are certified as advanced medical training by the Berlin Medical Association and the Austrian Medical Association. Physicians can receive three Continuing Medical Education (CME) points per lecture for a representation allowance. The lecture series is recognised as an elective/ optional subject at various German universities, for example in Aachen and Freiburg.

KLUG, the organisation that founded Planetary Health Academy, is financed by private donors and receives institutional funding by the Mercator Foundation , the European Climate Foundation , and by the Federal Environment Agency (115,000 Euro in years 2019-2021) and the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety and Deutsche Bundesstiftung Umwelt (DBU). The Planetary Health Academy incurs personnel costs for the organisation, moderation, preparation, and follow-up of materials, as well as costs for technical equipment. For the participants, the online lecture is free of charge and the lecturers do not receive a fee. Doctors can receive 3 CME points for an expense allowance of 25 euros per lecture. The lecture series has led to a significant number of health professionals and students to become active change agents for planetary health by hosting educational programs themselves, organising protest actions, creating public awareness, and reaching out to politicians. Examples of transformative action in the Planetary Health Academy lecture series sparked the formation of 20 new “ Health for Future ” groups in the course of the lecture series. Health for Future is a movement of health professionals and students who conduct transformational projects on a local, national and international level, currently including over 70 local groups in Germany, Austria, Switzerland and Belgium.

The semesters of the Planetary Health Academy have generated large interest in the topics. On average, 1000 participants attended each lecture with a peak at 1500 people/ lecture during the first semester. Free and online lessons are a key success factor that attracted large public, as well as the possibility to get a certificate of attendance. Over 70 physicians were accredited over the first three semesters. Regarding the limiting factors, it would be possible to reach even more people interested in the topic by communicating more broadly. The chosen language for each lecture series limited the audience to participants speaking German or English respectively. Advantages of an online format outnumber its restrictions; yet, still, some aspects as networking and a strong sense of community might benefit from in-person meetings. In addition, there is also a gap between the number of attendees and the low number of accredited physicians. Many physicians might have participated but not gone through the process to receive accreditation.