As international negotiations resume in Geneva this August on a landmark United Nations treaty to end plastic pollution, leading health experts are warning that the proposed agreement lacks the teeth needed to protect public health. Without stronger measures to regulate hazardous chemicals embedded in plastics and curb plastic production itself, scientists say the treaty could fall short of preventing a worsening global health crisis.
In a joint commentary, Nicholas Chartres from the University of Sydney, Bjorn Beeler of the International Pollutants Elimination Network (IPEN), and Dr Tracey Woodruff from Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California argue that the treaty must undergo a paradigm shift—from focusing narrowly on waste management to regulating plastic as a hazardous material throughout its entire lifecycle.
The urgency of their appeal is grounded in mounting scientific evidence. A new systematic review led by Chartres, published in biomedical and life sciences journal literature at the US National Institutes of Health's National Library of Medicine (NIH/NLM) found high-certainty evidence that microplastics negatively affect the human reproductive, digestive, and respiratory systems. Although only three of the 31 studies in the review involved human participants, data from 28 animal studies pointed to alarming biological effects. Researchers concluded that microplastic exposure is suspected to contribute to reduced fertility, gastrointestinal inflammation, and respiratory harm.
Microplastics and nanoplastics, formed from the breakdown of larger plastics or intentionally added to consumer goods, have been detected in human lungs, blood, kidneys, placenta, and even brain tissue. These particles often carry a toxic cocktail of chemicals, many of which are endocrine disruptors capable of interfering with hormonal and immune systems. "These chemicals interfere with hormonal systems and have been linked to chronic diseases," said Dr Woodruff.
Plastics are composed of more than 16,000 chemicals, with over 4,200 known to be hazardous. Many of these include substances like phthalates, bisphenols, and per- and polyfluoroalkyl substances (PFAS), also known as “forever chemicals,” which have been linked to cancer, infertility, neurodevelopmental harm, and endocrine disruption. Alarmingly, the vast majority of chemicals used in plastics have no publicly available hazard data, raising concerns among health professionals and environmental advocates.
Despite this growing body of evidence, health considerations have not featured prominently in the current draft of the UN plastics treaty. "The treaty must focus on plastics as a toxic material—not just as waste," said Beeler. “Otherwise, we’re just managing symptoms while ignoring the disease.”
According to the World Health Organization, approximately one in four global deaths are attributable to environmental causes including pollution and toxic chemicals, a burden that falls disproportionately on low and middle-income countries. Yet plastic production—driven largely by fossil fuels—is projected to triple by 2060, further aggravating the crisis. Each stage of the plastic lifecycle—from oil extraction and manufacturing to open-air incineration—releases harmful emissions and pollutants into the environment.
Health disparities linked to plastics are also deeply intertwined with environmental justice issues. Tianna Shaw-Wakeman, Environmental Justice Program Lead at Black Women for Wellness in Los Angeles, explained how plastics and fossil fuel industries continue to harm marginalized communities. “The community that I serve in South Los Angeles is home to the largest urban oil field in the United States. Active neighbourhood drilling operations cause respiratory and reproductive health harm,” she said. “Oil companies know gasoline demand is declining, so they’re shifting to plastics to survive. That proliferation is fuelling both pollution and climate change.”
Shaw-Wakeman emphasised that global South communities, Indigenous peoples, and African diasporic populations face disproportionate harm. “It’s not enough to be safe for patients in the short term—we must also be safe for communities and the planet in the long run,” she said, calling the plastics crisis “a reproductive justice issue.”
While most countries negotiating the treaty support lifecycle regulation—including limits on plastic production and bans on toxic chemicals—progress has been stifled by oil-producing nations and industry groups who oppose upstream controls. These groups advocate instead for recycling and better waste handling as the core solutions—approach public health experts argue has already failed. “Changes require time and resources,” the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) said in a joint statement. “Testing and validation of new materials can take up to 5 to 10 years. We believe it is possible to achieve a treaty that protects both the environment and human health, through harmonized, targeted compliance periods.”
The healthcare industry presents a particularly thorny paradox. It depends heavily on plastic products like IV bags, syringes, and protective equipment, especially since the COVID-19 pandemic accelerated the shift toward single-use plastic medical devices. But this reliance has led to massive waste generation, especially in low and middle-income countries where medical waste is often burned in open pits or low-tech incinerators. This releases toxic particulate matter and persistent organic pollutants such as dioxins and furans into nearby communities. Groups like Health Care Without Harm are pushing for reduced PVC use and safer, reusable alternatives, but transitioning to new materials is complex due to strict medical safety standards.
Leva Rucevska, project manager at GRID-Arendal—a center working with the United Nations Environment Programme—said key issues like primary plastic polymer production, chemicals of concern, and sustainable plastic use remain highly contested in negotiations. “Regarding chemicals of concern, 95 countries supported the statement read by Mexico, calling for the inclusion of a list of such chemicals in the new agreement,” she said. “If the new convention aims to protect health and the environment, unnecessary chemicals must be addressed.”
Emmy Noklebye, a scientist at the Norwegian Institute for Water Research, warned that downstream waste workers, fisherfolk, and landfill-adjacent communities bear the brunt of plastic pollution. “They are exposed to hazardous emissions in air, water and soil,” she said. “These exposures intersect with broader social inequalities related to caste, class, gender, religion and migration. A just transition must respond to these differentiated burdens with concrete provisions and inclusive governance.”
The scientists behind the recent review insist that the treaty must not only restrict hazardous chemicals and promote safe alternatives, but also mandate transparency in plastic production and ensure that polluters bear financial responsibility. They oppose blanket exemptions, including for plastics in healthcare, instead urging specific, time-bound carve-outs with clear transition plans.