Reflections from the roundtable discussion on the role of policy, advocacy, and financing in addressing climate-related health challenges

About the authors

Omari Isaac, Bhavini Gohel, David Castellanos, and Olukayode Fasominu are students on the MSc in Global Healthcare Leadership programme, run jointly by the Nuffield Department of Primary Care Health Sciences and the Saïd Business School.

Omari Isaac is a remote site physician with an occupational health background. He is interested in helping organisations build sustainable health culture in the workplace. He is passionate about social entrepreneurship, equity and social justice and has founded two community-based projects in Ghana geared towards achieving these goals.

Bhavini Gohel is Hospitalist and Care of the Elderly Physician and oversees the largest admitting service for Alberta Health Services (AHS) in Calgary. She is a Clinical Associate Professor with the Cumming School of Medicine, University of Calgary. She is overseeing the environmental resiliency and sustainability operations strategy within the AHS provincial health system and is a health systems leader.

David Castellanos is a Physician and an international development health specialist with expertise in global health, healthcare management, policy analysis and strategic planning, health reform, nutrition and pandemic preparedness. He currently serves as the United States Agency for International Development (USAID)’s Health Team Lead in Honduras working on health system’s pandemic preparedness. He holds a MSc in Health Services Management, he is an active member of the Oxford Global Health Society, and a recipient of the MSc Global Health Leadership Director’s Award.

Olukayode Fasominu is a Public Health Physician & Management Consultant. He currently serves as Principal at Volte Health where he spearheads engagements with governments and development partners across Africa on strategic investments in healthcare in the public and private sectors. He is a graduate of the University of Ibadan and Cardiff University; he enjoys watching football, providing mentorship, and making scholarly contributions on a range of pertinent subjects in global health.

Climate change poses a severe global health threat, leading to extreme weather, injuries, fatalities, and altered disease patterns. Rising temperatures increase heat-related illnesses, especially in vulnerable populations, while changing precipitation patterns cause food insecurity and malnutrition. Climate-related disasters displace communities, triggering mental health issues and disrupting healthcare access. Urgent actions are needed through advocacy, policy formulation and research on the climate-health nexus.

On Wednesday, 11 September 2024, at the Saïd Business School, University of Oxford, students from the MSc in Global Healthcare Leadership (MGHL) second cohort hosted a hybrid roundtable discussion on 'The Role of Policy, Advocacy, and Financing in Addressing Climate-related Health Challenges'.

Throughout the 21^st century, we have seen the impact of events triggered by climate change across different geographies. It is becoming evident that having a better understanding of these pathways (policy, advocacy, and financing), especially through a country-specific lens, can potentially help inform the development of the appropriate policies and interventions to protect health, promote equity and build resilient health systems, ensuring societal well-being and sustainability in a changing climate.

The event commenced with a keynote speech delivered by Aisha Ahmad (former Deputy Governor, Central Bank of Nigeria) on Navigating Dual Priorities: Integrating Climate Health Action with Immediate Local Needs in the Global South. Given that resources are scarce and there are always competing priorities, the note served as call on how leaders can balance these priorities, leveraging climate action as a springboard to drive health equity and broader development goals but also using levers to ensure climate-related topics are at the forefront of discussion across countries. Key examples were shared from countries in the global south from Costa Rica, Rwanda, Bangladesh, South Africa and Nigeria.

Climate change is like an iceberg—most people only see the visible impacts like extreme weather, shifting disease patterns, and food insecurity. These effects hit vulnerable populations hardest, deepening existing health inequities. But underneath lie hidden, more complex layers: the systemic patterns, structures and mindsets driving these challenges.

The panel, moderated by Dr Olukayode Fasominu, dove deeper into these underlying dynamics. Professor Akin Abayomi, Lagos State's Health Commissioner, highlighted the healthcare delivery challenges in a city three times larger than Denmark. He stressed the importance of partnerships and a comprehensive, whole-of-government approach to tackling climate-related health issues.

With limited public funding, Abayomi described how the state government advocates to increase budget allocations for critical health initiatives, demonstrating a strategic approach to address these complex challenges.

