• environmental medicine
• wilderness medicine
• global health

The greatest global health threat of the 21st century is upon us and global emergency medicine (EM) is nowhere to be found.1 As other medical specialties articulate and advise the public and policy-makers on the health effects of a changing climate, EM is conspicuously absent, lacking a coherent message or even a single policy statement. Yet like it or not, EM is already in the centre of this issue and is best suited to lead and to author the narrative on the impending clinical impact.

The science is unambiguous. The health effects of anthropogenic climate change are more obvious than ever and are accelerating at an ominous pace. Global warming will now continue under all future scenarios, and the impact on human well-being will be significant and pervasive.

For the past few years climate change has dominated the news—2015 was the warmest year in the history of weather record-keeping and 2016 is hotter still.2 3 The atmospheric carbon dioxide level has exceeded anything measured in the past 1.2 million years.4 The largest and most powerful storms ever recorded have occurred in the past 3 years.5 These drastic changes to our ecosystems will undermine healthy living, exacerbate chronic illness and stress socioeconomic determinants of health— all directly contributing to increased morbidity and mortality.6

Accordingly, a growing number of leading organisations within the health sector have recognised and addressed these threats. In the USA, the American Public Health Association, the American College of Physicians and the American Academy of Family Practitioners are just a few major colleges that have mobilised resources to affect education, mitigation and policy. In the UK, the Lancet Countdown has been transformative in promulgating attention to growing health impacts. Some emergency physicians say that we have no particular vested interest in issues of …