On Thursday, 13 November, in Belém, it felt different. After nearly a week of carbon accounting, negotiating blocs, and the usual alphabet soup of COP jargon, Health Day cut through the noise like a clearing in the Amazon canopy. Delegates packed into humid tents and over-air-conditioned halls to confront a truth that can no longer be tucked into side events: climate change is already a health emergency. The agenda shifted from emissions curves to human lives — the heat-stricken, the smoke-choked, the flood-displaced, the disease-exposed.
For a few rare hours, COP30 wasn’t just about parts-per-million or political posturing. It was about bodies, systems, and communities under strain, and what the world intends to do about it. That shift in tone was unmistakable, and long overdue, as Health Day finally put people — not just policies — at the centre of the climate story.
Climate-Sensitive Diseases on the Rise
Climate change is intensifying the spread and severity of infectious diseases that thrive in warmer, wetter environments. Delegates at COP30 highlighted how shifting rainfall patterns and rising temperatures are expanding the range of vector-borne diseases, such as malaria and dengue fever. “Rainfall patterns are less regular, facilitating the spread of mosquito-borne diseases such as malaria and dengue,” reports Doctors Without Borders (MSF), which notes these illnesses can become deadlier when combined with malnutrition.
In 2024, the Americas experienced their largest dengue outbreak in history – a sign of how a warming climate is amplifying epidemics. Meanwhile, extreme heat is emerging as a major killer: heat-related deaths have surged 23% since the 1990s, now exceeding half a million per year. Health officials warn that without more decisive climate action, diseases like cholera, Zika, and yellow fever could similarly gain ground, placing millions more at risk in the coming decades.
Photo Credit: Médecins Sans Frontières
A mother tends to her child suffering from malnutrition and malaria at an MSF clinic in Madagascar. Climate change exacerbates nutrition and disease crises – droughts, crop failures, and flooding drive malnutrition, which in turn makes infections like malaria or dengue more deadly.
Beyond tropical diseases, extreme weather events linked to climate change are causing direct injury and indirect health crises. For example, successive floods and landslides in Brazil’s Rio Grande do Sul state in 2023–2024 killed thousands and displaced hundreds of thousands. MSF teams on the ground provided mobile clinics and mental health support, treating injuries and waterborne disease outbreaks in overwhelmed communities. Each disaster weakens local health systems and increases vulnerability to the next. “We are not talking anymore about distant or possible threats,” noted Dr Jarbas Barbosa, Director of the Pan American Health Organization (PAHO). He pointed out that the Americas just experienced its hottest year on record, with cascading health impacts: in 2024 alone, 154,000 people in the region died from exposure to wildfire smoke. Such statistics underscore that climate-sensitive health risks are no longer hypothetical – they are happening here and now, and they disproportionately strike vulnerable populations with the least resources to cope.
Air Pollution: A Dual Climate and Health Crisis
Air pollution emerged as a prominent concern at COP30, given its tight links to both climate change and public health. The burning of fossil fuels – the chief driver of global warming – also poisons the air, causing an estimated 7–8 million premature deaths each year from respiratory and cardiovascular diseases. This makes air pollution “the climate crisis already inside our lungs,” as advocates framed it. Cleaner air is a clear example of the co-benefits of climate and health. Every measure to reduce greenhouse gas emissions (such as phasing out coal and oil) also reduces particulate pollution, yielding immediate health benefits. “Cleaner air, safer water, sustainable food systems, and resilient infrastructure mean healthier communities and better lives – a triple win for human health, the economy, and the climate,” noted UN Climate Chief Simon Stiell. Policymakers at COP30 stressed that decarbonising energy and transport systems could prevent millions of deaths from air pollution while also slowing climate change.
Despite this, there was debate about how explicitly the COP30 process should link the phase-out of fossil fuels with health outcomes. A major climate-health plan launched in Belém notably omitted any reference to fossil fuels, reportedly at the host country’s instruction. Health experts warned that ignoring the root cause of both global warming and toxic air would be a mistake: “8 million people are dying annually from air pollution, yet the plan didn’t mention phasing out fossil fuels,” one observer noted. The omission comes as the International Energy Agency warns that oil and gas demand could continue rising for decades unless stronger policies are implemented.
