February 9, 2025
25 C
Dhaka

Climate-Health Challenges : Local adaptation cornerstone of climate resilience

Increasing temperatures, fluctuating climatic and seasonal patterns, and extreme weather events are leading to heat stress, contagious disease surge, and climate change-fueled psychological challenges

Countries across South Asia, including Bangladesh, Nepal, Thailand, Myanmar, India, Pakistan, are witnessing a dramatic surge in Dengue cases.

These countries are also grappling with unusual, repeated seasonal changes and frequent heatwaves, which exacerbated the breeding and survival of Aedes mosquitoes – pushing these mostly climate vulnerable countries to the brink of a dire health emergency.

A World Health Organization (WHO) study had revealed that “Rising temperatures and changing weather patterns are altering the spread of vector-borne diseases,” and further identified “critical gaps” in the understanding how climate change is fueling infectious tropical diseases.

In today’s world, over 3.3 billion people are facing a highly climate-vulnerable and health-risk situation.

Increasing temperatures, fluctuating climatic and seasonal patterns, and extreme weather events are leading to heat stress, contagious disease surge, and climate change-fueled psychological challenges, further worsening the situation by damaging health-service facilities, infrastructures, and breaking supply chains in the affected areas.

Health impacts from climate change. This overview highlights the exposure pathways through which climate change affects human health. Exposure pathways exist within the context of other factors that positively or negatively influence health outcomes.
Health impacts from climate change. This overview highlights the exposure pathways through which climate change affects human health. Exposure pathways exist within the context of other factors that positively or negatively influence health outcomes.

Notably, throughout the last decade, the death toll due to extreme weather events was fifteen times higher than the less climate-vulnerable regions.

However, climate change-related health issues are continuously neglected and underfunded. Only 0.5% of multilateral climate finance is directed towards human health, and only 5% of the climate funding is allocated to health projects.

Therefore, to ensure the survival of the climate-affected country populations, it is essential to address the combined challenges of climate and health and organize effective and flexible finance based on vulnerable communities’ needs and priorities.

Global priority on health adaptation

Health adaptation aims to enhance the adaptive capacity of climate-affected populations to respond to or cope with a range of climate-sensitive health risks.

Historically, climate and health remained two distinct issues, but now “climate and health” is recognized together for their interconnectedness, and climatic impacts on human health and healthcare systems.

For the first time, UNFCCC COP28 included the “Health Day.” More than forty health ministers initiated the COP28 UAE Declaration on Climate and Health, and 150 countries endorsed it, setting a milestone for global climate negotiations to include health as an essential priority.

Furthermore, 194 countries adopted a resolution on “Climate Change and Health,” reaching a global consensus that “Climate change is a major threat to public health.”

Globally, health is increasingly seen as a key focus for climate investment. The Green Climate Fund (GCF), Adaptation Fund, Global Fund, World Bank (WB), and even philanthropies like Rockefeller Foundation and Wellcome Trust initiated to raise their allocation for health adaptation.

However, their efforts and committed funds are inadequate to meet the needs of the highly climate-affected 3.3 billion people.

Local actors key to health adaptation

Local actors’ engagement is uniquely positioned at the centre of health adaptation financing.

At the UN Summit of the Future, the Collective MindS Climate x Health Council, led by Foundation S and the Africa-Europe Foundation released a new report with an emphasis on financing the locally-led health adaptation, as a core element to combat climate-induced health risks.

Local communities are directly affected by climate change adversities, but their unique features expose them to distinct types of health risks based on geography, ecosystems, age, gender, religion, ethnicity, and disability.

Therefore, local actors are the source of best knowledge to design effective, fast, long-lasting, community-owned health adaptation solutions. Despite this, only 10% of climate finance reached local level to mitigate the climate-fueled health challenges.

Local leadership plays a pivotal role in developing timely and relevant health adaptation strategies, prioritizing community needs. Kenya’s Shibuye Community Health Workers (SCHW) is considered a good example of locally-led health adaptation.

In 2023, the Collective MindS Climate x Health Council called urgent attention to support and fund community-based health adaptation solutions, emphasizing on four action areas – placing local actors and communities at heart of decision-making process, validating local solutions, channeling flexible and direct finance to the communities, and fostering a suitable environment for local adaptation.

