A woman wears a protective mask in Chiang Mai, Thailand. Photo: anankkml / Getty Images

As the COVID-19 pandemic continues to surge around the world, Southeast Asia stands out for what it has done right. Although case and death numbers vary widely between nations, the region as a whole has reported significantly lower COVID-19 mortality rates than most other countries in the world. Experts have attributed this achievement to several factors , including the alignment between political and public health leadership that led to swift and decisive action, the region’s preparedness to respond to epidemics, and the willingness of the public to adhere to necessary measures.

However, 2020 was a year of converging crises, and Southeast Asian nations have fared less well when it comes to tackling the ongoing public health crises of air pollution and climate change. In this perspective, we reflect on the findings of the 2020 Lancet Countdown on Health and Climate Change report, and discuss how COVID-19 recovery efforts can pave the way toward more equitable health and climate change outcomes in Southeast Asia.

A region reliant on fossil fuels and facing extreme climate risk

Rising temperatures have led to a doubling of heat-related mortality in Southeast Asia over the last two decades for people older than 65, reaching 9,200 deaths per year on average between 2014–2018.

Fossil fuels currently make up 79% of the Southeast Asian energy mix. This dominance contributes to more than 450,000 premature deaths each year from air pollution – a death toll that has not changed since at least 1990. The rise in fossil fuel use – along with deforestation and land degradation – has also resulted in Southeast Asia recording the fastest growth in carbon dioxide emissions in the world between 1990 and 2010. Emissions have continued to grow since then.

At the same time, the region’s exposure and vulnerability to the impacts of climate change are significant. While climate-related disasters and extreme weather events tend to receive the most attention, evidence from the 2020 Lancet Countdown reveals many other socioeconomic impacts.

For example, rising temperatures have led to a doubling of heat-related mortality in Southeast Asia over the last two decades for people older than 65, reaching 9,200 deaths per year on average between 2014–2018. At the same time, rising heat is making outdoor work increasingly difficult, and the region has consequently suffered from reduced labour capacity, primarily in the agricultural sector – a key engine of its economy and workforce. The loss of earnings from this reduction is estimated to be in excess of US$7 billion individually in Vietnam, Thailand, and Indonesia in 2019.

Climate-driven shifts in temperature, humidity, and precipitation have also increased the transmission of infectious diseases, such as mosquito-borne Dengue fever, as well as undermined food security by contributing to a decline in the yields of major regional crops like corn, rice, and soybean.

These regional trends are illustrated in figures a to d below, alongside each nation’s current death toll from air pollution (e) and the share of fossil fuels in their energy mix (f).

These regional outlooks and national statistics – while painting a clear picture of climate change drivers and impacts – hide the inequities of impacts between and within communities and social groups. For example, research in marginalized ethnic minority communities in Northern Thailand has shown that girls and young women face greater vulnerability in the context of drought, water scarcity, and other climate risks, and has illuminated the importance of tailoring adaptation measures to the wishes and needs of individual and social groups.

Achieving equitable climate resilience and green recoveries

Numerous scientists, economists, and policy experts have urged governments to embed long-term sustainability, inclusivity, and resilience in their COVID-19 recovery planning and near-term spending.

However, so far, few member states of the Association of Southeast Asian Nations (ASEAN) – the region’s intergovernmental body – have seized this opportunity. For instance, as of January 2021, almost all of Indonesia’s US$6.8 billion stimulus expenditure for the energy sector has gone towards supporting fossil fuels. Meanwhile, economy-wide stimulus plans put forward by Thailand and the Philippines, totaling US$60 billion and US$25 billion, respectively, have failed to include any concrete green initiatives.

Many of the ASEAN member states’ individual NDCs are “critically” or “highly” insufficient for meeting the world’s collective goal of keeping global warming below 1.5°C or well below 2°C.

Even before the COVID-19 pandemic emerged, Southeast Asia was not on track to achieve their nationally determined contributions (NDCs) and lagged behind all but two of the 17 Sustainable Development Goals. Worse still, many of the ASEAN member states’ individual NDCs are “critically” or “highly” insufficient for meeting the world’s collective goal of keeping global warming below 1.5°C or well below 2°C.

This lack of ambition is manifested in the region’s long-term energy strategy. Even under the most ambitious scenario outlined in the latest edition of the ASEAN Energy Outlook, fossil fuels will still make up 71% of the region’s total primary energy supply by 2040. Indeed, Indonesia plans to remain one of the world’s largest coal producers.

ASEAN Member States have many policy options to reverse these worrying trends and align their COVID-19 recovery with a sustainable development pathway and climate resilience. For example, Indonesia and Brunei Darussalam could finance most or all of their recovery packages by phasing out inefficient fossil fuel subsidies .

The region could also take advantage of its considerable potential for solar and wind power to meet its growing energy demand, which currently only makes up around 15%. A reallocation of government spending and investments to support the manufacturing and deployment of clean energy would provide higher economic returns and more jobs, while also setting the stage for a structural decline in deadly greenhouse gas emissions and air pollution.

The 2020 Lancet Countdown serves as an important reminder that the human-caused climate crisis is already wreaking havoc on public health and the economy worldwide, especially in Southeast Asia. We do not have the time – or the financing – to deal with the COVID-19 and climate crises separately. ASEAN’s near-term economic recovery can pave the way for accelerating the transition away from fossil fuels, advancing climate-related health adaptation and resilience, and achieving more socially equitable outcomes for all.