Clinical Evidence and Rising Heat-Related Mortality
Data from the World Health Organization (WHO), the Robert Koch Institute (RKI), and the Lancet Countdown 2026 document the health impacts of global warming. In the summer of 2024, approximately 63,000 heat-related deaths were recorded in Europe. The European Declaration on Heat and Health, published in August 2026 by more than 80 organizations, concludes that existing mitigation plans have so far been unable to halt the rising mortality rate, particularly among older adults and people with chronic illnesses.
In addition, higher temperatures promote the spread of disease vectors: The climatic suitability for vectors such as the Asian tiger mosquito has recently increased by nearly 300% in Europe, raising the risk of infections with the dengue or West Nile virus.
Dr. Hans Henri P. Kluge, WHO Regional Director for Europe, believes it is “time to acknowledge an indisputable truth: The climate crisis is a health crisis. It is a security threat, a public health emergency, and an economic time bomb—all in one.”
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Physiological Risks and Adverse Effects of Medications
High temperatures have a direct impact on the body and on the handling of medications. The Federal Ministry of Health’s Action Plan on Medication Safety (AMTS 2026) and the scientific CALOR list outline specific risks:‍
- ‍Fluid and electrolyte loss: Diuretics (water pills) and laxatives exacerbate heat-related dehydration, leading to a drop in blood pressure and an increased risk of collapse.‍
- Kidney function: ACE inhibitors , sartans, and NSAIDs reduce renal blood flow in cases of fluid depletion and increase the risk of acute kidney failure.‍
- Impaired thermoregulation: Anticholinergic drugs and psychotropic medications inhibit sweating or reduce the sensation of thirst. In the case of drugs with a narrow therapeutic range, such as lithium, this can lead to a rapid increase in toxic plasma concentrations.‍
- Accelerated Absorption of Active Ingredients: At high temperatures, the body dilates the blood vessels in the skin to release heat. This increases blood flow to the skin. If a pain patch (e.g., containing the active ingredient fentanyl) is applied to the skin, this increased blood flow drastically accelerates absorption: The active ingredient is absorbed into the bloodstream much faster than intended, which increases the risk of a potentially life-threatening overdose.‍
- Loss of stability during storage: Thermolabile drug formulations lose their efficacy or form degradation products when the temperature exceeds 25 °C.
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The Role of the Pharmaceutical Industry: Current Status, Responsibilities, and Economic Outlook
The healthcare system is responsible for more than 5% of global greenhouse gas emissions. A significant portion of these emissions results from the synthesis, packaging, and distribution of pharmaceuticals. Droughts and low river levels—such as those on the Rhine or in the Panama Canal—also make it more difficult to transport raw materials and increase the risk of supply bottlenecks.
Some pharmaceutical companies have already taken initial steps—and are continuing to take further action. In the field of galenics, research is underway to develop thermally more stable formulations to mitigate disruptions in the cold chain. Manufacturers are switching the propellants in asthma and COPD sprays to more climate-friendly gases such as HFA 152a. This area is also gaining importance in corporate management.
Maria Paola Chiesi, Chair of the Board of Directors of the Chiesi Group since May 2026, spoke plainly on the matter a few years ago:
“Decarbonization is an essential step that, in our view, all companies must take to achieve a just and regenerative global economy. The survival of humanity depends on it.”
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However, decarbonizing the entire supply chain is essential: In addition to the company’s own factories (Scope 1) and purchased energy (Scope 2), this primarily affects upstream raw material suppliers and global transportation routes (Scope 3), which account for the majority of the carbon footprint. At the same time, manufacturers must reduce contaminants in production wastewater. When active ingredients such as antibiotics enter rivers and lakes unfiltered, environmental bacteria are constantly exposed to low doses. They adapt and develop resistance, causing life-saving medications to lose their effectiveness worldwide.
This transformation also offers strategic advantages for the industry. According to surveys, 87% of physicians are calling on pharmaceutical manufacturers to take concrete climate protection measures. Dr. Martin Herrmann, chairman of the German Alliance on Climate Change and Health (KLUG e.V.), sees this as a clear direction for the market:
“Companies—especially transnational ones—have a great deal of influence in a fragmented world. More and more customers are guided by such values. That is why I am confident that an increasing number of companies will come to understand that sustainability must be a strategic priority.”
