The climate crisis is inextricably linked to a global health crisis. From escalating heat-related illnesses to shifting patterns in vector-borne diseases and floods in East Libya, climate change is already taking a toll on global human health and healthcare systems. Recent international attention, like that garnered by the Africa Climate Summit in Nairobi, has elevated the discussion around securing better financial mechanisms for adaptation. Yet, an urgent and unresolved question looms: where will the necessary funds come from, especially for developing countries that are often hit the hardest and have the least resources for adaptation?
Attending the ENBEL (Enhancing Belmont Research Action to support EU policy-making on climate change and health) conference in Brussels, which focused on ‘Health Impacts of Climate Change — Advancing the European Adaptation Agenda to 2030,’ profoundly heightened my awareness of the pressing need for more robust financial resources in health adaptation to climate change. The conference unequivocally illuminated that current levels of health adaptation funding for addressing climate-related challenges are woefully inadequate.
New research, funded by ENBEL, provides concerning evidence that only a tiny fraction of international climate adaptation financing has been directed towards health needs over the past decade. Analysing data from 2009–2019, just 4.9% of multilateral and bilateral climate adaptation funds went to health projects globally. This equates to only US$ 1.4 billion out of over US$ 29 billion in total adaptation financing over a ten-year period. Worse still is the pitiful amount for projects with explicit health objectives, just US$ 0.1 billion.
Not only are overall volumes low, but very little targets core health system needs. Projects where health was the primary focus made up only 0.5% of multilateral climate funding, mostly for infectious disease control and surveillance. Vital areas like heat warning systems, climate-resilient health facilities, expanded mental health services, and local community health adaptation still lack investment.
The implications are troubling. As the Lancet Countdown on Health and Climate Change clarifies, climate change already contributes to disease, death, and health inequality worldwide. The Lancet Countdown tracks health financing via an indicator, showing a year-on-year increase in health adaptation spending from 4.6% in 2015–2016 to 5.6% in 2020–2021. However, more is needed to manage the health burden of recent climate events.
Sub-Saharan Africa faces an especially heavy burden yet still needs commensurate international support. The World Bank predicts the region will incur 80% of the global rise in climate-linked malaria and diarrheal disease by 2050. This will further strain overburdened health systems.
Adaptation financing can help change course. Funding water and sanitation systems adapted for climate extremes reduces water-borne illness. Warning systems allow preparation for heat waves and disasters. Resilient clinics maintain health services through storms and floods. We have the knowledge and tools for health adaptation but need the resources to implement them at scale.
Some progress was made at COP27, with a breakthrough agreement on a new “loss and damage” fund to support climate-vulnerable developing countries. But major gaps remain. Health ministries have yet to fully access climate funding opportunities, whilst health benefits often remain assumed, not measured, in many adaptation projects across sectors like agriculture and water. Accurate tracking of health financing is essential to verify where money flows.
Addressing the shortfall in climate funding for health adaptation is a shared responsibility that extends well beyond the donors. It’s imperative for governments in developing countries to prioritise health adaptation in their national climate plans and investments. Health leaders have a role in better articulating the risks and suggesting viable solutions.
Above all, the broader ecosystem of health financing — encompassing governments, global health organisations, and corporations — must internalise that climate resilience is not a separate issue but an integral component of strengthening health systems and achieving universal health coverage. As we ponder the pivotal question raised in the beginning — where will the needed funds come from — it’s clear that our collective health depends on an inclusive, multifaceted approach to financing climate resilience.