INTRODUCTION

Climate change is contributing to humanitarian health crises. However, research on the intersection of climate change and health in humanitarian settings often prioritises understanding impacts over identifying solutions. This study adopts a solutions-oriented approach, engaging humanitarians working in medical projects to explore both existing and potential adaptation strategies to mitigate the adverse health effects of climate change.

MATERIALS AND METHODS

The study involved 49 semi-structured qualitative interviews with humanitarian health workers from Médecins Sans Frontières (MSF) across 30 countries. Conducted in English, French, Spanish, Portuguese, and Arabic, the interviews focused on identifying adaptation solutions to address climate-related health impacts at individual, community, and organizational levels. Data were analysed using a hybrid coding approach, combining deductive and inductive techniques informed by framework analysis.

RESULTS AND DISCUSSION

The research highlights a perception of high vulnerability and low readiness to address climate change in the studied countries, exposing an adaptation gap—the disparity between adaptation needs and current efforts. Initially, participants found it challenging to identify adaptation strategies, often focussing on mitigation (emission reduction) rather than adaptation. From the adaptation activities identified, we developed an ‘Adaptation Continuum’ framework, which ranges from maladaptation to resilience-building. Additionally, we created a matrix of climate change adaptation (CCA) examples to illustrate how health risks can be addressed in contexts characterised by high vulnerability and low adaptive capacity.

CONCLUSION

Health and humanitarian actors are witnessing the profound impacts of climate change on communities and projects worldwide. Despite ongoing efforts to adapt, there remains a lack of consensus on how to effectively operationalize these initiatives. This research introduces the ‘Adaptation Continuum’, a conceptual framework designed to guide the planning, implementation, and evaluation of adaptation activities in four key domains: knowledge and awareness, infrastructure and technological solutions, operational adaptation, and policy and advocacy.

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.

South Asia emerges as one of the most susceptible regions to a plethora of direct and indirect repercussions stemming from climate change. These include, but are not limited to, the rising sea levels, heightened cyclonic activity, and shifts in ambient temperature or precipitation patterns. Despite an abundance of publications delving into the associated impacts, our objective is to synthesize pertinent literature with the aim of discerning commonalities in research findings, assessing the most affected areas in terms of health, and delving into potential avenues for mitigating the associated impacts.

Notwithstanding its relatively minor contribution to greenhouse gas emissions, South Asia finds itself exceptionally vulnerable to the perils of climate change due to a confluence of factors, including its geographical and topographical positioning, burgeoning population density, rapid urbanization, deficient health infrastructure, and an economy predominantly reliant on agriculture. This region stands at the forefront of vulnerability to various direct and indirect consequences of climate change, such as sea level rise, extreme weather events encompassing cyclones and droughts, as well as alterations in ambient temperature and precipitation patterns.

Our comprehensive review is centered on an in-depth, country-wise exploration of the available literature pertaining to four South Asian nations: India, Bangladesh, Nepal, and Sri Lanka. Through this analysis, we seek to evaluate the impacts of climate change from both direct and indirect perspectives. A discernible trend emerges, indicating that extreme weather events exert a palpable impact on health and healthcare systems in areas deemed 'climate-sensitive.' However, noteworthy gaps persist in the existing literature, warranting further investigation to substantiate the link between climate events and their health impacts. This void also presents an opportune moment to contextualize strategies for mitigation and adaptation, crafting more sustainable approaches that contribute to the well-being of both the populace and the planet