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The climate crisis and health in humanitarian settings

The climate crisis is also a health and humanitarian crisis, disproportionately impacting people in the world’s most climate-sensitive regions—mainly low- and low-middle income countries with the least capacity to respond.

MSF and other humanitarian organizations witness the consequences daily. More frequent, intense weather events and a warming planet contribute to food and water scarcity, more severe and widespread disease outbreaks, and more injuries and preventable deaths. They also drive massive population displacement, with over 32 million people fleeing their homes in 2022 alone due to floods, drought, storms and fire—nearly triple the number displaced by violence and conflict.

To mark Earth Day 2024 (22 April) we present a cross-section of work by MSF and collaborators, drawing from a range of data sources and from first-hand experience at our medical projects. Emphasizing the urgency of adapting humanitarian operations to the climate crisis, the collection also explores loss and damage through a health lens, proposes policies and practices for creating climate-resilient health organizations, and advocates for embedding fair, just ethics perspectives into humanitarian action and research on climate.


11 result(s)
Technical Report > Policy Brief

Joint brief: The Lancet Countdown on Health and Climate Change & Médecins Sans Frontières

Voûte C, Baker H, Baidjoe AY, Bartrem C, Charrier M,  et al.
29 October 2024

At the time of writing, many people around the world are feeling the pain, disruption, and devastating health consequences driven by climate change. The world has been shocked by the widespread flooding in Europe and the consecutive catastrophic hurricanes in North America. Yet far less attention is given to the impacts of climate change in places where Médecins Sans Frontières (MSF) works, such as Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of Congo, Myanmar, Niger, Nigeria, and South Sudan. In 2024, these populations have likewise been affected by devastating floods, many of them not for the first time.

Although immediate impacts like injury, displacement, and limited access to healthcare may be similar worldwide, the compounding crises that follow and the capacity to recover from these vary significantly. Individuals in low-resource and humanitarian settings face significant health threats while contributing the least to global emissions. These regions are often vulnerable to climate hazards and possess low adaptive capacity, increasing people’s susceptibility to the negative impacts of climate change.

In this brief, drawing on evidence from indicators in the 2024 report of the Lancet Countdown on Health and Climate Change, MSF teams present examples of how climate change and environmental degradation are making provision of assistance more difficult by amplifying health and humanitarian needs and by further complicating interventions. It also highlights activities that respond to the climate crisis using a three-pillar approach: mitigating MSF’s environmental footprint, adapting healthcare delivery and emergency response to the current and future realities of climate change, and advocating for those impacted.

The complexity of climate change and environmental degradation, coupled with highly politicised and siloed global response efforts often make it insufficiently clear to health and humanitarian implementing partners that every issue is part of a continuous process, where each component informs the others. In this brief, MSF staff outline six focus areas where teams are engaged in developing environmentally-informed health and humanitarian interventions, emphasising their interdependence, and how failure to act on one issue not only impedes progress on that specific component but also affects the entire sequence of subsequent actions.

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Journal Article > ResearchFull Text

Impacts of climate change on human health in humanitarian settings: Evidence gaps and future research needs

PLOS Clim. 6 March 2024; Volume 3 (Issue 3); e0000243.
McIver L, Beavon E, Malm A, Awad A, Uyen A,  et al.
PLOS Clim. 6 March 2024; Volume 3 (Issue 3); e0000243.
This mixed-methods study focuses on the evidence of the health impacts of climate change on populations affected by humanitarian crises, presented from the perspective of Médecins Sans Frontières (MSF)–the world’s largest emergency humanitarian medical organisation. The Sixth Assessment Report from the Intergovernmental Panel on Climate Change (IPCC) was used as the basis of a narrative review, with evidence gaps highlighted and additional literature identified relevant to climate-sensitive diseases and health problems under-reported in–or absent from–the latest IPCC report. An internal survey of MSF headquarters staff was also undertaken to evaluate the perceived frequency and severity of such problems in settings where MSF works. The findings of the survey demonstrate some discrepancies between the health problems that appear most prominently in the IPCC Sixth Assessment Report and those that are most relevant to humanitarian settings. These findings should be used to guide the direction of future research, evidence-based adaptations and mitigation efforts to avoid the worst impacts of climate change on the health of the world’s most vulnerable populations.More
Technical Report > Policy Brief

