Climate finance for health: 'Woefully short, woefully slow'

Climate change and its impacts on health are expected to get increased visibility in New York next week during the annual U.N. General Assembly. But a senior official at The Rockefeller Foundation hopes it translates to funding. “Walking the talk is all about a serious commitment to help countries with their adaptation plans, specifically on health. And I want to see the dollar number. I want to see it increase,” Dr. Naveen Rao, senior vice president for health at the foundation, told Devex. Donors committed about $1 billion for climate and health at the 28th U.N. Climate Change Conference in Dubai last December. That included $100 million from The Rockefeller Foundation, which pledged $1 billion at UNGA in 2023 to advance climate solutions over five years. But the funding is nowhere near the ocean of need to help low- and middle-income countries adapt to the direct and indirect health impacts of climate change. According to the U.N. Environment Programme, countries will need an estimated $11 billion a year to deal with increases in malaria, dengue, diarrheal diseases, and heat-related mortality, as well as to make resilient health infrastructure in the face of climate change. “We are woefully short, woefully slow, and woefully inadequate,” Rao said. But low- and middle-income countries that are disproportionately affected by the effects of climate change can help scale up that financing by clearly articulating their health needs and what they plan to do through their national adaptation plans. This should include how they’re linking climate and health data, working across sectors to tackle the problem, and how much money they need and how much they’re putting in to fill that need, he said. “They have to have a plan, and they have to actually take responsibility. And I don't mean that we abdicate ours. We should work with them. But … the only way it will happen is if it's a pull model, where they improve financing towards their needs,” he added. There are some challenges in doing this, including linking climate change to health and why it’s a problem that should be tackled now. Many effects of climate change, particularly indirect ones such as on mental health, can take years to show up. It’s unlike acute events, such as an earthquake, that immediately grabs people’s attention. According to a 2023 World Health Organization review, 91% of nationally determined contributions — self-defined climate pledges by countries under the Paris Agreement — now include health considerations. Two-thirds of those NDCs have health-specific adaptation actions or plans, and close to one-third, or 29%, include climate finance allocations to those health-specific actions or plans. It’s a significant increase from 2019 when only 15% of NDCs allocated climate financing for health. But most are still dependent on international financial support versus domestic financing. More and more people now however are talking about the need for climate adaptation funding in the health space, and Rao is excited with the increased attention on climate change’s effects on health at this year’s UNGA. Unlike two years ago when there were very few discussions on the subject, there are now more coalitions and meetings focused on the issue. Some studies are also making the links between climate change and antimicrobial resistance, another global health threat. Many of these are happening on the sidelines of UNGA, where Rao believes a lot of the work gets done. “There are two UNGAs,” he said. The first is what is often captured in news headlines, where a lot of political theater happens. The second are the side events and the meetings, where Rao said work gets done. “I do believe work gets done there, and people do bring in science and implementation, and politics and financing to the table,” he said. The first meeting the foundation organized to develop the set of guiding principles for financing climate and health solutions, which was launched at COP 28, was on the sidelines of UNGA last year. But UNGA can also serve up a lot of distractions. “It gets overtaken by the receptions, the … protocols, the traffic jams, the show. More of that happens than I wish would. Less of what I want happens, happens. But it does happen,” he said.