Many countries still heavily subsidise fossil fuels – in fact, 15 nations spent more on net fossil subsidies than on their entire health budgets last year. In side events, organisations like the Global Climate and Health Alliance urged governments to commit to a just transition away from fossil fuels, framing it as a public health imperative. They emphasised that bold mitigation action – shifting to clean energy and transport – is needed not only to meet climate goals but to reduce the enormous health burden of air pollution.
Mental Health: The Invisible Toll of Climate Change
COP30 brought unprecedented attention to the mental health impacts of climate change. As climate-related disasters multiply, communities face not just physical harm but profound psychological stress. “Repeated and overlapping extreme events…erode psychological and emotional resilience, causing complex trauma,” MSF observed in a statement. In flood-ravaged areas of Brazil, for instance, families suffered the trauma of displacement, loss of loved ones, and the anxiety of rebuilding in an uncertain future.
MSF responded by training local professionals in psychological first aid and providing mental health support in emergency shelters. Such stories highlight what experts call “climate distress” – the depression, anxiety, and hopelessness that can follow climate disasters or even the anticipation of climate change. Youth delegates at COP30 spoke out about climate anxiety, noting that the fear of an unstable future is affecting the mental well-being of young people worldwide.
For the first time in COP history, mental health featured centrally in an official climate-health framework. The newly launched Belém Health Action Plan includes a comprehensive section on integrating mental health into climate adaptation. It urges concrete steps, such as embedding mental health and psychosocial support (MHPSS) in national climate-health plans, strengthening mental health services to withstand disasters, and providing community trauma support after extreme events. “Resilient communities are also mentally healthy communities,” advocates stressed, calling mental health an essential component of climate resilience. Negotiators in Belém acknowledged that addressing psychological recovery and well-being is critical to a comprehensive climate adaptation.
There were calls to track mental health outcomes under the Global Goal on Adaptation, using new indicators (such as the proportion of communities with MHPSS programs for climate emergencies) to ensure countries report progress. This represents a significant shift – from historically sidelining mental health in climate talks to recognising it as a pillar of the response. As one Brazilian official put it, “If our efforts overlook local and Indigenous knowledge, we risk ignoring real needs and deepening existing inequalities”, – and mental health needs are part of those fundamental needs. By the close of COP30’s Health Day, countries were encouraged not only to cut emissions but also to invest in healing the invisible scars that climate change leaves on minds and communities.
Nutrition and Food Systems Under Strain
Climate change is undermining food security and nutrition, a point that has been repeatedly underscored at COP30. Droughts, floods, and shifting weather patterns are disrupting agriculture and worsening hunger in many regions. As crops fail or yields decline, communities face higher rates of malnutrition, which in turn exacerbates health vulnerabilities.
“In Zimbabwe, drought resulted in crop failures,” MSF reported, “which drove farmers to informal mining…then access to safe water became a major issue” requiring emergency intervention. In the Sahel and Horn of Africa, prolonged droughts have pushed millions into a food crisis, illustrating how climate change can trigger a vicious cycle of famine and disease. Malnutrition weakens immune systems and makes infections more deadly; MSF noted that diseases like malaria became more lethal amid malnutrition spikes in Nigeria. Conversely, climate-fueled disease outbreaks (such as diarrheal illnesses or cholera after floods) can worsen malnutrition by causing nutrient loss.
At COP30, experts highlighted the resilience of food systems as a priority for both mitigation and adaptation. Sustainable, climate-smart agriculture was promoted to both reduce emissions and ensure reliable food supplies. Representatives from vulnerable countries emphasised that erratic seasons and extreme weather are already crippling farmers and driving up food prices, with the poorest communities being hit the hardest.
The World Health Organization has warned that climate change is a “risk multiplier,” exacerbating food insecurity, which in turn leads to undernutrition and stunted growth. Indeed, the COP30 special health report found that 3.3 to 3.6 billion people already live in areas highly vulnerable to climate impacts – many of these are subsistence farming communities facing heightened risks of hunger. In policy discussions, there has been a push to incorporate nutrition into climate adaptation plans, for example, by developing early warning systems for crop failures and integrating nutrition programs into disaster response efforts.
