Health adaptation in low- and middle-income countries

Climate variability and change are exacerbating many climate-sensitive health outcomes and have the potential to affect the ability of health system institutions and organizations to maintain or improve health burdens in the context of changing climate and development patterns. While the health sector has long experience with controlling the burden of climate-sensitive health outcomes, there is limited knowledge of and experience with incorporating concerns about a changing climate into policies and programs. The first five years of implementation (2008-2013) of health adaptation projects in low- and middle-income countries were synthesized to identify lessons learned and best practices. The countries included were Barbados, Bhutan, China, Fiji, Jordan, Kenya, and Uzbekistan (in the UNDP/WHO GEF project “Piloting climate change adaptation to protect human health”); China, Jordan, and the Philippines (in the health components of the MDG Achievement Fund); and Albania, Kazakhstan, Kyrgyzstan, Macedonia, Russia, Tajikistan, and Uzbekistan (in the WHO EURO project “Protecting health from climate change: a seven-country initiative” funded by the International Climate Initiative of the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety). Conclusions include: (1) Increasing resilience to the health risks of climate variability and change is likely to be achieved through longer-term, multi-faceted, and collaborative (multi-disciplinary) approaches, with supporting activities (and funding) for capacity building, knowledge communication, and monitoring and evaluation. (2) National health plans, policies, and budget processes need to explicitly incorporate the risks of current and projected climate variability and change. (3) Sufficient time and resources are needed during the development phase of adaptation proposals, to ensure that country ownership, an enabling environment, stakeholder engagement, and other conditions that facilitate project success are maximized. (4) Capacity development is needed for the full range of actors from public health and health care professionals to the general public to decision- and policy-makers within the health sector and across ministries. This includes facilitating developing methods, tools, and guidance documents to support countries as they implement adaptation programs and activities. (5) Research and development should be supported to further understanding of the health risks of climate change, including projections of risks across temporal and spatial scales, and to further understanding of the programs and activities that if implemented would facilitate avoiding, preparing for, responding to, and recovering from impacts. (6) Adaptation projects are opportunities to identify co-financing for adding mitigation components.