Two words: “and health”. Apparently innocuous and anodyne. But in the context of the United Nations climate change negotiations, their inclusion into the voluminous draft decision to be taken this week in Lima provides an insight into the role that non-government actors can play behind the scenes at these events. More importantly, they underscore an issue too often overlooked in discussions about taking action to prevent dangerous climate change.

On Monday, when a draft text of the decision to be taken by countries was released, there was much excitement among a small group of medical students attending the conference.

Buried away on page four in sub-paragraph 28(a) the words “and health” had been inserted. It now read:

“Undertake a technical examination of opportunities for actions with high mitigation potential in relevant thematic areas, including those with adaptation and sustainable development and health co-benefits.”

At first glance, the change appears insignificant and commits countries to do nothing more than a “technical examination”. But it appears to be the first time the health implications of climate change have been recognised in the decisions of the conference of parties at the United Nations Framework Convention on Climate Change.

It is hard to believe that the health implications of tackling climate change have been omitted from official text until now. In countries like China, the health of its citizens from highly polluted cities is the predominant driver of action to tackle climate change. In the host city itself, the gridlocked roads of Lima pump smog into the atmosphere — it is estimated that 8% of Peruvian gross domestic product is wasted sitting in traffic jams (by some estimations, double the global average).

And this year, the World Health Organization estimated that in 2012 around 7 million premature deaths resulted from air pollution, more than double previous estimates. Road pollution was a major contributor to this. In developed countries, road transport accounted for half the cost of the health impacts of air pollution.

A recent report by the International Monetary Fund found that if the external health costs of burning coal were to be factored into its price it would add $3.30 per gigajoule of energy on top of the average world coal price in 2010 of $5/gigajoule. For fuel prices, it would add about 40 cents or more to a litre of petrol. On average, a nationally efficient price on carbon that reflected health co-benefits from reduced air pollution from coal plants and car emissions would be $57.50 a tonne. It makes the price under Australia’s departed carbon scheme look laughable.

“In short, the case for substantially higher energy taxes does not rest on climate change alone,” the IMF paper concluded.

Armed with such data and without much preparation, a small group of medical students in the International Federation of Medical Students’ Associations arrived in the first week of the conference and began knocking on delegation doors at the Lima conference. They provided a short one page brief outlining their argument to recognise health co-benefits in the text of the Lima decision.

For most of them, like Australian final year medical student Mark Hayes, it was their first experience of the impenetrable world of UN climate change negotiations involving the tedious process of haggling line by line, word by word over draft text. But they could teach some of the highly paid lobbyist firms back in Australia a thing or two. While some non-government organisations focused more on high-profile stunts to attract media attention (like Greenpeace’s ill-thought-out desecration of the Nazca lines), the medical students assiduously built support behind the scenes from both major developed and developing countries, including Australia, the United States, Brazil, Saudi Arabia and Canada, for the change.

“We basically looked at the draft text and worked out what needed to be changed,” said Hayes. “Then it was just finding someone who was particularly interested in the topic in a country’s delegation and getting them to push it internally.”

As if on cue, the London School of Economics released a report warning countries against taking a narrow focus in the negotiations and haggling over how to share the burden of cuts in greenhouse gas emissions. The report found that seven different approaches to determining national pledges for reducing emissions around “burden sharing” largely produced the same outcomes but concluded they were likely to be divisive and lead to a lack of ambition.

Instead, it recommends countries recognise that measures to cut greenhouse gas emissions have multiple benefits, including the reduction of local air pollution and traffic congestion.

“Recent evidence suggests that more than half of emissions reductions required to meet an ambitious target generate co-benefits. The existence of these benefits means that policy-makers should be less reluctant when considering undertaking such targets.”

Music to the ears of a couple of medical students.

*Marcus Priest was flown to Lima by the Clean Energy Council as the winner of its 2013 media award.