The sixth annual report of the Lancet Countdown that tracks 44 indicators of health impacts linked to climate change has sounded 'Code Red.'

It calls on global leaders to put actions and policies in place to address stark inequalities, improve health and deliver economic and environmentally sustainable COVID-19 recovery plans.

Coming ahead of UN Climate Change Conference COP26 in Glasgow, it will put pressure on world leaders gathering to address climate change impact to do more.

“It’s time to realise that no one is safe from the effects of climate change. As we recover from COVID we still have the time to take a different path and create a healthier future for us all,” a Lancet editorial warns.

Researchers from 38 academic institutions and UN agencies took part in preparing this report. The health impact warns of rising infectious diseases that were once the mainstay of developing countries:

The potential for outbreaks of dengue, chikungunya and Zika is increasing most rapidly in countries with a very high human development index, including European countries.

Malaria infections will increase in cooler highland areas of countries with a low human development index.

Coasts around northern Europe and the US are becoming more conducive to bacteria which produce gastroenteritis, severe wound infections, and sepsis.

The report sounds a stark warning for the 569.6 million people living less than five metres above current sea levels, who could face rising risks of increased flooding, more intense storms, and soil and water salinification.

Some important highlights of the report include:

• In 2018, 65 out of the 84 countries analysed by Lancet Countdown researchers had net-negative carbon prices equivalent to an overall subsidising of fossil fuels. The median value of the subsidy was US$1 billion, with some countries providing net subsidies to fossil fuels in the tens of billions of dollars each year.

• The 84 countries surveyed are responsible for around 92% of global CO2 emissions.

• In 2020, adults over 65 were affected by 3.1 billion more days of heatwave exposure and children younger than 1 were affected by 626 million more days than in the 1986–2005 baseline average. Chinese, Indian, American, Japanese, and Indonesian senior citizens were the most affected.

• Ideal conditions are being created for infectious disease transmission, potentially undoing decades of progress to control diseases such as dengue fever, chikungunya, Zika, malaria, and cholera.

• It highlights how ill-prepared healthcare systems are for current and future climate-induced health shocks.

• Only 45 (49%) of 91 countries in 2021 reported having carried out a climate change and health vulnerability and adaptation assessment.

Extreme weather events, infectious diseases, food insecurity, sea-level rising - the report shows how in 2020, the world was in a worse place than before:

• In 2020, up to of 19% of the global land surface was affected by extreme drought in any given month, a value that had not exceeded 13% between 1950 and 1999.

• Climate change is driving an increase in the frequency, intensity, and duration of drought events, threatening water security, sanitation, and food productivity, and increasing the risk of wildfires and exposure to pollutants. The five years with the most areas affected by extreme drought have all occurred since 2015.

• Climate change threatens to accelerate food insecurity, which affected 2 billion people in 2019. Rising temperatures shorten the time in which plants reach maturity, meaning smaller yields and an increased strain on our food systems. Maize has seen a 6% decrease in crop yield potential, wheat a 3% decrease and rice a 1.8% decrease, compared to 1981 – 2010 levels.

• Average sea surface temperature has increased in the territorial waters of nearly 70% (95 out of 136) of coastal countries analysed, compared to 2003-2005. This reflects an increasing threat to their marine food security. Worldwide 3.3 billion people depend on marine food.

• Globally, climate change adaptation funding directed at health systems represents just 0.3% of total climate change adaptation funding.

The data also measured the effect of heatwaves on people’s mental health. Nearly six billion tweets over five years from Twitter users around the world were analysed and the researchers found a 155% increase in negative expressions during heatwaves in 2020 relative to the 2015-2019 average.