The global climate crisis and its intersection with public health inequities represent one of the most pressing challenges of our time, disproportionately impacting marginalised populations in low- and middle-income countries through air pollution, energy poverty, and climate-driven disasters. Systemic inequities compound these dual crises: the Global South bears the brunt of climate impacts despite minimal historical emissions, while Global North institutions dominate financing and decision-making, perpetuating energy poverty and stalling progress toward the Sustainable Development Goals. Initiatives like the Health and Energy Platform of Action and just energy transition partnerships (JETPs) offer frameworks for progress, yet gaps persist. Nationally Determined Contributions (NDCs) lack concrete metrics to operationalise health co-benefits, and only 15% of climate finance targets health-related adaptations. As the world’s largest economies and emitters, G20 countries have unparalleled leverage to recalibrate this trajectory. To close this gap, this brief proposes four actionable pillars for the G20:

• Establishing a global environmental agency under UN auspices to enforce climate–health equity targets, harmonise fragmented initiatives like JETPs, and mandate accountability for NDCs through penalties and standardised metrics.
• Launching a climate justice council to reform multilateral finance by redirecting 30% of MDB concessional funds to health-centric energy transitions, introducing debt-for-climate– health swaps for LMICs, and adopting majority voting to accelerate climate finance decisions.
• Piloting a planetary emergency platform to operationalise regional coalitions such as ASEAN and the AU, scaling proven country platforms like Kenya’s solar clinics, and integrating WHO health–climate data into a “One Health” dashboard for real-time tracking.
• Creating binding sectoral agreements modelled on the IMO’s maritime emissions pact, including mandates for G20 nations to allocate 5% of climate finance to renewable-powered health infrastructure by 2025 and just transition covenants for coal regions.

By prioritising Global South representation in governance, blending public–private finance for decentralised energy grids, and leveraging the 2024 Summit of the Future to initiate UN Charter reforms, the G20 can transform climate–health synergies into a cornerstone of global governance. These measures would unlock a triple dividend: averting millions of air pollution-related deaths, accelerating fossil fuel phase-outs, and reducing inequality. Without urgent action, climate[1]driven health disparities will deepen, but by centring equity in multilateral frameworks the G20 can catalyse a just transition that safeguards both planetary and human health.