Lancet Countdown on Climate Change and Health: Policy brief from Médecins Sans Frontières 2023

Blume C, Dallatomasinas S, Devine C, Goikolea I, Guevara M,  et al.
15 November 2023
Most of the over 70 countries Médecins Sans Frontières /Doctors Without Borders (MSF) works in are in lower-income regions. They are facing not only humanitarian crises but also the most severe impacts of the climate emergency. In 2023, MSF continued to witness and respond to the consequences of extreme weather events around the world, including unprecedented flooding in South Sudan, severe cyclones in Myanmar and Madagascar, and the relentless heat and extended droughts that have driven millions to the edge of starvation throughout the Horn of Africa. This year, the organisation has also responded to epidemics of climate-sensitive diseases, including multiple concurrent cholera outbreaks and the rise of dengue and malaria in several areas, including in conflict-affected settings.

In a time of polycrisis, a simultaneous occurrence of multiple catastrophic events, MSF and other aid organisations are already struggling to meet the rising health and humanitarian needs. If human activities contributing to climate change and environmental degradation go unabated and unaddressed, including the continued dependence on fossil fuels, these needs will only escalate. With each fraction of a degree of global temperature rise, there will be further limitations on adaptation, and reckless losses and damages to lives, livelihoods, and general well-being.

Drawing on evidence from indicators in the 2023 Report of the Lancet Countdown on Health and Climate Change, MSF builds on previous experiences and messages with a focus on three key areas: MSF’s ongoing efforts to reduce its environmental impact; the challenges of adapting emergency humanitarian operations in a rapidly warming world; and the consequences of climate change when the capacities of communities to adapt are surpassed
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Journal Article > CommentaryFull Text

What cannot be mitigated or adapted to, will be suffered. Loss and damage in health and humanitarian terms

J Clim Chang Health. 9 September 2023; Online ahead of print; 100270.
Schwerdtle PN, Devine C, Guevara M, Cornish S, Christou C,  et al.
J Clim Chang Health. 9 September 2023; Online ahead of print; 100270.
Journal Article > ReviewFull Text

Ethics, climate change and health – a landscape review

Wellcome Open Res. 14 August 2023; Volume 8; 343.
Sheather J, Littler K, Singh JA, Wright K
Wellcome Open Res. 14 August 2023; Volume 8; 343.
Anthropogenic climate change is unequivocal, and many of its physical health impacts have been identified, although further research is required into the mental health and wellbeing effects of climate change. There is a lack of understanding of the importance of ethics in policy-responses to health and climate change which is also linked to the lack of specific action-guiding ethical resources for researchers and practitioners. There is a marked paucity of ethically-informed health input into economic policy-responses to climate change—an area of important future work. The interaction between health, climate change and ethics is technically and theoretically complex and work in this area is fragmentary, unfocussed, and underdeveloped. Research and reflection on climate and health is fragmented and plagued by disciplinary silos and exponentially increasing literature means that the field cannot be synthesised using conventional methods. Reviewing the literature in these fields is therefore methodologically challenging. Although many of the normative challenges in responding to climate change have been identified, available theoretical approaches are insufficiently robust, and this may be linked to the lack of action-guiding support for practitioners. There is a lack of ethical reflection on research into climate change responses. Low-HDI (Human Development Index) countries are under-represented in research and publication both in the health-impacts of climate change, and normative reflection on health and climate change policy. There is a noticeable lack of ethical commentary on a range of key topics in the environmental health literature including population, pollution, transport, energy, food, and water use. Serious work is required to synthesise the principles governing policy responses to health and climate change, particularly in relation to value conflicts between the human and non-human world and the challenges presented by questions of intergenerational justice.More
Conference Material > Video

Planetary health and neglected tropical diseases

McIver L
MSF Paediatric Days 2022. 1 December 2022
Conference Material > Video

Time for action: Climate change in the humanitarian sector

Issa R
MSF Paediatric Days 2022. 30 November 2022
Journal Article > CommentaryFull Text

