11 October 2023 – The climate crisis is the greatest health challenge of the 21st century. The mean temperature is increasing rapidly and other climatic variables are worsening – and these changes are occurring twice as fast in the Eastern Mediterranean Region as elsewhere in the world. The health impacts of climate change are substantial and include more deadly extreme weather events, increasing cases of noncommunicable diseases and the increased emergence and spread of infectious diseases. These impacts are already affecting the Region’s health workforce and infrastructure, reducing the capacity to achieve universal health coverage. Deep, rapid and sustained climate mitigation efforts and faster implementation of climate adaptation actions would reduce the projected damages and losses for humans and ecosystems. Further delays in acting on climate change will increase the risks and undermine decades of public health gains. Failing to act now will also contravene our collective commitments to the Sustainable Development Goals and the human right to health for all. As we speed towards 2030, WHO proposes a new regional framework for action to build climate-resilient and environmentally sustainable health systems; to prioritize health in climate change policies; to engage the health sector effectively to support climate action by other sectors; to improve the health sector’s access to climate change funding; and to build a robust evidence base for policy-making. The framework is proposed for the period 2023–2029. Achieving these targets will require multisectoral transformative action across society. This includes: working within formal health systems; collaborating with health-determining sectors, such as energy, food, agriculture, water, transport, social affairs, security and finance; and engaging with the general public to make a critical contribution to combating and adapting to climate change and accelerating progress towards health for all. Thirteen countries of the Region need to accelerate action through the Alliance on Transformative Action on Climate and Health. The remaining countries and territories of the Region are urged to join this WHO-led initiative. A technical report on climate change, which introduces the proposed framework for action, will be discussed at the 70th session of the WHO Regional Committee for the Eastern Mediterranean. The report’s aim is to support every country and territory of the Region to commit to the Alliance and to accelerate action on climate change.