5 ways to strengthen health systems in the face of climate change

Once seen as an environmental challenge, climate change is now being recognized as the largest public health crisis of our time. Worldwide, increased pollution and extreme weather are already negatively affecting the health of millions — including more frequent cholera outbreaks, lung disease, heat-related illness and death, and mental health issues — and further burdening strained health systems.

This unprecedented challenge demands resilient and well-resourced health care systems at a time when many are unable to cope. While many high-income countries are still on the back foot after the pandemic and struggling to meet the needs of aging populations and an increase in chronic disease, less-resourced countries face compounding challenges including shortages of health workers, funding gaps, and disruptions in essential supply chains.

The Declaration on Climate and Health at the 28th United Nations Climate Change Conference put the climate-health nexus higher on the global agenda than ever before, yet experts say its $1 billion funding commitment is a drop in the bucket of what’s needed.

This is why, during the recent World Economic Forum annual meeting, Michel Demaré, board chair at AstraZeneca and Dr. Vanessa Kerry, CEO of Seed Global Health and World Health Organization special envoy for climate change and health, co-hosted a roundtable discussion to identify actionable and scalable solutions that can bring about transformative change for health systems and health care.

The conversation, held under the Chatham House Rule, was moderated by Devex President and Editor-in-Chief Raj Kumar and included more than a dozen health and environmental leaders who candidly shared their challenges, lessons, and commitments to action.

Here are five main takeaways from the discussion:

1. Reinforce the climate-health connection for decision-makers

The prerequisite for action is awareness. Decision-makers and citizens around the world must recognize the serious and sustained health threat posed by climate change — and the benefits of more sustainable and resilient health care.

We must let go of what participants characterized as “emergency thinking” and instead impress upon leaders that events such as heat waves and disease outbreaks are now regular occurrences placing untenable strain on our health systems.

So, how can we make this complex issue relatable and demonstrate the direct link between climate change and health outcomes today? Suggestions from leaders included highlighting individual human stories with a strong emotional appeal, as well as connecting the health effects of climate change to frameworks that stakeholders are already familiar with, including the U.N. Sustainable Development Goals and corporate, environment, social, and governance commitments.

2. Make health system resilience a political imperative

The health sector can’t steer this change alone. Re-designing health systems and health care delivery to cope with climate change challenges alongside ongoing population health needs requires collaboration at the highest levels and support from policymakers beyond health, including climate, finance, infrastructure, and transportation. Participants stressed the urgency for health care leaders to engage directly with governments, campaigning to build a strong social mandate on climate action for health.

This requires zooming out from individual outcomes to show the dire socioeconomic consequences that may compel political leaders to prioritize action: slower economic growth, exacerbated inequalities, forced displacement, and even national security risks.

The good news is some countries are already leading by example. As highlighted at the event, Brazil’s government now sees deforestation as a direct public health threat — partly because habitat fragmentation increases contact with zoonotic pathogens that cause infectious diseases — and has managed to curb it drastically in the last year alone.

3. Boost fiscal preparedness and increase climate-health financing

If there is one thing all discussion participants agreed on, it is that existing funding commitments are insufficient to tackle the climate-health challenge. Much more financing for adaptation and mitigation needs to be unlocked, bearing in mind that this is not a temporary crisis but a “new normal,” and one that less-resourced countries are simply not adequately financed to handle.

To that end, it is crucial to engage the private sector to co-design funding mechanisms, for example, banks could issue social bonds as they did during the COVID-19 pandemic, or explore revenue streams from air quality and electrification initiatives. Insurers could also play an important role in helping secure health care and climate investments that may be pivotal but where risk is a key factor in decision-making.

Leaders also acknowledged the health sector is currently responsible for around 5% of greenhouse gas emissions worldwide, which means we must develop solutions that can improve health outcomes while lowering the environmental footprint of health care. Notable developments in this space include a recent agreement between five health care companies, including AstraZeneca, to access renewable power in China, a key global market for pharmaceuticals manufacturing. This collaboration, convened by the Sustainable Markets Initiative, aims to support the transition to net-zero health systems and demonstrate that concrete, scalable action to decarbonize is possible through partnership.

4. Close the research gap

We can’t manage what we don’t measure. Yet the nexus between climate and health remains largely uncharted territory. Connecting the dots between climate and health project outcomes and developing more robust standards and indicators are all imperatives if we want to make the investment case and adequately finance systems to prevent human suffering and save lives.

Medical professionals also must be empowered with relevant information. A “revolution in education” was called for by one roundtable participant, explaining that most current health care training materials don’t even mention climate change and its direct impact on health outcomes. Incorporating sustainability into medical curricula would encourage future practitioners to consider environmental and climate impacts in their clinical practice. After all, a healthier patient is a greener patient.

5. Act now and act together

The pressure of climate change on our health systems grows by the minute. “We must act on what we know,” said one global health leader. Straight-forward interventions to adapt health systems, such as addressing health worker shortages, relocating medical equipment from basements to higher ground, or removing medicine stockpiles from flood-prone areas, can already make a difference.

Additionally, there is increasing evidence to show that acting earlier to prevent, detect, and treat disease can benefit people, health systems, economies, and the planet. Simply put, we need to move away from “sick care” systems to health care systems because the best thing we can do for the health of the planet is to keep people healthy.

While there is no silver bullet for solving this global, and equally very local, climate-health challenge, the key, participants insisted, is to embrace an unwavering sense of urgency and genuine willingness to collaborate.

If we do so, we may still be in time to galvanize political support, unlock long-term financing, and apply our learning fast enough to build truly resilient systems. Because, when it comes to climate and health, success will not be measured in carbon emissions but in human lives.