Connecting Climate Change and Health for Better Development

The World Bank
James Close
Olusoji O. Adeyi

Woman wears mask to protect from pollution. China.
Photo: © Curt Carnemark / World Bank

Climate change is already having real, measurable impacts on human health, and those impacts are expected to grow. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak health systems and poor infrastructure. The good news is that the cumulative impacts of climate change on health have been extensively discussed for decades and understanding is growing.

Climate change could drag more than 100 million people back into extreme poverty by 2030, with much of this reversal attributable to negative impacts on health. The co-pollutants associated with carbon emissions are already responsible for more than 7 million premature deaths each year. An additional 7.5 million children are expected to be stunted by 2030, 4 million of which are expected be affected by severe stunting (a 4 percent increase). The World Health Organization estimates that with climate change, this number will increase to 10 million additional children stunted by 2050. The impact of climate change on food prices in Africa could be as high as 12 percent in 2030 and 70 percent by 2080 – a crippling blow to those nations where food consumption of the poorest households amounts to over 60 percent of total spending. And the direct costs to health (excluding costs in health-determining sectors such as agriculture and water and sanitation), is estimated to be between US$2-4 billion/year by 2030.

Unfortunately, only 15 percent of countries that have developed plans for climate change have plans that specifically refer to health. Recognizing this need and hearing the increasing call from communities in research and on the ground, the World Bank Group (WBG) has developed a program in response.

World Bank Group Approach to Climate Change and Health

Over the past three years, the WBG has worked in consultation with experts and development partners to establish a major program addressing climate change and health.

The program has been built with two primary considerations in mind: (i) establishing a knowledge base to inform development lending and (ii) ensuring this work directly supports our clients.

Given our focus on working with countries, a first logical step was to identify those with the greatest degree of climate change-associated health impact. We drew upon established indices of climate impact and vulnerability to reveal countries at high risk- both in terms of health impacts associated with carbon co-pollutants, such as cardiovascular and respiratory disease, as well as health impacts caused by climate change, like infectious disease, malnutrition, and heat stress. Findings are presented in Geographic Hotspots for World Bank Action on Climate Change and Health and point to critical areas in Sub-Saharan Africa and Southeast Asia.

We have also undertaken a new analysis of climate connections to the health sector. Working with leading partners in the space, like Health Care Without Harm, we have uncovered an enormous opportunity both for our own portfolio and for others designing and operating health systems. This new report, Climate-Smart Healthcare: Low Carbon and Resilience Opportunities for the Health Sector, is a first of its kind, linking climate change, the health sector, and development. It describes in-depth approaches for building and sustaining health systems that are prepared for climate change and provides tools and resources to help practitioners turn this knowledge into action.

Ensuring uptake of this knowledge within the WBG and partners is also critical for on-the-ground implementation. We have developed the WBG Climate Change and Health Approach and Action Plan as a blueprint for connecting our research to investment. In it, we provide guidance for training staff, describe new areas of investigation and analytics, and define approaches for reviewing on-going investment. We also specify targets, including ensuring that 20 percent of all new Health, Nutrition, and Population projects consider climate change in their design by 2020.

Applying the Approach on the Ground

In tandem with the overarching global strategy, we are implementing projects to operationalize this new approach. For example, we conducted an initial climate change and health assessment in Mozambique. This project, developed in partnership with the government, delivered broad climate and health support, including a review of climate change and health impacts, integration of climate change into Ministry of Health emergency protocols, integration of health into the government climate change action plan, a country-level geospatial analysis of climate and health vulnerability, and new research linking health, climate, and cook-stoves.

We are also launching a new climate change and health diagnostic to be deployed in countries to assess climate and health impact and opportunity, and linking directly to development investment. The first application is occurring this summer in Madagascar and is being conducted to support a new WBG nutrition investment. It is anticipated that the lessons learned here will firmly embed climate change considerations into this project and others like it.

Moving into the future, we will continue to translate research into development action. We look forward to making good on the targets we have outlined in our climate change and health action plan, working with those countries in greatest need, and expanding the uptake and implementation of Climate-Smart Healthcare.

We also recognize the invaluable contributions of our partners: the Nordic Development Fund, GIZ, USAID, US NIH, WHO, WMO and the dozens at agencies, foundations, NGOs, universities, and in governments, in particular Mozambique and Madagascar, who have helped us undertake this work.