Sunday was devoted to health at the UN COP28 climate summit in Dubai. But it was also a day of reflection on what has been achieved so far and where this summit is going. As usual, many see achievements, while others are critical that the summit outcomes so far fall short of what is needed.

This was the first-ever health-day at a COP summit, with emphasis on building climate-resilient health systems and accelerating and scaling-up collaborations to transition to a “fairer, cleaner, and healthier global environment.”

Central to this is the ‘Alliance for Transformative Action on Climate and Health’ (ATACH), led by the World Health Organisation that used the COP28 platform to highlight “game-changing partnerships and collaboration that are driving the evolution and sustainability of green health systems”.

The summit president, Sultan Al Jaber, said that factors related to climate change “have become one of the greatest threats to human health in the 21st century”. Tropical diseases, malnutrition, malaria and heat-stress are worsening globally as temperatures rise, but especially in poorer developing countries that are unable to cope. Altogether, $777 million was pledged to eradicate neglected tropical diseases and help improve the lives of 1.6 billion people.

The World Bank also launched a programme to explore possible support measures for public health in developing countries.

More than 120 countries signed a declaration acknowledging their responsibility to keep people safe as global warming worsens.

The ‘Bill&Melinda Gates Foundation’ supports public health research and projects for the developing world. Bill Gates said scientists were working on new treatments for and prevention of mosquito-spread malaria, saying: “We have new tools at the lab level that decimate mosquito populations.”

In addition, the philanthropic foundation of UAE President Sheikh Mohamed and the Gates Foundation, together with other global partners, announced increased funding of the ‘Reaching the Last Mile Fund’, set-up to fight ‘Neglected Tropical Diseases’ (NTDs). This will help it accelerate progress to 39 African countries.

As if to bring attention to the problems of air pollution, on Health Day at COP28 Dubai’s skies were covered by a blanket of smog, with air quality rated as “unhealthy”.

As the summit progresses, the future of fossil fuels is drawing clear dividing lines at this COP. Antonio Guterres, UN secretary-general, fanned the flames of the antis on Friday when he urged world leaders to plan for a future without fossil fuels. “The 1.5-degree limit is only possible if we ultimately stop burning all fossil fuels. Not reduce. Not abate,” he said.

But developing economies that are also some of the world’s biggest energy users, China and India, disagree, citing energy security as their top priority. So do Russia, Africa and oil-producing countries. China’s Special Envoy for Climate Change, Xie Zhenhua, summed the dilemma up when he said “the intermittent nature of renewable energy and the immaturity of key technologies like energy storage means the world must continue to rely on fossil fuels to safeguard economic growth.”

Hopefully a compromise will be reached, but it does not look likely that this summit will arrive at any clear decisions or plans about fossil fuels. But it should not detract from the progress made so far that clearly takes the fight against climate change forward.

The process to arrive to a COP28 final deal has already started. The emphasis now appears to be on how the Paris Agreement goal of limiting global warming to within 2oC above pre-industrial temperatures can be achieved.

Monday is finance day, with expectations that more funding will be announced to support the climate initiative announced so far.

Charles Ellinas is a senior fellow at the Global Energy Centre for the Atlantic Council