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The World Health Organization projects that between 2030 and 2050, climate change will cause about 250,000 additional deaths annually from undernutrition, malaria, cholera and heat stress alone. Despite this evidence, climate change is still not widely recognised or addressed as a critical health issue. But what exactly is climate health and why does it matter now?
In an exclusive interview with Healthcare Rising, Kirigo Wachira, the Chairperson of the Climate-Health Technical Working Group at the Federation of African Medical Students’ Associations, explains the intersection of climate and health, why health must be central to global climate action and what steps governments and institutions are already taking.
“A health system that is not climate-resilient will fail its people. And when health systems fail, societies cannot survive climate change.” says Kirigo.
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Kirigo Wachira is the Chairperson of the Climate-Health Technical Working Group at the Federation of African Medical Students’ Associations.
To begin, what exactly do we mean by the term “climate health” and why is it urgent?
Climate and health refers to how climate change shapes human wellbeing. For years, climate change was viewed as an environmental or economic issue. But it is now recognised as one of the greatest health threats of the 21st century. Rising temperatures, shifting rainfall, frequent floods, prolonged droughts and unpredictable weather events fuel malnutrition, spread infectious diseases, worsen non-communicable illnesses and strain health systems. Children, women, older people and low-income communities are among the hardest hit.
The conversation around this is urgent because climate change and health are inseparable. Without addressing climate change, we cannot achieve the Sustainable Development Goals or secure long-term wellbeing. Without resilient health systems, communities cannot withstand the shocks already happening.
When was climate change first recognised as a health issue?
Health did not feature in the earliest climate discussions. The Intergovernmental Panel on Climate Change (IPCC), established in 1988, was tasked with compiling scientific evidence on global warming. Its first report in 1990 confirmed that human activity was driving rapid warming. This report laid the foundation for the 1992 UN Framework Convention on Climate Change (UNFCCC) at the Rio Earth Summit. Still, the UNFCCC initially focused on emissions and economic systems, not health.
Over time, evidence mounted showing health consequences: heatwaves killing thousands in Europe and South Asia, floods in Africa and Asia spreading cholera, droughts causing widespread malnutrition and malaria expanding into new areas. It was only in the 2000s that health began to be systematically linked to climate change. The World Health Organization (WHO) played an important role in this shift, publishing evidence and frameworks to help countries integrate health into climate planning.
When did climate and health first appear in COP discussions?
The real breakthrough came at COP26 in Glasgow in 2021. For the first time, a Health Programme was launched within the UN climate talks. It was led by the UK government (as COP26 President), together with WHO, Health Care Without Harm and the UNFCCC Climate Champions.
At COP26, the first-ever Health Pavilion was set up, giving the health community a visible platform. Countries used the moment to announce new commitments to build health systems that are both climate-resilient and low carbon. These commitments are meant to guide investments and action in the years ahead.
What were the main areas of focus for the COP26 Health Programme?
The programme focused on two main areas. The first was building climate-resilient health systems. Countries committed to carrying out climate and health vulnerability and adaptation assessments, either at the population level or within health facilities, by a set date. They also pledged to develop health national adaptation plans informed by these assessments and to integrate them into wider National Adaptation Plans. These plans would then be used to access climate finance from mechanisms such as the Green Climate Fund or the Adaptation Fund.
The second area was the development of low-carbon sustainable health systems. High-emitting countries committed to setting target dates for achieving net zero emissions in their health systems, ideally by 2050. All countries agreed to deliver baseline assessments of greenhouse gas emissions from their health systems, including supply chains, and to prepare action plans for low-carbon, sustainable health systems that not only cut emissions but also reduce exposure to air pollution.
How far have countries gone in implementing the COP26 Health Programme commitments?
Progress has been uneven. One of the key commitments was for countries to conduct climate and health vulnerability and adaptation assessments, yet very few have completed them. In Africa, only Tanzania, Ghana, Malawi, Ethiopia, Djibouti, Madagascar and Sierra Leone. have so far submitted comprehensive assessments. These assessments are crucial, because they identify how vulnerable health systems, populations and health workforces are to climate risks such as droughts, floods and heatwaves. They also form the evidence base for health national adaptation plans, which in turn help countries secure climate finance. The slow pace of implementation shows that while political commitments have been made, translating them into concrete national action remains a major challenge.
