When a patient’s last breath met a planet’s turning point, Kigali was the world’s call to action
In the weeks following the loss of my father to lung disease in 2016, the Kigali Amendment united the world’s nations to confront climate change—linking human health and the planet’s future.
In the shadow of a life cut short by chronic obstructive pulmonary disease (COPD), the United Nations gathered to take the action that would ensure longevity for our planet and its people, agreeing a pledge to phase down hydrofluorocarbons (HFCs)—chemicals that worsen climate change and indirectly intensify the very conditions that make breathing harder for millions. The treaty would remind us that climate policy is health policy, and that saving the planet also saves lives.
Climate change and respiratory health
My father’s COPD wasn’t born of climate change—it was forged in smoke and steel. His lungs carried the scars of tobacco, welding fumes, and silica dust from furnace linings stripped and replaced each summer in the steelworks of my hometown. Safety equipment was unheard of, and cigarettes were part of the rhythm of work in a culture that prized productivity over protection.
As my father took his last laboured breaths, the world was preparing for another kind of struggle—the fight to protect breathing on a planetary scale. Global warming doesn’t directly cause COPD, but it makes it worse by amplifying the environmental stressors—pollution, allergens, and extreme weather—that trigger exacerbations and accelerate disease progression.
The contrast was profound: one man’s lungs marked by the residue of labour, and a planet’s lungs imperilled by rising heat and thickening haze. As we faced an ending, Kigali signalled a beginning—a collective promise that future patients might breathe easier because the world resolved to act.
The Kigali Amendment: A landmark treaty
As we mourned our family’s loss, the nations came together to agree a phasedown schedule for HFCs—powerful greenhouse gases that trap heat hundreds of times more effectively than carbon dioxide, creating an invisible blanket around our planet. Building on the Montreal Protocol (1987), which was designed to protect the ozone layer by phasing out ozone-depleting substances like chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs), the Kigali Amendment (2016) was adopted at the 28th Meeting of the Parties (MoP28) in Kigali, Rwanda, on October 15, 2016.
This landmark treaty was more than environmental policy; it was also a public health commitment. By cutting HFCs, the Kigali Amendment could prevent up to 0.4°C of global warming by the end of the century, slowing climate change and reducing the factors that worsen respiratory illness, making it one of the most significant climate mitigation measures ever agreed.
An industry responds
The pharmaceutical industry responded by launching a search for alternatives to the HFCs used in pressurised Metered Dose Inhalers (pMDIs), while simultaneously working with environmental regulators to ensure that global and local policies on inhaled therapies would safeguard patient access to medicines as well as meeting HFC phasedown commitments. Over the decade since the Kigali Amendment, the industry and its supply chain have made a substantial collective effort, investing hundreds of millions of pounds in the development of low Global Warming Potential (GWP) medical propellants and advanced components, such as precision valves, to deliver performance matched drug therapy to the lungs. This has enabled the successful reformulation of asthma and COPD treatments and driven a transformation of the global manufacturing footprint for pMDIs.
Bespak’s leadership: Founded on sustainability
As the green transition advanced, Bespak evolved from a key player in the pMDI supply chain into a position of true leadership. Spun out as an independent company to focus on sustainable respiratory care, we built the formulation, development, and manufacturing capabilities required to drive the industry‑wide shift to low GWP propellants, while forging expert collaborations across the supply chain. The urgency was clear—the world would not wait, and neither would we. At Bespak, leadership is not claimed, it is demonstrated. From optimising our trusted valves for next generation propellants to achieving the milestone of becoming the first CDMO with commercial manufacturing capacity for low GWP propellant filled aerosols, we’re enabling our partners to deliver low carbon pMDIs at scale and with confidence.
The transition to sustainable propellants is mission critical, but our commitment goes further. For us, sustainability is not an add on—it is the foundation of how we operate. We take a holistic approach to climate action, maximising our impact through innovation, collaboration, and direct operational action.
Our valves exemplify how we are setting the benchmark for innovation and sustainability. Engineered with precision and optimised for next generation propellants, they are backed by a life cycle assessment independently validated by sustainability experts, ensuring a clear pathway for carbon reduction within our SBTi approved net zero strategy.
