From Commitments to Action: ADBI’s Roadmap for Climate-Resilient Healthcare Systems

The Asian Development Bank Institute emphasizes the urgent need for multisectoral measures to climate-proof health systems, highlighting commitments from global summits like COP28 to decarbonize healthcare and enhance resilience against climate impacts, especially for vulnerable populations. Their policy brief outlines strategies for sustainable, low-carbon health systems and the importance of robust climate legislation, capacity-building, and multisectoral action to safeguard health.

The intensifying impacts of climate change on health demand urgent multisectoral measures to climate-proof health systems, with a focus on safeguarding vulnerable populations. The Asian Development Bank (ADB) has been at the forefront, supporting G20 health working groups in integrating climate and health agendas, leading to significant commitments by G20 Health Ministers and reaffirmations during the G20 New Delhi Declaration in September 2023. At the COP28 Summit in December 2023, progress was made in tackling climate change, emphasizing the urgent need to phase out fossil fuels and mobilize funds for climate-vulnerable countries.

The Rising Threat of Climate Change to Global Health

The policy brief from the Asian Development Bank Institute (ADBI) offers evidence-based strategies to build resilient healthcare systems capable of protecting against the severe health effects of climate change. Despite previous pledges to reduce greenhouse gas emissions, global temperatures are projected to surpass the targets set by the 2015 Paris Agreement, potentially increasing by 3°C by the end of the century. This increase would have catastrophic repercussions on human health, particularly for vulnerable groups, exacerbating heat-related health problems, malnutrition, mental illness, chronic diseases, and infectious diseases. The economic burden of climate change is already substantial, with health costs amounting to 2 billion dollars to 4 billion dollars annually, a figure expected to rise to 54 trillion dollars for a 1.5°C increase and 69 trillion dollars for a 2°C increase by 2100.

Historic COP28 Summit and Its Implications

Despite the historic steps taken at COP28, which managed to mobilize 85 billion dollars in new climate financing and establish a Loss and Damage Fund to support the world's poorest countries, there remains an urgent need for decisive action. The initial 800 million dollars raised for the fund represents only a fraction of the necessary climate financing. For the health sector, COP28 marked a historic moment with the first-ever Health Day, highlighting the catastrophic health impacts of climate change. The UAE Declaration on Climate and Health, endorsed by 120 countries, calls for strengthened cross-sectoral collaboration, increased financing for climate and health solutions, and the building of climate-resilient health systems.

ADB's Climate and Health Initiative: A Strategic Response

The ADB's Climate and Health Initiative (CHI) aims to operationalize these commitments by accelerating investments in climate and health, fostering collaboration, and promoting scalable innovations. CHI focuses on decarbonizing healthcare, building sustainable and low-carbon health systems, and mobilizing finance for resilient, low-carbon healthcare systems. Mitigation measures in healthcare are essential, given that the sector accounts for roughly 5% of global greenhouse gas emissions. If the sector were a country, it would be the fifth-largest polluter on Earth. Adopting green strategies, such as product redesign, can significantly reduce healthcare emissions, cutting them by 70% by 2030, with 40% achievable without increasing overall costs.

Essential Steps for Building Climate-Resilient Health Systems

The policy brief also outlines the need for robust and enforceable climate legislation, capacity-building for healthcare professionals, and the development of Health National Adaptation Plans (HNAPs) to respond to climate change. HNAPs should be informed by vulnerability and adaptation assessments, which evaluate current and future vulnerability to climate change. These plans should be developed at community, regional, and national levels within a multisectoral framework, engaging communities and local experts for stronger impact. Adequate funding is crucial to ensure that low- and middle-income countries can finance and prioritize the integrated delivery of national action plans. Strong leadership in Ministries of Health is essential for the successful development and implementation of HNAPs, including the appointment of a well-resourced climate change focal point.

Multisectoral Action: A Necessity for Safeguarding Health

The brief emphasizes the importance of weather systems monitoring and robust information systems to collect relevant data on climate-sensitive health outcomes. Robust weather monitoring systems should track existing weather events and plan for future ones, including early warning systems for extreme weather events and the monitoring of health impacts on marginalized groups. Effective monitoring requires sustained human and financial resources, innovative partnerships, and greater institutional awareness of the complex interconnections between climate change and health. Low- and middle-income countries are likely to require considerable funding and technical expertise to build robust weather monitoring systems.

The policy brief underscores that multisectoral action is vital to safeguard health against the catastrophic impacts of climate change. The world is still far from achieving Universal Health Coverage (UHC) by 2030, and multiple groups remain highly vulnerable. Women, for instance, are 14 times more susceptible to death from climate-related disasters than men and account for 80% of people displaced by the climate crisis. To address these systemic vulnerabilities, ambitious multisectoral actions are required, ranging from reducing income inequality and providing economic assistance to climate-vulnerable groups to transforming food systems and maintaining food and water security. Ministries of Health should lead climate and health initiatives in close partnership with relevant ministries. Robust mechanisms and incentive structures are needed to ensure that multisectoral action to adapt to climate change is streamlined, coherent, and impactful. The ADBI policy brief provides a comprehensive roadmap for building resilient healthcare systems to protect global health in the face of a changing climate.