What do these commitments on adaptation and mitigation actually involve for health systems?
Adaptation and mitigation are the twin pillars of climate action. Adaptation is about preparing health systems and populations for the impacts already underway like droughts, floods, heatwaves and wildfires. Countries are encouraged to conduct climate–health vulnerability assessments. In these assessments, WHO recommends examining the six building blocks of health systems: governance, workforce, infrastructure, finance, commodities and research. From there, governments can design adaptation plans, such as reinforcing hospitals against floods, ensuring backup power for vaccine cold chains, stocking essential supplies ahead of outbreaks and training health workers on climate-sensitive diseases.
Mitigation refers to reducing the health sector’s own emissions. Globally, healthcare contributes 4-5% of greenhouse gases. Major sources include energy use, pharmaceuticals, transport and waste. Solutions include transitioning hospitals from diesel generators to solar power, adopting greener procurement and waste management, phasing out high-emission anaesthetic gases and introducing low-carbon inhalers. Conducting carbon footprint baselines at facility or national level is the first step to designing effective net-zero plans.
COP26 set the stage for health in climate negotiations. What further progress was achieved at COP28?
COP28, held in Dubai in December 2023, built on the momentum of COP26 and raised the political profile of the climate–health agenda. For the first time, the presidency organised a health day and a climate–health ministerial, in collaboration with WHO and other partners. A key outcome was the endorsement of the COP28 UAE Declaration on Climate and Health, which reaffirmed global commitment to integrating health into climate action.
In addition, WHO and the Wellcome Trust hosted the COP28 Health Pavilion for the third time. This created a watershed moment, bringing together ministers, health and climate professionals, civil society organisations, youth representatives and the private sector. WHO, working with members of the Alliance for Transformative Action on Climate and Health, also continued to push countries to honour and expand their commitments to building climate-resilient, sustainable and low-carbon health systems.
How has global climate governance shaped climate health discussions?
The UNFCCC provided the global platform. The Kyoto Protocol of 1997 was the first legally binding treaty, requiring industrialised nations to cut emissions. But progress was slow. In 2015, the Paris Agreement was adopted, marking a new era where all countries, both developed and developing, committed to action. The Paris Agreement introduced Nationally Determined Contributions (NDCs), which require countries to submit plans detailing emission reductions and adaptation strategies. To ensure fairness and transparency, the Paris Rulebook was developed in 2016. In addition, countries were encouraged to create National Adaptation Plans (NAPs) which, for the first time, recognised health as a critical sector requiring resilience.
How do these commitments link to other global agendas?
The climate–health agenda is woven into multiple global frameworks. The Sustainable Development Goals (SDGs), especially SDG 3 on health and SDG 13 on climate action, highlight the need for integrated solutions. The Sendai Framework for Disaster Risk Reduction places health at the centre of disaster preparedness, calling for resilient health infrastructure able to withstand floods, cyclones and earthquakes. Most recently, the Belém Health Action Plan, launched at the 5th Global Conference on Health and Climate in Brasília in preparation for COP30, provides a playbook for governments and communities. It sets out three action lines: surveillance and monitoring; evidence-based policy and capacity-building; and innovation and resilient production systems. All are grounded in health equity, inclusive governance and social participation.
Turning to Africa, how is the continent approaching climate and health?
Africa is the most climate-vulnerable continent. East Africa faces recurring droughts, West Africa devastating floods, Southern Africa cyclones and the Sahel intense heat stress. These crises worsen food insecurity, displace families and fuel outbreaks of diseases such as cholera and malaria. Children under five are especially at risk, suffering higher rates of malnutrition, diarrhoea, pneumonia and malaria. Recognising this, the African Union has placed climate and health within its Agenda 2063 vision. In July 2025, the Africa CDC launched its Climate and Health Strategic Framework to strengthen disease surveillance, emergency preparedness and resilient health systems. This represents a decisive step towards systematically embedding health in Africa’s climate agenda.
Beyond government action, who else has a role to play?
Health professionals need to recognise climate change as a health issue. Updating medical training to include climate–health is vital, so health workers are prepared for disease surges after floods or droughts. Communities, youth groups and civil society organisations must continue to advocate and hold leaders accountable. Development partners and funders should channel resources towards building climate-resilient health systems. Without this, many adaptation plans remain unfunded.