Invest in climate adaptation for better health care

The spectre of the climate crisis looms large across India, casting a long shadow on public health. Increased mortality rates, a surge in heat-related illnesses, and the proliferation of vector-borne diseases are just a few of the grim realities we face. These impacts not only devastate individual lives but also erode livelihoods and contribute significantly to the burden of disease, as measured by Disability-Adjusted Life Years (DALYs). India had 9.7 million deaths and 486 million DALYs in 2017.

The situation is further compounded by the vulnerability of the health care infrastructure. According to the 2023 XDI Global Hospital Infrastructure Physical Climate Risk Report, Southeast Asia has the highest percentage of hospitals at high risk of damage from extreme weather events worldwide. In India one out of 10 hospitals are at the risk of complete or partial closure by the end of the century due to the climate crisis. This brutal reality exposes the stark need for innovative solutions and robust financing mechanisms to strengthen health care systems in the face of the climate crisis.

In good news, a range of adaptation strategies can significantly improve health care preparedness and resilience. These include:

• Building resilient infrastructure: Hospitals and clinics must be built to withstand the increasing frequency and intensity of heat waves, floods, and other weather extremes. This may involve using heat-resistant materials, elevating structures in flood-prone areas, and investing in renewable energy sources to ensure uninterrupted medical care. Currently, 9% of Primary Health Centres (PHCs) in India lack electricity, and about 41% face unreliable grid power, while a significant 7.5% have access to diesel generators – which contribute to greenhouse gas emissions.
• Training and capacity building: Health care professionals need specialised training to effectively manage climate-related health emergencies. Rural India has 65% of the country’s population but only a third of health care resources. Further, high out-of-pocket expenses push millions of Indians into poverty each year. Given these regional disparities, telemedicine can be a powerful tool to expand health care access in remote areas during natural disasters.
• Strengthening early warning systems: Early detection of climate-sensitive health hazards, such as outbreaks of mosquito-borne diseases, is crucial for timely interventions and minimising health impacts.
• Securing reliable supply chains: The climate crisis can disrupt essential medical supply chains. Cold chain improvements for vaccine distribution and innovative drone deliveries for remote areas, as seen with Zipline in Japan and Redwing Labs in India, can be vital solutions.

Currently, climate finance in health care remains woefully inadequate. A mere 0.5% of global climate finance reaches the health sector, leaving a massive gap between needs and resources according to the United Nations Environment Programme’s Adaptation Gap Report 2023. To address this, we advocate for a continuum of capital approach, recognising that social investing encompasses a spectrum of financial instruments. This includes philanthropy, blended finance, and impact investing, which range from impact-only investments to those that combine social and environmental returns with financial gains. Apart from financial capital, it also encapsulates human capital (technical assistance, mentorship), with intellectual capital (research, knowledge sharing). This will facilitate the flow of these resources across different stages of an organisation’s life cycle, breaking down silos and promoting a more integrated approach to social investing. This collaborative approach seeks to maximise impact and address the critical challenges of the climate crisis and health care in India.

Ensuring a robust health care system in the face of climate change necessitates a multi-pronged approach:

• Policy and regulatory frameworks: The government must develop policies that incentivise investing in climate-resilient health care solutions.
• Investment priorities: Strategically allocating resources to areas with the greatest climate-health impact, such as resilient infrastructure, early warning systems, and climate-resilient health technologies, is essential.
• Collaboration is key: Synergistic efforts across research, advocacy, and stakeholder engagement will amplify the impact of adaptation efforts.
• Metrics matter: Including healthcare metrics in existing climate funds and vice versa will enable more holistic climate action planning.

The climate crisis poses a serious threat to health care in India. By prioritising adaptation strategies and aligning financial resources, we can build a more resilient health care system, safeguarding the health and well-being of millions across the country.

This article is authored by Aravindan Srinivasan, executive director, Climate Action, and Madhavika Bajoria, executive director, Health Impact, AVPN.