I had to flee from the Camp Pendleton fire while recovering from my second open-heart surgery, still bandaged, unable to drive, and only able to escape due to the kindness of a neighbor.

The day I flew from California for the last time, I was suffering from breathing difficulties as a result of yet another wildfire, where even closed windows couldn’t keep out the soot and lingering smell of smoke from the indoor air.

And as a caregiver for a blind parent with mobility difficulties, I’ve experienced having to decide between staying in a house without electricity during a multiday power outage and evacuating to a hotel that doesn’t have enough rooms accessible to people with disabilities or an evacuation chair or other equipment to help someone get to the lobby when the hotel loses power.

People with disabilities, who are among the most negatively affected by climate change impacts, are often the least heard in global discussions. This lack of representation means our voices are not among those shaping policies that directly impact the lives of a billion people. When people with disabilities are not actively involved in the conversation, the policies and solutions often fail to address their unique needs and challenges.

That’s why although COP28 — the global climate negotiations taking place in Dubai — has been touted as the most inclusive for attendees for disabilities COP yet and even has a dedicated webpage that showcases needed accommodations for several types of disabilities, I can’t help but feel a twinge of disappointment.

I attended many webinars about what to look out for at this year’s COP, read over the entire agenda for both the Blue Zone (closed meetings where formal negotiations occur) and Green Zone (side events open to the general public), read the agendas of several large and small nonprofit organizations, as well as the U.S. Department of State’s programming at COP28. But almost nowhere do I see inclusion of people with disabilities as speakers, presenters, and in official delegate roles. During this multiweek conference, the single session focused on disability is relegated to a Green Zone event at the same time while official delegates and heads of state attend a Blue Zone parliamentary session.

According to several reports, people with disabilities are four times more likely to die during natural disasters and those who can evacuate are less likely to return home. They’re also more likely to experience food, water, and electricity shortages. As a population, people with disabilities earn less than non-disabled peers and are less likely to be able to return to work post-disaster. They often face transportation difficulties to and from heating and warming centers, warning systems are less likely to be accessible, and there is a shortage of qualified health professionals and accessible health facilities. Unfortunately, climate scientists tend to overlook how climate change affects people with disabilities in multiple domains.

As much as I hate the medical model of disability, the reality is that climate change presents a public health emergency for people with disabilities and negatively impacts our access to health care, housing, social ties, food availability, and sense of belonging. Yet at COP28, where heads of state, climate scientists, health experts, and CEOs will be a captive audience, there are few specific sessions dedicated to the intersection of disability, health, and climate change led by disability experts.

Read: How extreme weather threatens people with disabilities

This isn’t just a rare oversight. Globally and nationally, there is a long history of delayed and underfunded policies and programs to improve the lives of people with disabilities affected by climate change. The federal requirement for the number of accessible units in newly constructed, climate-resilient affordable housing developments remains at 5%, instead of the proportional amount of people with disabilities in the U.S. Many jurisdictions do not use emergency alerts that are accessible to people with disabilities. Municipalities, including my own, created resilience hubs but do not have a transportation plan to and from those centers.

COP28 did make strides in some areas, like having a quiet room, accessible modes of transportation, and biodegradable single-use utensils as accommodations. But these are micro accommodations for a macro problem. COP28 still falls short in the participation and representation of people with disabilities in climate change discussions.

This missed opportunity is a reminder that the journey toward truly inclusive and equitable climate policy is far from over. As we move forward, it’s crucial that global leaders and organizations not only add inclusivity to reports but actively embody it in their actions and decisions.

Rosanita Ratcliff is a former special education teacher and disability advocate based in Ann Arbor, Michigan. She is a Public Voices Fellow on the Climate Crisis with the Op-Ed Project and Yale Program on Climate Change Communication.