Delegates noted that every climate adaptation measure – from drought-resistant crops to flood-proof infrastructure – ultimately has a human face: “These are not statistics – they are families, communities, and futures already paying the price of global heating,” said Simon Stiell, emphasising that food security and health security go hand in hand. By the end of the summit, calls for “sustainable food systems” were woven into the broader narrative that climate action must protect the foundations of health, including the availability of nutritious food and clean water.
Building Climate-Resilient Health Systems
A clear theme at COP30 was that health systems themselves must be fortified against climate change. Hospitals and clinics on the front lines are increasingly overwhelmed by climate shocks – from cyclone damage to heatwaves flooding emergency rooms – and many lack the capacity to respond effectively. The WHO warned in a new report that “over 540,000 people [are] dying from extreme heat each year and 1 in 12 hospitals worldwide [is] at risk of climate-related shutdowns” as of 2025. By mid-century, the number of health facilities at risk could double unless we bolster infrastructure to withstand floods, storms, and heat. Already, hospitals face a 41% higher risk of damage from extreme weather compared to 1990. These stark figures underscore the urgency of investing in climate-resilient health systems, enabling clinics to withstand disasters and continue providing care when it’s most needed.
Photo Credit: Médecins Sans Frontières
MSF teams navigate a landslide in Mexico to reach remote communities after intense rains. Climate-related disasters are striking vulnerable areas with increasing frequency, underscoring the need for resilient infrastructure and rapid health responses.
At the COP30 Health Day, Brazil, as the host nation, unveiled the Belém Health Action Plan, a comprehensive framework to strengthen global health sector adaptation. “For decades, WHO has been calling for action to adapt health systems… The Belém Health Action Plan is how we can do that,” said Dr Tedros Adhanom Ghebreyesus, WHO’s Director-General. The plan lays out over 60 recommended actions across three pillars: (1) climate-informed surveillance and early warning, to predict outbreaks and extreme events; (2) evidence-based policies and capacity-building, to protect communities through measures like heat-health alert systems, clean energy in hospitals, and mental health support; and (3) innovation and green technologies, from telemedicine to climate-resilient medical supply chains.
These strategies align with the plan’s cross-cutting focus on health equity and climate justice – recognising that poor and marginalised groups are most at risk. “The climate crisis is one of the most significant health challenges of our time,” the plan declares, warning that rising temperatures and collapsing health systems will claim ever more lives without urgent intervention.
Real-world examples illustrate the scope of climate-resilient health measures. PAHO expanded its “Smart Hospitals” initiative, which has retrofitted over 70 Caribbean hospitals with disaster-proofing and solar power. Those upgrades paid off when Hurricane Melissa struck recently – the smart hospitals in Jamaica stayed operational and saved lives, even as other infrastructure failed. Similarly, early warning systems are scaling up: between 2015 and 2023, the number of countries with Multi-Hazard Early Warning Systems doubled to 101, covering approximately two-thirds of the global population.
However, many low-income nations still lack these capabilities (only ~46% of Least Developed Countries have an effective warning system). Critical gaps remain: fewer than half of national health adaptation plans assess climate risks to health facilities, and fewer than 30% consider the impacts on vulnerable groups, such as people with low incomes or women. Health workforce training is another gap – most countries need more climate-trained health personnel and emergency planners.
“Many health systems are fragile – lacking climate-trained personnel, resilient infrastructure, and adequate surveillance,” noted Stiell. To address this, delegates emphasised the need to integrate climate considerations into health sector planning at all levels, from hospital design standards to medical education curricula. The mantra of the day became “climate-proof every clinic” and ensure “no healthy people on a sick planet” – meaning a healthy future is impossible unless our health systems adapt to and mitigate climate change.
Policy Initiatives and Funding Commitments at COP30
Policymakers and organisations used COP30 to drive home the message that protecting health must be a core part of climate action – and they backed it with new initiatives (if not enough funding). Over 60 countries and numerous institutions endorsed the Belém Health Action Plan as a voluntary commitment to accelerate health adaptation. Initial supporters spanned Europe (e.g., France, Spain), small island states like Tuvalu, African nations from the Congo to Zambia, and others, including Canada, Japan, the UK, and Malaysia. Endorsing countries agreed to report on their progress by the Global Stocktake in 2028, using the WHO’s climate-health tracking framework (the ATACH initiative).