The relationship between climate change, health, and the humanitarian response

Lancet. 5 November 2022; Volume 400 (Issue 10363); 1561-1563.
Baxter LM, McGowan CR, Smiley S, Palacios L, Devine C,  et al.
Lancet. 5 November 2022; Volume 400 (Issue 10363); 1561-1563.
The climate emergency is a humanitarian and health crisis. Extreme weather events, heat stress, declining air quality, changes in water quality and quantity, declining food security and safety, and changes in vector distribution and ecology threaten all of us. As the planet heats, climate risks are increasingly complex, frequent, and unpredictable, compounding existing vulnerabilities and inequities within populations and causing emergencies that cascade across different systems and sectors. Humanitarian agencies are now seeing how these problems are putting millions of people across the world at immediate risk of famine and death.More
Journal Article > ReviewFull Text

Climate-sensitive disease outbreaks in the aftermath of extreme climatic events: A scoping review

One Earth. 15 April 2022; Volume 5 (Issue 4); 336-350.
Alcayna T, Fletcher I, Gibb R, Tremblay LL, Funk S,  et al.
One Earth. 15 April 2022; Volume 5 (Issue 4); 336-350.
Outbreaks of climate-sensitive infectious diseases (CSID) in the aftermath of extreme climatic events, such as floods, droughts, tropical cyclones, and heatwaves, are of high public health concern. Recent advances in forecasting of extreme climatic events have prompted a growing interest in the development of prediction models to anticipate CSID risk, yet the evidence base linking extreme climate events to CSID outbreaks to date has not been collated and synthesized. This review identifies potential hydrometeorological triggers of outbreaks and highlights gaps in knowledge on the causal chain between extreme events and outbreaks. We found higher evidence and higher agreement on the links between extreme climatic events and water-borne diseases than for vector-borne diseases. In addition, we found a substantial lack of evidence on the links between extreme climatic events and underlying vulnerability and exposure factors. This review helps inform trigger design for CSID prediction models for anticipatory public health action.More
Journal Article > CommentaryFull Text

A failure of ambition on climate action will amplify humanitarian needs

BMJ. 3 December 2021; Volume 375 (Issue n3008); n3008.
Voûte C, Guevara M, Schwerdtle PN
BMJ. 3 December 2021; Volume 375 (Issue n3008); n3008.
Humanitarian actors are struggling to keep up with the demands of increasingly frequent, erratic, and overlapping crises at current levels of warming.
Journal Article > CommentaryFull Text

Calibrating to scale: a framework for humanitarian health organizations to anticipate, prevent, prepare for and manage climate-related health risks

Global Health. 9 July 2020; Volume 16 (Issue 1); 54.
Schwerdtle PN, Irvine E, Brockington S, Devine C, Guevara M,  et al.
Global Health. 9 July 2020; Volume 16 (Issue 1); 54.
Climate change is adversely affecting health by increasing human vulnerability and exposure to climate-related stresses. Climate change impacts human health both directly and indirectly, through extreme weather events, changing distribution of health risks, increased risks of undernutrition, population displacement, and greater risks of injuries, disease, and death (Ebi, K., Campbell-Lendrum, D., & Wyns, A. The 1. 5 health report. WHO. 2018). This risk amplification is likely to increase the need for humanitarian support. Recent projections indicate that under a business as usual scenario of sustained greenhouse gas emissions, climate change could double the demand for humanitarian assistance by 2050 (World Health Organization. Operational Framework for building climateresilient health systems. WHO. 2015). Humanitarian assistance is currently not meeting the existing needs, therefore, any additional burden is likely to be highly challenging.

Global health advocates, researchers, and policymakers are calling for urgent action on climate change, yet there is little clarity on what that action practically entails for humanitarian organizations. While some humanitarian organizations may consider themselves well designed to respond, climate change as a transversal threat requires the incorporation of a resilience approach to humanitarian action and policy responses.

By bringing together authors from two historically disparate fields - climate change and health, and humanitarian assistance – this paper aims to increase the capacity of humanitarian organizations to protect health in an unstable climate by presenting an adapted framework. We adapted the WHO operational framework for climate-resilient health systems for humanitarian organizations and present concrete case studies to demonstrate how the framework can be implemented. Rather than suggest a re-design of humanitarian operations we recommend the application of a climate-lens to humanitarian activities, or what is also referred to as mainstreaming climate and health concerns into policies and programs. The framework serves as a starting point to encourage further dialogue, and to strengthen collaboration within, between, and beyond humanitarian organizations.
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The climate crisis and health in humanitarian settings