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.
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
Recognising the role of the climate crisis in amplifying humanitarian needs, MSF is adapting its operations to be more responsive to the populations it serves while also facing up to the challenges of measuring and reducing its own environmental footprint.
To describe the implementation and feasibility of an innovative mass vaccination strategy - based on single-dose oral cholera vaccine - to curb a cholera epidemic in a large urban setting.
METHOD
In April 2016, in the early stages of a cholera outbreak in Lusaka, Zambia, the health ministry collaborated with Médecins Sans Frontières and the World Health Organization in organizing a mass vaccination campaign, based on single-dose oral cholera vaccine. Over a period of 17 days, partners mobilized 1700 health ministry staff and community volunteers for community sensitization, social mobilization and vaccination activities in 10 townships. On each day, doses of vaccine were delivered to vaccination sites and administrative coverage was estimated.
FINDINGS
Overall, vaccination teams administered 424 100 doses of vaccine to an estimated target population of 578 043, resulting in an estimated administrative coverage of 73.4%. After the campaign, few cholera cases were reported and there was no evidence of the disease spreading within the vaccinated areas. The total cost of the campaign - 2.31 United States dollars (US$) per dose - included the relatively low cost of local delivery - US$ 0.41 per dose.
CONCLUSION
We found that an early and large-scale targeted reactive campaign using a single-dose oral vaccine, organized in response to a cholera epidemic within a large city, to be feasible and appeared effective. While cholera vaccines remain in short supply, the maximization of the number of vaccines in response to a cholera epidemic, by the use of just one dose per member of an at-risk community, should be considered.
• Apply a cross-sector and interdisciplinary approach to humanitarian and global health responses and local, regional and international collaborations
• Identify, highlight and respond to the disproportionate needs of vulnerable groups
• Better understand the connections between climate-sensitive diseases and climate variability to improve humanitarian planning and responses based on predicted increases in disease burdens in already-vulnerable populations
• Urgently enhance cholera preparedness and response in countries without surveillance capacity
• Develop monitoring and evaluation frameworks and better document risks and interventions with a climate change lens, update health needs assessments, analyze patterns and changes over time and contribute data to operational research
• Document environmental health-related and climate change effects on vulnerable populations to contribute to broader policy advocacy and legal initiatives
• Identify and reduce health disparities in urban slums, including through ensuring access to services and provision of mental health support
• Provide protection for people fleeing including through urging respect and development of people-centred policies
• Recognise that human needs outstrip the humanitarian response: as such, health considerations should be integrated into national and international mitigation planning to reduce suffering
• Invest funds in strengthened humanitarian responses
• Commit to efforts to rapidly and exponentially reduce the negative environmental impact of global health and humanitarian organizations, including MSF, in line with medical ethics.