A call for action: integrating climate change into the medical school curriculum

The world is experiencing unprecedented changes in the global climate system. The increase in the number of extreme weather events, including rising temperatures, extended heatwaves, hurricanes, flooding, droughts and wildfires, has been steadily increasing in every region of the world since the 1990s [1]. The global mean surface temperature has increased and atmospheric concentrations of carbon dioxide and other greenhouse gases (e.g., methane) have risen. Ice caps are melting; sea levels are rising. The 2018 Lancet Countdown report, which monitors the impacts of climate change on health, concluded that many of the global trends identified in its 2015 report (e.g., vulnerability to heat, vectorial capacity for disease, terrestrial and marine food security) have accelerated in terms of the impact of climate change on health [2]. The 2018 report ominously concludes that based on analysis of the data, climate change is ‘the biggest global health threat of the 21st century’. The implications of extreme weather and climate events on the environment as well as on health status are apparent, with young children, the elderly and patients with comorbid conditions most vulnerable [3]. Twenty-three percent of global deaths and 22% of global disability adjusted life years (DALYs) were attributable to environmental risks in 2012, and nearly a quarter of global disease burden could be prevented by reducing environmental risks [4]. For example, coal burning power plants spew harmful levels of sulphur dioxide and particulate matter into the air and exposure to ambient air pollution and fine particulate matter have serious implications for respiratory diseases. Air pollution alone contributed to an estimated 6.5 million deaths in 2015 [5]. Heat stress ex-