Climate x health: Building resiliency through better data, technologies, and systems integration

June 24, 2024 by Kimberly Green, Swati Mahajan, and Amy Dempsey

Urgent responses to the impacts of climate change on health are most effective when we co-create local solutions.

Rickshaw pullers on a flooded street in Dhaka, Bangladesh. Climate change is changing the way we look at everything—including health systems.  Photo: Sk Hasan Ali.

Rickshaw pullers on a flooded street in Dhaka, Bangladesh. Climate change is changing the way we look at everything—including health systems. Photo: Sk Hasan Ali.

Climate change poses a complex, multifaceted threat to health and well-being everywhere, particularly in low- and middle-income countries, given the rate of warming and extreme weather events, limited resources, and less resilient infrastructures. With a population of approximately 3.6 billion, climate-vulnerable regions face increasing and worsening weather events—devastating storm systems, floods, wildfires, and heat waves—resulting in a death rate 15 times higher than in less vulnerable regions. Over a third (37 percent) of heat-related deaths, and deaths caused by undernutrition, pollution, Ebola, antimicrobial resistance (AMR), and diarrheal disease, are attributed to climate change. For every 1°C rise in global temperatures, the risk of maternal mortality and morbidity goes up by 7.7 percent.

The World Health Organization (WHO) estimates that between 2030 and 2050, climate change will cause 250,000 additional deaths annually, and by 2030, direct costs to health systems at the forefront of preventing, detecting, responding, and adapting to the health impacts of climate change will be $2–4 billion per year. But health systems are not just impacted by climate change—they are the fifth largest global contributor to climate change because they release 5.2 percent of global carbon emissions.

PATH applies a comprehensive, partner-oriented approach toward advancing action that mitigates the effects of climate change and builds resilient health systems for a healthier, more sustainable future in three key areas: climate-informed decision-making, sustainable solutions, and resilient health systems.

“With climate and health, there are two aspects to consider. One is that climate change impacts human and animal health. The other is that health systems contribute to climate change. In India, we look at the impact from both sides.”
— Neeraj Jain, Country Director, PATH India

Accelerating climate-informed decision-making

There are intricate linkages between climate change and the spread and epidemiology of infectious diseases. Primary health care (PHC) is the first and best line of defense, so PATH collaborates closely with governments and health care workers to strengthen their health systems’ large-scale testing, screening, surveillance, outbreak management, and response capacities.

Along with our technology partner, the Artificial Intelligence & Robotics Technology Park (ARTPARK), we are deploying a climate-informed artificial intelligence (AI)–based early warning system, which can predict impending dengue fever outbreaks four weeks in advance with close to 70 percent accuracy. This warning, in turn, enables the district and subdistrict officials to provide timely outbreak management and response.

In Uganda, PATH partnered with veterinarians and medical professionals to vaccinate cows and raise community awareness; this effort protected lives and livelihoods while preventing the spread of zoonotic diseases, such as anthrax. Now, as part of the USAID-funded Infectious Disease Detection and Surveillance Project, Uganda is the first country in Africa to have two veterinary labs recommended for international accreditation by the South African National Accreditation System.

We joined forces with Senegal’s Ministry of Health to develop a multisectoral plan for better disease surveillance, decentralized diagnostic testing, and a community-based surveillance system to help health care workers identify and report zoonotic pathogens—including COVID-19. We also teamed up with Kenya’s Ministry of Health to train their health care workers on the importance of risk reduction and treatment adherence for people with noncommunicable diseases and mental health issues.

PATH also supported the Vietnam Administration for Medical Services to expand its current AMR surveillance system and improve infection prevention and control practices among health care providers. The infection surveillance network was established in 6 hospitals, which then was scaled up to 18 hospitals.

In Tanzania, we contributed to developing the government’s National AMR Surveillance Framework; in four AMR sentinel sites, we now train staff, execute AMR susceptibility testing, and report AMR surveillance data with WHONET, microbiology software that supports WHO’s AMR surveillance efforts.

Health surveillance assistants from Nsalu Health Centre walk to Phanga   Village carrying vaccines and supplies for a mobile vaccination site during Malawi’s typhoid conjugate vaccine campaign. Photo: PATH/Madalitso Mvula.

