The World Health Organization has called the climate crisis the biggest global health threat of the 21st century. The effects of climate change on human health are wide-ranging – from direct impacts of extreme weather such as hurricanes, drought, and heatwaves, to indirect effects like new and reemergent diseases, to third-order effects like mental stress and undernutrition due to crop failure. By 2030, the direct damage costs to health from climate change are estimated to be as high as US$4 billion annually. There is an urgent need for action on climate to protect and sustain human health, including a focus on health systems and health policies.
At the December 2021 UN Climate Change Conference in Glasgow (COP26), a group of more than 50 countries committed to develop climate-resilient and low-carbon health systems in response to growing evidence of the impact of climate change on people’s health. However, there is not yet a shared understanding of what this commitment means. There is no widely accepted definition of what constitutes a climate-resilient or a low-carbon health system. While national policy-makers recognize the challenge of climate change, they do not always know exactly what to do or how to do it. There is a need to support countries to better understand where to start and what to prioritize to ensure health systems and health policies are mitigating and adapting to the ongoing climate crisis.
To help address this challenge, the Alliance established a project in mid-2022 to identify how health systems policy-makers and managers are responding to climate change and to share lessons on how countries can overcome existing barriers. This project is synthesizing evidence to respond to the climate crisis and move towards climate-resilient, low-carbon and sustainable health systems. Using mixed-method approaches and working closely with national health policy-makers, the results are expected to improve health policy as well as broader resilience.
Health policy and systems research is crucial to understanding the impact and implications of climate change. HPSR draws on a blend of public health, economics, sociology, anthropology, political science and epidemiology. It analyses how health systems respond and adapt, and how health policies can shape and be shaped by health systems and broader determinants of health. The interdisciplinary nature of HPSR positions it well to tackle the complexity of climate change and improve the analysis of linkages between health and climate. More broadly, the HPSR community can help identify, codify and prioritize interventions and make the link between policy-makers and researchers to accelerate evidence sharing and implementation to mitigate and adapt to the ongoing climate crisis.
Following an open call for proposals in 2022 for Round 1 of this project, the Alliance’s Scientific and Technical Advisory Committee selected six country research teams to carry out this work in Bangladesh, Guyana, the Islamic Republic of Iran, Mozambique, Nepal and Peru.
Based on the success of Round 1, in 2023 the Alliance has decided to continue and expand this important work. Another six countries have been selected to expand the knowledge base and identify further lessons learned. These studies will shed valuable insights on the challenges and opportunities in addressing climate change within health systems. In line with the Alliance’s values, this project will focus on equitable and inclusive solutions that prioritize the health and resilience of those who are most at risk. This research will help inform policy-makers and managers worldwide, fostering the development of evidence-based policies and interventions that safeguard public health in the face of climate change.
Explore the map or tables below to find out more on the areas of focus of the Round 1 (red) and Round 2 (blue) studies.
Round 1
| Country | Grantee institution | Project objective |
|---|---|---|
| Peru | Universidad Peruana Cayetano Heredia, Unidad de Ciudadania Intercultural y Indígena, Facultad de Salud Pública y Administración | To understand how Indigenous communities and leaders’ responses to shocks are being articulated and adapted within the health system of two Amazonian regions: Loreto and Junín. |
| Guyana | College of Medical Sciences, University of Guyana | To examine how national policies incorporate and address the health impacts of climate change and assess current implementation of health-related climate change interventions in Guyana’s health system. |
| Bangladesh | Initiatives for Climate Change and Environment (ICCE), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) | To identify and document existing health system policies responding to climate change, in terms of mitigation and adaptation; to improve health policies in collaboration with health policy-makers to establish climate resilient health systems; and to synthesize evidence for the development of improved guidance to overcome health system barriers. |
| Nepal | Dhulikhel Hospital, Kathmandu University Hospital | To document how health system policy-makers in Nepal are responding to climate change and to share knowledge and experience in the formulation of mitigation and adaptation measures moving towards a climate resilient health system. |
| Islamic Republic of Iran | Tehran University of Medical Sciences | To identify the Iranian health system’s vulnerabilities to climate change and analyse strengths, weaknesses, opportunities and threats towards building a climate-resilient health system and eventually formulate strategies and policies towards an adaptation plan for climate-resilient health systems. |
| Mozambique | Instituto Nacional de Saúde, Mozambique – National Observatory of Health (Climate Environment and Health Platform) | To understand the main health-systems-related challenges encountered in the response to climate change and assess current efforts to prepare, adapt and respond. Using case studies of recent cyclones, lessons will be developed to inform new strategies to build climate-resilient health systems in Mozambique. |
Round 2
| Country | Grantee institution | Project objective |
|---|---|---|
Argentina | Fundación Interamericana del Corazón | To describe the strengths and weaknesses of the institutional and normative setup that governs the integration of climate and health policies, and to describe to which extent the Argentinian health system – at the national, regional, and local levels – are taking action to address climate change. |
India | Taru Leading Edge Private Limited | To evaluate current policies, programmes and practices to identify and document examples where the health system is actively responding to climate change, whether by trying to mitigate climate change, adapting health systems or improving
health policies and broader resilience. |
Pakistan | Sustainable Development Policy Institute (SDPI) | To identify barriers at leadership, governance, infrastructure and human resource levels and move towards climate resilient, low-carbon, sustainable health systems at the district level. As well as to provide awareness to policy-makers
on how to integrate mitigation and adaptation policies and interventions. |
West Bank and Gaza Strip | Institute of Community and Public Health, Birzeit University | To explore the context-specific challenges regarding the climate change crisis in the West Bank and Gaza Strip and to understand the roles of the different entities of the health system in building resilience as well as a framework for
creating a climate-resilient health system. |
| United Republic of Tanzania | University of Dar es Salaam | To determine the current state of implementation of the Tanzanian Health National Adaptation Plan (H-NAP) and its successes and challenges, as well as to document on-the-ground adaptation practices and translate them into lessons learned
for policy-makers. |
| Uganda | Makerere University School of Public Health | To explore the health systems and policy mitigation and adaptation measures instituted to build resilience against landslides and floods in the Bududa and Cases districts of Uganda to inform creating environmentally sustainable and climate
resilient health systems. |
NOTE: This article was originally published on 22 May 2022. It has been republished on 24 August 2023 to reflect the addition of a second round of grantees.