Can we build resilience to both pandemics and climate change?

BERLIN — It is easy to understand why climate change activists might be looking at the aggressive global response to COVID-19 with some envy. With some notable exceptions, the pandemic has spurred a rapid, globally coordinated reaction. It has also unlocked significant money — including grants and support worth $160 billion from the World Bank and $1 billion from The Global Fund — some of it targeted at shoring up health systems in low- and middle-income countries that have been overwhelmed by the virus and ensuring they are better prepared for the next pandemic. The World Bank is making its funding, which includes a specific focus on addressing health implications, available over 15 months. And The Global Fund has released an initial allocation of $500 million aimed at mitigating the impact of the pandemic on countries’ HIV, tuberculosis, and malaria programs. Yet rather than framing the climate and health crises as separate or competing for scarce resources, Leonardo Martinez-Diaz, the global director of World Resources Institute’s Sustainable Finance Center, said there is an opportunity to leverage the money coming from donors and development banks toward investments that simultaneously make communities more resilient to both pandemics and climate change. “We need to get the health community to think more about climate change and to incorporate climate change and the challenges that come from it into their programs in both rich and poor countries, alike,” Martinez-Diaz said. “On the other side of the equation, we need to get those providing funding for climate change to think more about the health sector.” While there is more demand and “fewer dollars,” Martinez-Diaz highlighted the “overlapping middle.” “There are investments that help us deal with both of these threats.” “There is so little money being spent to try to connect the dots in a broader way.” --— Dr. Aaron Bernstein, director, Center for Climate, Health, and the Global Environment at Harvard’s T.H. Chan School of Public Health. Where to start? The most obvious investment opportunities in this overlapping middle are ensuring health systems are adapting to the effects of climate change, said Dr. Aaron Bernstein, director of the Center for Climate, Health, and the Global Environment at Harvard’s T.H. Chan School of Public Health. Without functioning health systems, communities have no hope of stopping the spread of a future pandemic. “We need to be thinking of innovative ways of buffering the risk [of] climate change,” he said, particularly in poor countries that lack resources to easily rebuild. Heavy rainfall, heat waves, and droughts caused by climate change are already more prevalent, and the United Nations Intergovernmental Panel on Climate Change predicts they are likely to increase. To withstand some of the effects of these events, Bernstein said, hospitals and health centers need to be built or retrofitted with alternative sources of power, in case extreme weather events shut down the grid, and health outposts need to be decentralized so that if one location is damaged or incapacitated, it does not leave an entire community cut off from health care. According to Bernstein, improving disease surveillance systems will also be key so that the emergence of unusual disease patterns can be identified faster and prevented from growing into pandemics. At the same time, there must be a simultaneous improvement in distributing information that emerges from this surveillance so that people are better aware of how to protect themselves when these incidents occur. Because warming temperatures are already affecting how diseases are spread, there are some smart information gathering and distribution systems emerging from experts interested in climate change’s impact on disease patterns. These systems might expand to accommodate the interests of experts trying to prevent the next pandemic. Christopher Perine, environmental management specialist at Chemonics, pointed to Mozambique, where health officials recognized that rising temperatures could translate into increasing cases of malaria in areas that were previously free of the mosquitos that transmit the disease. They proactively pushed for the creation of a climate and health observatory in 2016, which synthesizes data from weather forecasts to warn communities when to prepare for a possible malaria outbreak. That gives health officials time to take preventive measures and also raise awareness within communities, so if people develop symptoms, they know to quickly seek treatment. “This happened because someone in the ministry of health did see the connection between health and climate change,” Perine said. New investments meant to shore up countries’ ability to withstand future pandemics can also contribute to actually mitigating some of the causes of climate change. If the health care sector were a country, it would be the fifth-largest greenhouse gas emitter on the planet, according to the international NGO Health Care Without Harm. To help reduce the carbon footprint of the sector, Bernstein said any new investments in health infrastructure as a result of the pandemic could be both climate-friendly — for example the solar-powered clinics the social-justice non-profit Partners in Health constructed in Rwanda — and also resilient to the effects of climate change. The United Nations Development Programme is also spearheading an effort to promote sustainable procurement of health-related items across seven U.N. agencies. Together those agencies account for more than $5 billion in annual purchases, but there is an opportunity for other global institutions and donors to also invest in more eco-friendly and resilient procurement efforts. Rethinking the disaster risk architecture There are also lessons for COVID-19 and other pandemic responses in existing investments to make communities more resilient to climate change, Martinez-Diaz said, like disaster risk architecture — and an opportunity to reconceptualize it to accommodate health-related crises. “How can we look at resilience as not just climate-specific, but as a broader set of activities that make communities better able to withstand some of these losses resulting from different shocks?” he asked. Among the specific tools are general national disaster funds and climate-centered parametric insurance products — risk transfer instruments that deliver fast recovery payouts when disasters strike or offer protection to agencies looking to increase their programs in contexts where climate-related disasters are more likely. Beginning in 2018, the German and British governments have both put money — €25 million ($29 million) by the German government and £25 million ($33 million) by the British — into funds that development actors or financial institutions can tap into to pay for these kinds of products. The project is still in its early stages, although the British funding was used to purchase an option to buy up to $5 million of a catastrophe bond to offset the risk of volcanic activity. The bond would issue a quick payout to relief agencies if the height of possible ash plumes exceeds certain parametric measures laid out in the bond. It makes sense to broaden the expectations to cover both climate- and health-related disasters, because “these tools are going to be relevant in both contexts,” said Lauren Sidner, a WRI research associate. She also highlighted the potential of social safety net programs, particularly cash transfer programs, which can rapidly expand in response to a crisis. The problem, Sidner said, is that these are not rapidly built — relying on significant amounts of data and pre-defined rules about how to scale up and who should be targeted. But there is a growing acknowledgment they might be worth the investment. “They are seen as a tool that builds resilience to a lot of shocks,” she said. The World Bank, for instance, has called attention to the potential of scale-able social protection programs to help people caught in a disaster or pandemic — or both. Connecting the dots Given the opportunities to make communities simultaneously more resilient to climate change and health, it is particularly galling to experts that it has received so little focus — whether from major organizations and donors or smaller members of the development community. Even interventions designed to help countries adapt to and mitigate climate change have offered little support to the health sector. The Green Climate Fund and other dedicated climate funds have consistently underfunded activities in the health sector compared to the support countries have requested, according to WRI research. Martinez-Diaz did caution that it’s possible these funding requests are being met by other sources. “There is so little money being spent to try to connect the dots in a broader way,” Bernstein said, pointing to a legacy of siloed thinking that separates climate scientists from health experts. But with the global community grappling with demands to respond to both a climate and health crisis, now is an obvious opportunity to start looking for some overlapping opportunities, he said.