Health surveillance assistants from Nsalu Health Centre walk to Phanga Village carrying vaccines and supplies for a mobile vaccination site during Malawi’s typhoid conjugate vaccine campaign. Photo: PATH/Madalitso Mvula.

Innovating sustainable solutions

Innovation is central to PATH’s mission, so we seek out opportunities to co-create sustainable technologies that perform effectively in health facilities at low or no cost. In India, PATH zeroed in on populations struggling with an intermittent power supply. We deployed Blackfrog® Technologies’ Emvóliosolar-powered portable medical-grade refrigerator—which can maintain any preset temperature for 15 hours—to 800 PHC facilities and trained more than 1,000 health workers in vaccine storage and transport. Its effectiveness in maintaining medical supply cold chains during extreme weather events led to more than 150,000 routine and COVID-19 vaccination doses administered in hard-to-reach areas. PATH is now deploying 100 units to PHC facilities in Kenya.

Oxygen generator plants (OGP) are a critical tool, but they use significant amounts of energy; the electricity alone costs health facilities between 70 and 80 percent of the total maintenance cost. To challenge this inefficiency, PATH assessed the benefits, cost-effectiveness, and sustainability of setting up solar-powered OGPs in government hospitals. We found significant cost savings and a reduction of 4,900 tons of greenhouse gas emissions over the OGP’s 25-year lifespan.

Climate change is a global responsibility, so we foster alliances and coalitions to advance adaptation and mitigation goals. At COP28, PATH and the Commonwealth Secretariat co-launched the Accelerator for Resilience in Climate and Health (ARCH), an end-to-end platform that scouts, deploys, funds, and scales low-carbon innovations. It supports health systems and communities in the 56 Commonwealth countries to reduce their carbon footprint.

Through strategic interventions—climate-health vulnerability assessments, capacity-building activities, private-sector engagements, innovative financing mechanisms, sourcing and matchmaking, operational and commercial validation, innovation transfers, and regional hubs for knowledge sharing—ARCH will touch the lives of 2.5 billion people and has a pipeline of 20 high-impact innovations ready to be deployed.

Scaling resilient health systems

Climate emergencies have a significant impact on the mental health of the populations involved. These communities face heightened risks when compounded by poverty, inadequate housing, and loss. PATH values climate-aware mental health support as a critical part of reducing long-term distress.

After Cyclone Mocha in Myanmar, 3.4 million people were homeless or in severe distress, 10,000 people were at risk for depression, and 50,000 were at risk for anxiety. In partnership with WHO, PATH provided technical and emergency response support to the government for mental health: approximately 14,000 people participated in educational and community-led activities (expected to increase to 25,000), and almost 1,000 community members received psychological first aid and basic counseling (expected to increase to 5,000).

PATH and the Centre for Health Research and Innovation in New Delhi—with funding from USAID—launched the Sustainable Action for Climate Health (SACH) Initiative to catalyze collective climate-health action. SACH comprises more than 70 key partners, including corporations, academic institutions, private-sector actors, health care chains, development organizations, donors, philanthropists, local community-based organizations, and innovation partners.

SACH uses a multipronged approach to enhance the climate adaptiveness and resilience of health facilities, workplaces, and communities in India. An online platform—which will be live by August 2024—facilitates coherent demand/supply matching and collates existing knowledge on climate and health, including technical publications, demand-generation materials, and capacity-building packages. It provides an interactive space where SACH partners support one another by sharing information about climate adaptation goals and mitigation efforts, such as reducing air pollution and improving water, waste, and heat stress management.

At the 2024 World Health Assembly, member states approved a landmark resolution on climate and health to spur greater action. The resolution calls out a strong and resilient primary health care as part of an essential defense against health threats and is at the forefront of preventing, detecting, responding to, and adapting to the health impacts of climate change.

PATH hosted a “Climate x Health—The next frontier of climate-resilient PHC” webinar on June 25. It was rich with insightful discussion on local solutions and future opportunities to mitigate and adapt to climate change as part of a strong and resilient PHC and for health systems overall, featuring concrete examples across Africa, Asia, and Latin America. Watch the webinar.