Momentum and milestones
As an industry, we can now say with confidence that the transition is firmly underway. In 2025—nine years after Kigali—the first low carbon pMDI, developed by AstraZeneca, received regulatory approval. At Bespak, we were proud to play a pivotal role in this milestone, supplying the first ever valve approved for use with the near zero GWP propellant HFO‑1234ze, created by our supply chain partner Solstice Advanced Materials.
Soon after AstraZeneca’s breakthrough, both Chiesi and GSK announced the successful completion of clinical studies in 2025, setting the stage for a new generation of carbon minimal pMDIs to reach the market, powered by Orbia Fluor & Energy Materials’ next generation propellant HFA-152a. With momentum building, Bespak strengthened its commitment by expanding aerosol production capacity, reinforcing the UK’s position as a centre of excellence for pMDIs as the global manufacturing base began to transition to sustainable propellants.
The transition is no longer a distant goal—it’s happening now. With proven technological solutions available, regulatory approvals progressing, and manufacturing capacity rapidly scaling, the path forward is clear. There is no justification for delay and no excuse for inaction. Companies must accelerate the development of their next generation portfolios or risk surrendering market share to those who had the vision and resolve to invest early in a sustainable future.
Kigali set a global deadline of 2047 to reduce HFC consumption by 80–85%. A decade later, it is clear the pharmaceutical industry will move much faster. Regional legislation is already accelerating local phasedowns, and the ultimate phaseout now rests in the industry’s hands. Unlike the CFC to HFA transition, this shift is not a ban but a phasedown—creating uncertainty in propellant supply across sectors, which in turn fuels urgency and action.
The industry has drawn valuable lessons from the last transition—knowing what to build upon and what to approach differently. Today’s journey is defined by collaboration, trust, and a shared determination to go further, faster. There is a clear recognition that no company can, nor should, take this on alone.
Climate, health, and the call to action
Ten years on from the adoption of the Kigali Amendment, the question remains—have we as an industry truly done enough? At CoP30 in Brazil in late 2025, the latest emissions gap report revealed that the world is still on course for roughly 2.8°C of warming, far beyond the Paris Agreement thresholds and deep into the zone of severe, irreversible consequences. Rather than galvanising collective action, CoP30 laid bare widening divisions between regions, interest groups, and political systems.
We often treat “environmental issues” and “health issues” as separate, yet they are inseparable. The Kigali Amendment demonstrates that when nations act together, they can safeguard both the planet and the people who live on it. The pharmaceutical industry is proving its ability to collaborate meaningfully, contributing to climate action under Kigali in ways that ease the burden on patients—like my father—whose lungs struggle against polluted air, rising temperatures, and the hidden weight of climate driven health risks.
This is why climate agreements matter. They are not abstract treaties; they are lifelines. Every cut in emissions is a breath made easier, a child with asthma able to play outdoors without fear of breathlessness, a parent with progressive COPD given more time with their loved ones.
I am not a climate scientist, a product designer, or an engineer—I am a daughter who watched her father’s final breath come too soon. That loss makes the transition to low carbon inhalers my mission. At Bespak, I am proud to help lead the change our industry must deliver—and that patients everywhere are counting on.
When I think back to my father’s latter years living with COPD, I remember the quiet struggles—the laboured breaths, the hospital visits, and how even the smallest shift in weather could make life harder. His passing was a deeply personal loss, yet in the weeks that followed, the Kigali Amendment reminded me that his story was part of something bigger: the fight for cleaner air, a safer climate, and healthier lungs.
Kigali carried a promise—that fewer families would have to watch loved ones struggle for breath, that future generations might inherit skies less burdened by pollution, and that climate action could be measured not only in degrees avoided but in lives made easier.
For me, the Kigali Amendment is more than a diplomatic milestone. It is a reminder that every policy has a human face, and every emission reduction brings a human benefit. My father’s story is one of millions, and together they form the reason climate action matters—not in the distant future, but now.
We cannot reclaim the breaths already taken. But we can choose to safeguard those yet to come. As we reflect upon our industry’s progress in the decade since the world came together in Kigali, I invite you to consider one simple question: have you done enough?
