Lancet launches global health ‘Countdown’ on plastics as historic UN treaty talks enter final stretch

As delegates in Geneva battle over the terms of the world’s first global plastics treaty, a new independent initiative from The Lancet is set to hold governments and industries to account — no matter what happens inside the negotiating rooms.

The Lancet Countdown on Health and Plastics, unveiled on 5th August to coincide with the opening of the resumed fifth session of the Intergovernmental Negotiating Committee (INC-5.2), is the first long-term global monitoring effort dedicated to tracking the human health impacts of plastics across their entire life cycle.

For Professor Philip Landrigan of Boston College — one of the initiative’s architects, and a long-time collaborator with the Centre Scientifique de Monaco and the Prince Albert II of Monaco Foundation — the timing is deliberate. “This will be an accountability mechanism — parallel to the treaty but separate from it — that tracks progress, or lack thereof, in addressing the plastic crisis,” he told Monaco Life’s Cassandra Tanti. “Even if negotiations stall, the world will still know the truth.”

A treaty in the balance

INC-5.2, which concludes on 14th August, is widely seen as the decisive round in a process launched by the United Nations Environment Assembly in 2022. The goal: to create a legally binding international instrument to end plastic pollution in all environments, with protection of human health embedded in its mandate.

The stakes are high. Negotiators are grappling with whether the treaty will regulate plastics across their entire life cycle — from fossil fuel extraction and manufacturing to chemical composition, use, and disposal — or take a narrower approach focused on waste management. One of the most contentious issues is whether to impose a global cap on plastic production, backed by over 100 countries but opposed by major oil-producing and plastics-exporting nations.

For Landrigan, the breadth of the treaty is critical. “Plastic production has increased 250-fold since plastics came on the market in the 1950s. It is projected to double again by around 2040 and triple by 2060. If you think we have a lot of plastic in the world today, you haven’t begun to see what’s coming. That’s why a cap is essential.”

He believes the treaty also needs robust chemical regulation, full transparency on what goes into plastics, adequate financing for low-income countries, and legally binding enforcement mechanisms. Without those, he warns, “then the treaty is just empty paper”.

A proven model for accountability

The Lancet Countdown on Health and Plastics draws inspiration from the Lancet Countdown on Health and Climate Change, launched nearly a decade ago. That earlier initiative shifted the global climate conversation by documenting the health consequences of climate change and making them impossible to ignore in UN negotiations.

“In climate, the health frame helped move the discussion from abstract molecules and greenhouse gases to the real impacts on human health,” Landrigan explained. “We intend to follow these models in launching the Lancet Countdown on Health and Plastics.”

The new Lancet Countdown on Health and Plastics will monitor four interconnected domains, beginning with emissions, tracking hazardous releases across every stage of the plastic life cycle, from production through to disposal. It will also examine exposures, measuring environmental and biological concentrations of plastics, including micro- and nanoplastics, as well as the chemical additives associated with them.

Alongside this, it will assess the health impacts, documenting disease and death linked to plastics and their chemical components. Finally, it will follow interventions and engagement, from laws and policies aimed at reducing exposure to public awareness and societal action on the issue. Indicators within each domain will be chosen through a rigorous, multidisciplinary process, combining existing evidence with new data collection and analysis. Working groups will be led by global experts in each area.

“This will be an independent mechanism — parallel to the treaty but separate from it — that tracks progress, or lack thereof, in addressing the plastic crisis,” said Landrigan. “It’s about equipping the world with the facts.”

Following plastics from cradle to grave

One of the Countdown’s defining features is its full life cycle approach.

“Ninety-nine percent of plastics are made from fossil fuels — gas, oil, or coal. The plastic life cycle begins with fracking, drilling, or mining. Then fossil carbon is turned into raw plastic, fabricated into products, used — where people are exposed to plastic and its chemicals — and finally disposed of, burned, landfilled, recycled, or shipped to low-income countries, where it accumulates in beaches or massive dumps,” Landrigan said. “When considering the hazards plastics cause to human health and the environment, you have to look at the entire life cycle — not just one stage in isolation.”

The chemical dimension is especially alarming. Of more than 16,000 known chemicals used in plastics today, many are toxic — linked to cancer, brain damage in infants, hormone disruption, obesity, diabetes, cardiovascular disease, and reduced fertility. Yet 75% have no publicly available toxicity data.

“In my view, putting chemicals into plastics without testing — or without publicly disclosing the results — is irresponsible,” he said. “The treaty must close this loophole.”

Funded but fiercely independent

The Countdown’s independence is a point of pride. It is principally funded by the Australian philanthropic Minderoo Foundation, with additional support from Boston College, the Centre Scientifique de Monaco, Heidelberg University, and The March Foundation in conjunction with Woods Hole Oceanographic Institute. None of these funders will have influence over its findings or their publication.

The governance structure includes a steering committee, working group co-leads, an advisory board, and dedicated staff for project management and outreach. Over time, its membership is expected to expand, with careful attention to expertise, geographical representation, and gender balance.

Beyond statistics: the human toll

Landrigan, a paediatrician and epidemiologist, is clear that numbers alone will not win the argument. “We’ll track production statistics, levels of plastic chemicals and microplastics in the environment, and levels in human blood and urine. We’ll monitor the health effects of plastics, estimate how much disease and death they cause each year, and calculate the related economic costs,” he said.

“But data have to be connected to human stories. Plastics are not just an environmental issue; they’re a public health crisis. We see plastics in people’s blood and breast milk. We see microplastics crossing the placenta. These exposures are happening to all of us, every day, often without our knowledge.”

A long view in a short-term world

The Countdown will publish its first major report in September 2026, about 14 months after launch. This will establish baseline data and the first set of indicators. Updates will follow every one to two years.

“This is a decades-long commitment,” Landrigan said. “We’re not here for one news cycle or one conference.”

Geneva’s moment — and the road ahead

Back in Geneva, the negotiations remain fraught. Bracketed text — the sign of unresolved disputes — still fills key sections of the draft treaty. Some delegations fear that without compromise on production caps, chemical controls, and financing, the agreement will be too weak to stem the rising tide of plastic pollution.

Yet for Landrigan, the very existence of the talks — and the Countdown’s launch alongside them — marks a turning point. “It’s encouraging. More than 100 nations are calling for a plastics treaty, and many want it to include global production caps and science-based chemical regulation. Yes, opposition is fierce — especially from the fossil fuel and plastics industries — but as Martin Luther King Jr. said, ‘The arc of the moral universe is long, but it bends towards justice.’ We’ve seen this with climate change. Industry denial turned to reluctant acknowledgment, then to international agreements like the Paris Accord. Progress is slow, but we’re moving in the right direction. I think plastics are following the same trajectory, just a few years behind.”

Whether INC-5.2 delivers an ambitious text or defers the hardest decisions, the Lancet Countdown on Health and Plastics will begin its work. Its reports will serve as both mirror and measure, reflecting the scale of the problem and the adequacy of the world’s response.

“You can’t manage what you don’t measure,” Landrigan said. “And now, we’re going to measure plastics, their chemicals, and their health impacts — relentlessly. No one will be able to say they didn’t know.”

See also:

Podcast interview: Prof. Philip Landrigan on childhood cancer and the “chemical crisis”

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Main photo credit: Jack Lee, Unsplash