“There’s a very strong commitment from our government and ministers of health in this plan,” affirmed Brazil’s Health Minister Dr Alexandre Padilha. By COP30’s close, Brazil will have announced that over 80 nations and organisations had signalled support, describing the plan as a “blueprint… Now we have no alternative but to adapt and face climate change. If we don’t adapt, we will increase inequality…we will kill people”. Even the UNFCCC leadership embraced it:
“The Belém Health Action Plan gives us the blueprint. What we need now is sustained, coordinated, and well-financed action to turn its promises into protection for all,” said UN Climate Executive Secretary Simon Stiell. Importantly, health is becoming mainstream in climate policy: over 90% of national climate plans now include health considerations, and every National Adaptation Plan since 2024 addresses health risks, ranging from heat to infectious diseases – a remarkable shift toward health-centric climate planning.
However, financing emerged as the Achilles’ heel of these lofty commitments. The Belém plan was launched without any new funding pledges from governments attached. The only notable funding announcement was from a coalition of philanthropies (Wellcome Trust, Gates Foundation, Rockefeller Foundation, etc.), which committed $US 300 million toward climate and health initiatives. That one-time grant, while welcome, is a drop in the bucket. The UN Environment Programme estimates that low- and middle-income countries require at least $ US$11 billion annually for basic health adaptation, covering measures such as malaria and dengue control, climate-driven diarrhoea prevention, heatwave response, and surveillance upgrades. Even that $US 11B figure omits many costs included
in the Belém plan, such as addressing respiratory illnesses, malnutrition, mental health services, protecting healthcare workers, and decarbonising hospital systems. By 2050, the UNFCCC projects that global adaptation needs for health could reach US$277–29 billion per year. In stark contrast, current health-specific climate finance is estimated at only $US 500–700 million annually, roughly 0.5% of total climate finance.
“Health systems, already stretched and underfunded, are struggling to cope with these growing pressures… Existing finance falls short by billions. Without urgent investment, we will not be able to protect populations from escalating climate impacts,” warned Dr Marina Romanello of the Lancet Countdown on Health and Climate Change. Carlos Lopes, African Union envoy, lamented the “colossal deficit” in health adaptation funding. Indeed, many developing countries spend more on debt servicing than on healthcare, underscoring the need for grants and debt relief to fund climate-health needs.
To bridge this gap, COP30 negotiators and health leaders pressed for the integration of health into all climate funding mechanisms. They urged that a larger share of the promised US$100 billion or more in climate finance be earmarked for health adaptation (currently, only ~2% of adaptation funding goes to health). “The evidence is clear: protecting health systems is one of the smartest investments any country can make,” said Professor Nick Watts, chair of the COP30 health report advisory group. He noted that allocating just 7% of adaptation finance to health (up from ~2% now) could safeguard billions of people by keeping essential services running during climate shocks.
In line with this, the COP30 Special Report on Health and Climate Change calls on governments to integrate health into their climate plans (NDCs and NAPs), invest in resilient infrastructure (especially hospitals), and leverage the cost savings from low-carbon policies to reinvest in health capacity. It also highlights the need to empower communities and incorporate Indigenous knowledge in designing health responses, ensuring solutions fit local realities.
By framing climate change as “fundamentally, a health crisis”, COP30 succeeded in elevating health to the top tier of climate negotiations. Countries left Belém with a more explicit mandate: protect people’s health as a priority outcome of climate action. Achieving this will require following through on plans, such as the Belém Health Action Plan, with real resources. As Dr Tedros summed up, “This special report provides evidence of the impact of climate change on individuals and health systems, and real-world examples of what countries can do – and are doing – to protect health…
Now it’s time to turn commitments into action”. The challenge ahead is to turn the promises and piloted projects into scaled-up, well-funded programs that save lives. The hope emerging from COP30 is that health can become a unifying priority – a human-centric lens that drives faster climate ambition. In the words of one negotiator, “Humanity can only win this global climate fight if we connect stronger climate actions to people’s top priorities in their daily lives… and there are few higher priorities than our health”.
MSF teams navigate a landslide in Mexico to reach remote communities after intense rains. Climate-related disasters are striking vulnerable areas with increasing frequency, underscoring the need for resilient infrastructure and rapid health responses.
