The Current Column

Health at the centre of climate action

How can climate-resilient health systems be successfully established?

Strupat, Christoph
The Current Column (2023)

Bonn: German Institute of Development and Sustainability (IDOS), The Current Column of 27 November 2023

Bonn, 27 November 2023. The climate crisis is undoubtedly also a health crisis. Climate change poses a direct and serious threat to human health and is already having an impact on almost half of the world’s population. The World Health Organization (WHO) estimates that climate change is causing an additional 250,000 deaths per year.

Rising temperatures, extreme weather events, air pollution, forest fires and negative impacts on water, land and food security lead to loss of life. The most convincing reasons for climate action measures lie not in the distant future, they’re right here, and right now. It is highly commendable that the presidency of the 2023 UN Climate Conference (COP28) has chosen health as a priority area, designating 3 December 2023 as Health Day, on which a climate-health ministerial meeting will be held – the very first as part of a UN Climate Change Conference.

The aim is to establish health as a key topic on the climate agenda. It is imperative that the health sector takes on a greater role in climate transformation. On one hand, the health sector itself is responsible for 5 per cent of global greenhouse gas emissions. If the sector were a country, it would be the fifth-largest emitter after China, the USA, India, and Russia. On the other hand, the health impacts of climate change can be mitigated through the development of climate-resilient health systems. How can this be implemented?

Expanding financing: Only 0.5 per cent of the funds for climate adaptation measures has been devoted to the health sector to date – an alarming figure. This insufficient financing is particularly critical for African countries, which are severely affected by the climate crisis. These countries receive a mere 14 per cent of the urgently needed adaptation financing. The developed nations urgently need to considerably increase their financial contributions to multilateral climate funds established under the UN climate change frameworks such as the Green Climate Fund (GCF) as these are vital for supporting low and middle income countries to develop and implement national adaptation strategies in the health sector. In this context, particularly the strengthening of Universal health coverage is required as it has been identified as a primary indicator of health resilience to climate change.

Creating climate-resilient structures: Health systems can enhance their climate resilience by extending early warning systems for the outbreak of climate-sensitive infectious diseases and by setting up a health infrastructure that can withstand extreme weather conditions. This includes investing in resilient buildings, emergency power supplies and water storage systems. It is equally important to develop heat protection plans and raise public awareness of climate-related health risks. Furthermore, intensified cooperation between the health sector and other health-relevant sectors (agriculture, environment, etc.), as outlined in the One Health approach, is crucial. This collaboration also aims to fully understand and address the root causes of climate change and its impacts on health.

Promoting global urgency governance: Reforming global governance after the COVID-19 pandemic, including revision of the International Health Regulations (IHR) and the negotiation of a new pandemic treaty, can make a key contribution to tackling some of the climate-related health challenges. The German Advisory Council on Global Change (WBGU) supports this approach and calls for global urgency governance to be strengthened in its flagship report on “Healthy living on a healthy planet“. For example, infectious diseases such as dengue are increasingly spreading to new regions, favoured by changed climatic conditions. The market for an effective dengue vaccine will increase by US $125 billion in the coming years. To avoid repeating the mistakes made in the course of the COVID-19 pandemic, in which unequal access to COVID-19 vaccines is estimated to have led to 1.3 million deaths in 2021, equitable and fair access to vaccines should be stipulated as part of the new pandemic treaty. This also includes ensuring that vaccines are produced in low-income countries.

Decarbonising the health sector: The health sector can play a considerably greater role in the global reduction of emissions. This could be achieved by reducing direct emissions that are produced through the generation of electricity used by health care facilities. In addition, emissions created during the production, packaging and transport of the products used in the health sector could be reduced. Sustainable construction of health care facilities can also contribute to reducing emissions. Moreover, health care providers can combine their purchasing power through joint procurement decisions, thereby creating pooled demand for sustainably produced goods and services.

Defining health as a priority area in connection with COP28 will provide a key impetus for the rapid and sustainable reduction of emissions and acceleration of the necessary climate adaptation strategies in the health sector. It is important to ensure that climate-related deaths do not increase unchecked and a future worth living does not become an ever more distant prospect in climate-vulnerable countries.