Barriers to health adaptation finance

The Collective MindS Climate x Health Council’s 2024 report identified four key barriers that prevent health adaptation finance to reach local level.

First, lack of adequate funding, unfit projects for locally-led adaptation, and lack of proper accountability, transparency and monitoring of funding’s distribution increase the incompatibility of the health adaptation projects.

Ministerial silos too are significantly responsible for missing collaborative approaches in this case. Furthermore, governmental structures lacking any participatory approach, and complex funding procedures limit effective health adaptation project implementation.

For instance, in Bangladesh’s Bogura district, a community cyclone shelter was built without consulting local communities, resulting in an inaccessible shelter center on the other side of a river.

Second, funders prefer science-based external lenses undervaluing local communities’ traditional knowledge and lived experiences, viewing locals as risks. Also, there are significant gaps in local data. These all restrict funding for promising community-led projects.

Key barriers to health adaptation finance for local communities
Key barriers to health adaptation finance for local communities

Third, power imbalances, and inequalities within the society and communities restrict representation and engagement of the locals, and marginalized groups.

Local leaders, organizations, and community members are usually occupied with diverse competing priorities, and dealing with climate disasters, leaving little scope to engage in projects and funding related wide ranges of activities.

Key priorities to act on

The study conducted by the Collective MindS Climate x Health Council’s, recommended nine actions under three priorities to unlock progress on locally-led health adaptation. The first priority is breaking down silos to ensure collaborative decision-making, involving local actors at all levels.

The Thai Coordinating Unit for One Health is considered as a good example for establishing climate and health decision-making units at the national level.

Since 2014, it has facilitated an integrated national approach to combat environmental health challenges, serving as the focal point for One Health cooperation both nationally and globally.

Secondly, governments, donors, and project developers should create ways for locals to co-create funding priorities, especially for global funding mechanisms.

Thirdly, including local leadership in project design and execution, and ecosystem-wide capacity building across countries is crucial to support large-scale community-based health adaptation programmes.

For instance, the Indigenous Peoples of Africa Co-ordinating Committee (IPACC) brings together 135 Indigenous Peoples’ organizations from 20 African countries, successfully blending indigenous knowledge and science in adaptation decisions.

Then, bridging capacity gaps is the next priority to capacitate locals to increase access to climate-health finance.

First of all, the funders should embed locally led adaptation principles in funding processes, simplify the funding mechanisms and processes, remove unnecessarily technical complexities, and tailor proposal processes to fit community-based projects.

It will help locals to get timely climate and health funding.

A pathway to fast-track flexible finance for locally-led health adaptation
A pathway to fast-track flexible finance for locally-led health adaptation

Secondly, funders and project developers should support local actors to develop proposals and design solutions.

Thirdly, to support implementation, governments and donors should fund dedicated research initiatives that reinforce local research excellence and spread the effectiveness of traditional knowledge.

Finally, creating dedicated financial mechanisms for locally-led health adaptation, building new and innovative funding channels is crucial.

First call to action is to regrant large funds to support multiple microgrant facilities, and small-scale community-led health adaptation projects and organizations. In particular, Prospera – a global network of women’s funds – delivers direct funding to grassroots feminist movements.

Second, funders should expand innovative funding for community-based health adaptation, such as blended finance, green bonds, resilience bonds, debt swaps, and result-based finance.

For example, the Seychelles worked with the Natural Conservancy on a “debt-for-nature swap” initiative, converting its $21.6 million in debt for marine protection funding. This arrangement also supports local projects to protect offshore ecology.

Additionally, funders and investors should support co-designing new pilot debt swaps engaging local actors.

Third, investors and donors should expand emergency response funds and catastrophe insurance to tackle climate and health risks.

For instance, the India Extreme Heat Income Insurance Initiative, a microinsurance programme, provides direct payments to women for lost wages during heat waves. In the May 2024 heat wave, it supported 46,000 women with $3,40,000 in payments to stay home.

To sum up, the intertwined climate and health issues pose a grievous threat to humanity, but still under-addressed.

It is imperative that governments, funders, and the international community collaborate with the climate-affected communities to overcome barriers. By taking proper measures to effectively and timely fund locally-led health adaptation, humanity will advance towards a resilient future.

Umme Sayeda, the author of this article, is a researcher and advocate for ecological justice.

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