The 2024 China report of the Lancet Countdown on health and climate change: launching a new low-carbon, healthy journey

2023 was a landmark year for climate change globally, across Asia, and within China. Global average temperatures were 1·45°C higher than the pre-industrial average, making it the warmest year on record since 1850. In Asia, 2023 was the second-hottest year documented. China recorded its highest-ever average temperature at 10·71°C (0·82°C above the 1981–2010 average), had its second-lowest rainfall since 2012, and endured notable flood and drought events.<br>In a world rapidly approaching the long-term goal of Paris Agreement to “hold the increase in the global average temperature to well below 2°C above pre-industrial levels and pursuing efforts to limit the temperature increase to 1·5°C”, the importance of action and implementation is urgent. As the world's largest emitter of greenhouse gases, a powerhouse for renewable energy deployment, and one of the nations most affected by climate-related health risks, China's proactive role in addressing climate change and its health risks is crucial both locally and globally.<br>This is the fifth annual China report of the Lancet Countdown on health and climate change, the flagship report for tracking progress, or lack thereof, on climate change and health in China. Over the years, what began as the marginal effort of a few dedicated individuals has grown into a considerable movement at the forefront of global climate and health discourse. The report is led by the Lancet Countdown Asia Centre, with contributions from 77 experts across 26 institutions. Progress is assessed with 31 indicators across five domains: climate change impacts, exposures, and vulnerability (section 1); adaptation actions (section 2); mitigation efforts and their health implications (section 3); economic and financial aspects (section 4); and public and political engagement (section 5). This year, the report adopts a forward-looking perspective, including projections of health risks associated with climate change, and tracks the concerning trends in compound exposure, highlighting the importance of ongoing adaptation efforts. Additionally, two new indicators have been introduced: stranded coal assets from the low-carbon transition (indicator 4.2.5) and health-care sector emissions (indicator 3.4). Both indicators underscore the need for mitigation actions to safeguard the health of people in China. Wherever possible, we have aligned our indicators with the UN Framework Convention on Climate Change 28th Conference of the Parties (COP28) discussions and enhanced them with updated data and improved methodologies.