Climate Change Is A Public Health Crisis—But Most Plans Ignore It

An unidentified farmer (right), with his family, stands in an agricultural field as he holds the title to their new plot of land, San Vicente department, El Salvador, July 1982. (Photo by Robert Nickelsberg/Getty Images)

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As the planet warms, it’s not just glaciers melting and forests burning. It’s kidneys failing, pregnancies at risk, and entire communities being pushed into poverty.

In Central America, farmworkers are suffering from kidney failure, while in Senegal, healthcare workers receive alerts that warn of upcoming heatwaves, which advise them to prepare for climate-related illnesses. And in Rio de Janeiro, Brazil, officials have developed extreme heat plans to prevent a mass disaster during Carnival.

Those aren’t isolated incidents. They’re part of the new reality—the one that must handle much more climate-related stress and therefore design health systems appropriately. In fact, the Global Conference on Climate and Health in Brasília, Brazil, focused on this subject this month. There, government leaders, researchers, and global foundations, including The Rockefeller Foundation, pushed to make health a central pillar of climate action ahead of COP30 next year in Belém.

“When we look at the challenges of the 21st century, climate and extreme heat are among the biggest challenges that we see. Many of our public health systems today are reactive, underfunded, and siloed—built for a world with linear threats and a stable climate. But today’s reality is different. We know that there is extreme heat,” says Emilia Carrera, director for health initiatives at The Rockefeller Foundation.

She says heat-related economic damages are now costing the global economy $143 billion annually, expected to rise to $2.4 trillion by 2030.

We spoke virtually when she highlighted that extreme heat causes a wide range of health issues and economic risks: infectious diseases, heart attacks, and food insecurity. But here’s the thing: most national climate strategies treat health as an afterthought, if they mention it at all.

The Foundation’s data shows that 4 billion people faced extreme heat last year, leading to approximately 489,000 deaths from heat annually. Central America is a clear example: Agricultural workers there have a 35% higher death rate from heat-related illnesses, with chronic kidney disease among this group rising from the 12th to the 4th leading cause of death between 1990 and 2019.

From Rio To Senegal: Early Warnings That Save Lives

In many families, the burden of lost income pushes children out of school and into the same fields that made their parents sick. Several countries in the region are piloting heat-protection programs that use heat index prompts to adjust working hours and expand access to water, rest, and shade. But more support is needed.

“We know that heat overwhelms the body’s ability to regulate its own temperature, and it may trigger cardiovascular collapse, kidney failure, pregnancy complications, and death, especially among infants, older adults, and people with chronic conditions—and this creates a cycle of poverty,” says Carrera.

In Rio de Janeiro, the city’s implementation of a national heat action plan during Carnival showed how large cities can respond to heat stress in real time. Officials activated messaging systems, emergency response teams, and cooling centers to handle the risk. However, Rio is an uncommon example. Most urban areas—even those at high risk—lack similar preparedness.

Senegal has become a model for what proactive climate-health adaptation can be. A detailed early warning system provides forecasts to healthcare facilities and vulnerable groups before extreme heat events. Health workers are trained to identify and treat heat-related conditions that could otherwise be misdiagnosed. It’s an approach that blends prediction with prevention, and case studies show it’s already saving lives.

“Climate change is not solely an environmental issue, but also a health crisis that demands immediate and coordinated action at all levels of society,” said Dr. Ibrahima Sy, a senior climate change fellow at the Africa Policy Research Institute and senior lecturer at the University Cheikh Anta Diop in Dakar, Senegal. This remark comes from a report he co-authored that emphasizes proactive and coordinated efforts to tackle climate-related health risks, aligning with the theme of proactivity rather than a reflexive response.

Carrera argues that adaptation and resilience deserve more emphasis alongside mitigation. Adaptation and resilience aim to minimize harm and recover, while mitigation focuses on lowering greenhouse gas emissions by using renewable energy sources. The Rockefeller Foundation has committed $100 million to climate-health innovation, focusing on three key strategies: climate-informed early warning systems, anticipatory action protocols, and collaboration among health, energy, agriculture, and infrastructure sectors.

Financing Health Systems, Not Just Green Infrastructure

The goal is to set the agenda for the Belém Health Action Plan—the first-ever global framework designed to center health within the climate agenda. This plan will guide policymakers in aligning their health systems with the growing realities of climate change, particularly in vulnerable regions disproportionately affected by heat, infectious diseases, and extreme weather events.

A key part of the Belém Health Action Plan is the creation of innovative financing methods designed to address the urgent needs of these regions. Traditional climate finance primarily focuses on reducing emissions and funding infrastructure; however, this new approach promotes dedicated funding sources to develop climate-resilient health infrastructure, including heat-ready hospitals, early warning systems, and trained healthcare workers.

For countries in the eye of the storm, these financing models could mean providing proactive healthcare—not reactive emergency responses. The Columbia Climate School identified 65 “Red Zone” countries that face extreme climate risk and lack adequate financial capacity. Eight Latin American countries are on the list, including Haiti, El Salvador, and Bolivia, where affordable finance is impossible, intensifying climate-related health risks.

Essentially, the Belém Health Action Plan aims to shift global climate policy from primarily focusing on environmental impacts to explicitly recognizing health as both an important indicator of climate risk and a key target for adaptation efforts. With COP30 approaching, this strategy could reshape international cooperation, making human health a primary focus rather than an afterthought in the fight against climate change.

“The heat threatens livelihoods and productivity,” says Carrera. “It reduces performance and forces an unfair trade-off between income and survival.”

Most climate finance today flows toward emissions reduction or hard infrastructure. Yet, as examples from Senegal, Rio, and Central America demonstrate, soft infrastructure—such as responsive health systems and protective labor policies—might determine whether societies can withstand future challenges.

These steps must no longer be overlooked in the fight against climate change. In fact, human health should be a top priority in this effort. As COP30 approaches, the world cannot treat health as a minor aspect of climate strategies. The global community needs to establish systems that safeguard the most vulnerable from rising heat.