The First ‘Health’ COP Must Prioritize Sexual and Reproductive Health and Rights for Young People

COP28 is being hailed as the first “Health COP,” bringing attention to critical climate and health issues—but gaps remain on issues like sexual and reproductive health.

Participants arrive at the Health Day Opening Session at Al Waha Theatre on day four of the UNFCCC COP28 Climate Conference on Dec. 3, 2023, in Dubai, United Arab Emirates. (Sean Gallup / Getty Images)

The 28th U.N. Climate Climate Change Conference (COP) currently meeting in Dubai until Dec. 12, is being hailed as the “Health COP“––promising to bring the climate and health agenda into the mainstream. Yet we are seeing almost no direct focus on sexual and reproductive health and rights (SRHR), which is a critical gap because climate change creates barriers to fulfilling those rights.

Ensuring the SRHR of girls and women supports their bodily autonomy and ability to control their life choices, building resilience and adaptive capacity to climate change, which in turn can facilitate engagement in climate action.

Young people, particularly adolescent girls and young women, are at the forefront of the climate crisis because they will experience compounding and cascading events over their lifetime, with implications for their ability to finish school, control their own bodies, live healthy lives, and make their own choices. 

Girls and women are already often in vulnerable situations, and climate change is reinforcing harmful gender norms and economic insecurity that will limit their progress and well-being. 

  • During a climate-related disaster, adolescent girls may move into shelters where they are at risk of gender-based violence or assault, face challenges to menstrual dignity and have no access to vital services such as contraception, maternal and newborn care and safe abortion, among others. 
  • With chronic droughts and agricultural losses, adolescent girls and their families may manage household economic insecurity by pulling girls out of school early or marrying them at young ages.

In Malawi, an estimated 1.5 million girls are at risk of becoming child brides. Rising temperatures mean that adolescent girls and young women face worse pregnancy and birth outcomes, such as miscarriages and preterm births, with lifelong implications for mothers and their families over the life course.

The burden to create change should not rest with adolescent girls and young women themselves.  

Funding, attention and political will for climate change has disproportionately centered on mitigation (ways to reduce greenhouse gas emissions). A recent push by many advocates for climate policy to balance mitigation with climate adaptation, or the ways that people and communities will need to adjust and cope with climate change, has been slow to action. This shift to prioritize adaptation is crucial for improving everyone’s health and well-being and must acknowledge:

  • Climate justice: Those who contribute the least to emissions are disproportionately affected; and therefore, the response to the climate crisis must hold those responsible to account while prioritizing the needs and rights of marginalized and vulnerable communities.  
  • Intergenerational inequity: A child born in 2020 will face up to seven times more extreme climate events than one born in 1960. 
  • Intersections with gender equality: Climate change disproportionately harms women and girls, and existing economic and social inequalities make many girls and women even more vulnerable.

Young people in low- and middle-income countries (the majority world) are intergenerationally and geographically impacted inequitably by climate change—yet they have not contributed to the crisis. They are harmed by its effects, and feel a sense of anxiety and fear about their futures. They also have ideas about how to address the crisis, a desire to support change in their communities, and a right to be part of decision-making processes. But, the burden to create change should not rest with adolescent girls and young women themselves.  

The responsibility of reducing emissions, supporting adaptation and financing climate action rests with the wealthy nations—and corporations—who have contributed to the current crisis. The average person in a high-income country emits over 30 times the carbon dioxide, a major contributor to climate change, as those in low-income countries, while 100 companies are responsible for an estimated 71 percent of global emissions since 1988. 

Activists protest on day seven of the UNFCCC COP28 Climate Conference at Expo City Dubai on on Dec. 6, 2023, to demand loss and damage payments by rich countries to poor countries affected by climate change. (Sean Gallup / Getty Images)

It is also critical to highlight that SRHR, especially access to contraception, must be firmly situated in an adaptation and resilience frame that centers human rights, social justice and equity. We cannot place the burden of mitigating greenhouse gas emissions on girls’ and women’s bodies—particularly marginalized women who have made negligible contributions to climate change but disproportionately face the worst consequences of it.     

COP is where countries and governments set the global climate change agenda for the upcoming years. Therefore, if SRHR is missing at COP, it will not be well represented in country policies—including national adaptation plans (NAPs) and nationally determined contributions (NDCs). NAPs and NDCs outline country policies to meet global goals to address climate change impacts and reduce emissions, and they define priorities and guide decisions to allocate resources and investments.

  • A recent report found only 10 out of 19 NAP documents reviewed reference SRHR related issues. 
  • A UNFPA review of 119 NDCs found 38 with direct references to SRHR or gender-based violence. Gender was referenced in 109, and gender in relation to health in 48 of them. These have increased over time but still fall short in driving gender-responsive action.

Health was identified as a relevant area in all 119 NDCs reviewed by UNFPA—yet the critical intersection of SRHR for young people requires more attention. 

The world is currently home to the largest population of young people in history, with 1.8 billion young people. As COP28 takes place, we are inspired to see the additional focus on health—but to drive effective change, this must include language regarding the intersections of SRHR, gender and youth with a focus on the most vulnerable and marginalized groups. 

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About , and

Jessie Pinchoff is an associate at the Population Council and also serves as co-lead of the Council’s Population, Environmental Risks, and the Climate Crisis (PERCC) initiative . In this role, she provides strategic input to climate change–related work across Council offices and guides the Council’s work in examining critical intersections between climate and health. Pinchoff has a PhD in global disease epidemiology and control from the Johns Hopkins University Bloomberg School of Public Health. You can find more of her work here.
Karin Watson Ferrer is a 25-year-old human rights activist and designer. She was born and raised in Chile, and currently lives in Barcelona, Spain. She works especially on the intersection between climate justice and gender equality. Karin was a founding member of Amnesty International’s Global Youth Collective and Co-founder of the Re-earth Initiative. For Latinas for Climate, she is one of the general coordinators and is in charge of design and communications. You can find more of her work here
Eleanor Blomstrom serves as Senior Manager, Policy and Advocacy for Women Deliver. She brings more than ten years of experience in global policy and advocacy at feminist NGOs, including with Fòs Feminista, the International Women’s Health Coalition (IWHC) and the Women’s Environment and Development Organization (WEDO). She holds a BA in Environmental Science from Northwestern University and a Master of International Affairs in Urban and Environmental Policy from the School of International and Public Affairs at Columbia University. You can find more of her work here.