• Climate change - experienced primarily through shifts in temperature, rainfall, sea - level rise and weather volatility - can have drastic impacts on human health.

    • Climate change could see more than 100 million people return to extreme poverty by 2030 unless concerted action is taken. The negative impacts of climate change on people’s health could play a major role in this reversal.
    • Not all of these impacts will fall on future populations: climate change is already having measurable impacts on human health.
    Climate change influences health through changing the distribution and occurrence of vector-borne diseases.
     
    • Warming of 2-3°C is estimated to increase the number of people at risk of malaria by up to 5 percent globally, or more than 150 million people.
    • Climate change is also closely linked with increased incidence of dengue – a mosquito-borne disease whose transmissibility has increased by between 3% and 6% due to climate change since 1990.
    • Climate change could increase the burden of diarrhea by up to 10 percent by 2030 in susceptible regions, such as South-East Asia.

    The combined effects of higher temperatures, increasing rainfall volatility and weather extremes have dire impacts on crops. In the extreme, climate change can result in complete crop failure. 

    • For these reasons, undernutrition has been identified as the largest health impact of climate change in the 21st century.
    • A 6% decline in global wheat yields and 10% decline in rice yields is expected for each additional 1°C rise in global temperature, with substantial impacts on undernutrition and stunting in food insecure or poor regions. An additional 7.5 million children are expected to be stunted by 2030, 4 million of whom are expected to be affected by severe stunting, increasing to 10 million children by 2050. 

    The impacts of weather-related disasters on the health of people expand beyond mortality and include injuries, mental health issues, the spread of disease, food, and water insecurity, and limited access to healthcare and other basic services. 

    Air pollution is the fourth-leading risk factor for deaths worldwide

    • Many of the same pollutants responsible for climate change also affect human health through air quality impacts that are linked to respiratory and cardiac threats, as well as certain cancers.
    • Climate drivers that affect health include fine particulate matter (including black carbon which is a strong warming agent) and methane, which contributes to the formation of ground-level ozone or smog.
    • Air pollution is already responsible for more than 7 million premature deaths each year; 1 in 10 deaths is attributable to air pollution exposure.

    Low-and middle-income countries are seeing the worst health effects from climate change as they tend to be more vulnerable to climate shifts and least able to adapt given weak health systems and low access to basic services.

    The economic impact of climate change on health is striking.

    • The economic costs of climate change on health are difficult to calculate because of the many associated environmental and social determinants of health. Nevertheless, there are some valid economic quantifications of health and climate relationships:

      1. By 2030, the direct costs from damage to health (excluding costs in health-determining sectors such as agriculture, water, and sanitation) could reach between $US2 billion and $4 billion per year by 2030.
      2. The economic costs associated with the air pollution-related burden of disease correspond to US$1.7 trillion of lost output annually in OECD countries, US$1.4 trillion in China, and US$500 billion in India.
      3. Labor productivity losses due to excess heat may be as much as 11–20 percent in heat-prone regions such as Asia and the Caribbean by 2080.

    Without adequate investment in health sector resilience, recent development gains are at risk. 

    • Pathways to resilient health sectors are possible, building on the growing evidence-base of understanding of the threats climate change imposes on health.
    • Many countries and development institutions have recognized the importance of building climate resilience into the health sector. 121 of 184 (66%)  Nationally Determined Contributions (NDCs) include references to climate change’s impacts on health, driven by strong support for action in many developing countries (90% of African states, 69% of Asian states, 82% of Latin American states).
    • Conversely, only 15% of countries that have developed national climate change action plans referred to health.
    • Health and health-related adaptation funding account for only 13.3 percent ($47.3bn) of total global adaptation spending.
  • Ensuring healthcare systems and facilities are climate-smart is part of the World Bank’s approach.  

    • It is also at the forefront of climate adaptation, preventing and responding to human disease and casualties caused by the changing environment.
    • The overlap between adapting to climate change and avoiding contributing to the emissions that cause climate change is central to the World Bank’s approach to building climate smart healthcare systems.
    • Climate-smart healthcare can strengthen health sectors and communities by ensuring access to clean and reliable energy, safe water, clean transport, and clean waste disposal mechanisms, while also preparing the sector for a future of accelerating climate change. 

    Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. 

    Low-carbon healthcare helps to put health systems on a climate-smart development path, aligning healthcare development with global climate goals. Key elements of low-carbon healthcare include:

    1. Building design and construction based on low carbon approaches 
    2. Investment in renewable energy and energy efficiency
    3. Waste minimization and sustainable healthcare waste management
    4. Sustainable transport and water consumption policies
    5. Low-carbon procurement policies for pharmaceuticals, medical devices, food, and other products

    Low-carbon healthcare can improve the quality of care in a diversity of settings: low-carbon healthcare strengthens health systems by increasing facilities’ resilience to extreme weather events through better planning, more resilient built infrastructure, off-grid energy systems, and sustainable water practices.

    Building a resilient health sector involves taking steps to predict and prevent the impacts of climate change. It involves building health systems that can withstand future threats.

    Building resilient health systems encompasses a wide range of activities and investments to support the general functioning of the health sector in the face of change, particularly with regards to climate change:

    1. Early warning and disaster preparedness systems to predict, prepare for and prevent death or illness from weather extremes or other disasters.
    2. Disease-specific or nutrition-focused responses to ensure health and health-related sectoral programs are designed to build resilience to climate change. 

    The approach to tackling climate impacts on health is collaborative, linking with other international agendas. 

    • Of the 17 Sustainable Development Goals, five have direct implication for human health and #13 specifically addresses climate change. Achieving success in any of them requires coordination with the others.
    • The World Bank program on climate and health has convened a community of practice with major development organizations and academic institutions, including the World Health Organization (WHO) and World Meteorological Organization (WMO), among others.
    • The World Health Organization (WHO) has identified the health impacts of climate change and environmental change as one of its five priorities. The World Bank is working in partnership with the WHO to ensure this work continues to be translated into direct support to countries.
  • Over the past three years, the World Bank has worked in consultation with governments, development partners, and experts to establish a climate-smart healthcare program.

    The program has been built with two primary considerations: 

    1. Establishing a knowledge base to inform development lending.
    2. Supporting countries to integrate climate change and health considerations into development planning. 

    Other levels of country and region-specific climate change and health analysis and consultation are taking place. For example, there is the recently completed Bulgaria Climate Change and Health Analysis, Climate Vulnerability Assessment: Make Fiji Climate Resilient (health chapter), Climate change and health impacts: how vulnerable is Bangladesh and what needs to be done?, and Adapting to Climate Change in Eastern Europe and Central Asia (health chapter).

    The World Bank, supported by the Nordic Development Fund, has also carried out a climate change and health assessment in Mozambique, integrating climate change into emergency protocols and the national climate change action plan.

    In addition to these country-and region-specific reports, there are a number of other tools that have direct climate change and health operational utility: