Managing Director & Partner
Climate change is an urgent health crisis. As the World Health Organization (WHO) notes, it presents a fundamental threat to health. The consequences are already being felt today. The increasingly severe and frequent climate-related events around the world, from rising temperatures to floods, have significant direct and indirect impacts on human health. (See “Climate and Health by the Numbers.”)
At the first ever Health Day at COP28, 123 countries signed the Declaration on Climate and Health. Although it was a great step in the right direction, it is not enough. With the health care ecosystem both contributing to and impacted by climate change, there’s a lot of work to do on mitigation and adaptation. Careful coordination is needed across funding and implementation to ensure that stakeholders focus where it is most impactful.
BCG conducted a study of more than 70 organizations—including philanthropies, multilateral development banks (MDBs), government agencies, nongovernmental organizations, private sector actors, and others—to understand how key stakeholders are approaching this complex challenge. (See “About Our Research.”) We found that:
Our findings point to the value of developing a strong evidence base on the ways that climate and health intersect and building transparency on what different funders, implementers, and policymakers are doing to address it. This will enable organizations to prioritize activities based on the role they want (and are best positioned) to play, current levels of funding and attention, and the future health burden attributable to climate. It will also allow organizations to better collaborate with each other and to mobilize around cost-effective, impactful solutions.
We hope that unlocking a coordinated and prioritized approach, enabled by evidence and transparency, will accelerate progress on climate and health. Right now is the time to build on the momentum and commitments generated at COP28.
Our research identified three challenges to taking action on climate and health.
The relationship between climate and health is complex. Climates broad impacts range from injury and mortality from extreme weather events to escalating infectious diseases, malnutrition, and mental health impacts to worsening health outcomes due to reduced health service delivery (such as when a clinic is flooded). Then there are also health’s impacts on the climate. This complexity and breadth were reflected in the wide-ranging topics discussed at COP.
However, the specific risks, levels of vulnerability, and magnitude of impact differ across locations and demographics. For example, there are more than 200 human diseases that can be aggravated by climate change and more than 1,000 different pathways of transmission.
Decision makers lack the tools and data they need. Despite the growing body of evidence linking climate and health, better data—and stronger evidence—is still needed to enable the setting of priorities. The most recent assessment of projected climate-related annual deaths by the Intergovernmental Panel on Climate Change (IPCC) noted a lack of available literature for some diseases and most mental illnesses.
Capital and resources remain limited. Despite encouraging recent commitments from philanthropies, countries and MDBs and collaboration on funding (e.g., a new co-investment facility from GCF, UNDP, and WHO; a new climate and health initiative by ADB), the total amount of funding is still likely insufficient. While the COP28 press briefing referenced over $1 billion of funding for climate and health, much of this is a commitment to add a climate-lens to existing health funding vs incremental additional funding or is in early stages, without clear priorities for near-term investments.
Out of the global health funders we examined, foundations (often by applying climate or health lens to their existing portfolios) and multilateral development banks (through both specific climate and health strategies and cross-sectoral funding) are helping pave the way on climate and health.
Many governments don’t have clearly defined or published official development assistance strategies on climate and health, but they still recognize the overlap and intersection between the topics and have committed funding to the topic. For example, 123 countries signed a Declaration on Climate and Health at COP28, committing to incorporate health targets in their national climate plans and increase international collaboration. In other notable developments, the UK has committed £18 million to support partner countries to assess vulnerability, identify priority actions, and support planning in climate and health.
Governments are also introducing domestic policies on climate and health. Notably, 91% of nationally determined contributions to the Paris Agreement now include health considerations.
However, despite several players clarifying their ambition and releasing strategies in the run up to COP, most of the players we assessed are still early in their journeys—exploring what a climate and health offering looks like and where their action is most needed—and many are applying a climate or health lens to their existing priorities rather than leading or shaping the field. (See Exhibit 1.) Few have clear, discrete, and ambitious enough strategies. However, 20 organizations, while still figuring things out, stood out in their ambition and efforts to drive action in the ecosystem.
Four key observations from our study:
Building on our findings and learnings from other global efforts, we have identified three key actions that climate and health players can take to help accelerate action.
Coordinate and develop the evidence base. Decision makers need a stronger base of evidence to inform the setting of priorities. They need to understand where, and to what extent, climate change will affect human health, as well as the potential impact of various interventions and economic consequences. WHO and IPCC assessed the future burden of climate-sensitive health risks (CSHRs) in 2014, finding heat and undernutrition of greatest concern until 2050—but this assessment is almost a decade old and limited to certain impacts. While evidence is growing, there is still a pressing need to coordinate and develop the evidence base that will allow organizations to assess where the highest need is.
Double down on prioritization: We can act on the known risks now. Once we understand the relationships, impact, and economic consequences, we will be able to re-evaluate and prioritize efforts and ensure that our action is balanced and appropriate to burden, across and within geographies and topics. A better understanding will help us assess whether and where our limited resources are best spent (e.g., on mitigation vs adaptation efforts, specific impacts, etc.), and what sort of action is needed. Some key questions to ask:
Given the breadth of the climate and health nexus, it will be important that stakeholders mobilize around a prioritized, data-driven shared agenda to ensure maximum impact.
Build transparency to unlock collaboration. With several strategies published in the run-up to COP, organizations are starting to build transparency. However, with new players entering the field and deciding where to play and as more nascent strategies are translated into specific near-term actions or priorities, there’s a long way to go. Global health players will benefit from a greater understanding of what others are doing, so that all can more effectively target their contributions, secure funding, and work with each other to mobilize around a shared, high-impact agenda, otherwise we risk unhelpful fragmentation. Uniting around a common terminology and framework that help understand the climate and health landscape and priorities will be important in this.
The prioritization discussed above needs to be actor specific. Different types of players will be positioned to address different impacts, and in different ways—be it by influencing, funding, or implementing solutions. For example, we identified significant action in adjacent fields that may address some CSHRs. For these CSHRs, global health influencers can deliver great value by targeting advocacy efforts on these ecosystems, and global health researchers can advance thinking on the health-specific impacts. On the other hand, global health funders and implementers may need to play a more direct role in tackling certain vector-borne diseases and zoonoses and mental health impacts that will be unlikely to be addressed by activity in other fields. (See Exhibit 3.)
The growing interest in tackling the intersection climate and health is encouraging. We hope that coordination of research, a stronger evidence base, and building transparency within the climate and health ecosystem will allow a more targeted and prioritized response—accelerating action that can save millions of lives.
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