Sofia Mendez, Project Management Specialist/Deputy Mission Environment Officer, USAID, Honduras, provided insights into the role of USAID in supporting the Government of Honduras through the development of climate adaptation actions owned and co-designed with communities, as contained in the countries national adaptation plan (NAP). The NAP is an essential strategic document developed through a country-driven process that helps identify and address the risks of climate change. The goal of NAP is to reduce vulnerability to climate change and integrate adaptation into existing policies and programmes. Sofia emphasised the critical role of communities in ensuring these climate-centric actions are sustainable. She also provided early insights about mapping the impact of climate change in the health sector in Honduras.

Dr Bhavini Gohel, Clinical Associate Professor, University of Calgary, Alberta, Canada, shared insights on the role of healthcare workers in contributing to the reductions in greenhouse gas (GHG) emissions. She highlighted the importance of raising awareness among healthcare workers and patients, empowering them to demand care aligned with decarbonisation practices and make health decisions that contribute to reducing GHG in healthcare. She also reiterated the similar role of pharmaceutical companies and the supply chain in mitigating these climate-related crises.

Professor Jacob McKnight discussed innovative financing approaches such as the National Institute for Health and Care Research (NIHR) funded Novel Extreme Weather Risk Insurance System for Kenya (NEWRISK) project. NEWRISK focuses on using the latest methods to provide data on extreme weather, population vulnerability and health system capacity readiness across various climatic zones in Kenya. By capitalising on needed expertise and considering the diversification of such risks, countries can manage their exposure as a group in a financially efficient manner in response to probable but uncertain climate challenges that impact healthcare delivery.

Professor Abayomi's closing remarks emphasised the urgent need for a fundamental paradigm shift in our approach to addressing climate change and its impact on global health. His call to rethink our existence in the world aligns with the concept of deep leverage points, as proposed by Donella Meadows, which we explored in Module 3 of the MGHL programme.

Leverage points for systemic change

Meadows identified 12 leverage points for intervening in complex systems, with the most impactful being those that address the underlying paradigms and goals of a system

In the context of climate change and global health, this translates to:

• Shifting paradigms: Challenging our current ways of thinking about consumption, energy use and our relationship with the environment.
• Redefining goals: Setting ambitious targets for reducing greenhouse gas emissions and improving global health outcomes.
• Restructuring systems: Redesigning our economic and social systems to prioritise sustainability and health.

Climate change and global health

The impact of climate change on global health is significant and far-reaching.

By 2050, climate change is projected to cause an additional 14.5 million deaths and $12.5 trillion in economic losses worldwide.

Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths. Thus, climate change exacerbates existing health threats and creates new public health challenges.

Actionable steps

To address these challenges, our panellists highlighted key areas for leveraging change:

• Policy implementation: Developing evidence-based policies and plans, such as Health National Adaptation Plans (H-NAPs).
• Infrastructure improvement: Transforming health infrastructure to be more resilient and environmentally friendly.
• Intersectoral collaboration: Promoting health co-benefits through partnerships with other sectors.
• Education and awareness: Building capacity through training and awareness programmes on climate change and health.

The MGHL programme's emphasis on practical application allows participants to immediately implement these learnings in their respective fields. This approach bridges the gap between theoretical knowledge and real-world impact, demonstrating the power of education in driving systemic change. By rethinking our existence and leveraging these key points, we can work towards creating a more sustainable and healthier world, addressing the existential climate crises impacting our health systems and beyond.

By bringing together University of Oxford staff, students and global experts, we believe the roundtable inspired and educated participants, fostered advocacy for policies and sustainable financing to build climate-resilient health systems and champion a healthier, environmentally sustainable future. The roundtable increased awareness and understanding of the role of policy and advocacy at the intersection of climate change and health. It provided an understanding of the critical leverage points to raise public awareness and influence policymakers on the importance of integrating health considerations into climate change initiatives. We hope initiatives like this will drive policy changes in both local and global contexts, provide innovative financing frameworks and funding mechanisms and attract sustainable investment from both public and private sectors for climate-related health initiatives.

How can we collectively transform policy insights into tangible steps for building climate-resilient health systems worldwide?

We look forward to ongoing collaborations on this topic from academics, practitioners, policymakers and advocates committed to deepening this dialogue, continuously sharing resources, and coordinating efforts to address climate-related health challenges globally.

Please use this YouTube link to watch a recorded version of the event. We encourage you to watch, reflect and join us in our ongoing efforts to create a healthier, more sustainable world for all. 

Note – Authors, who are members of the second cohort of the MSc in Global Healthcare Leadership (MGHL) programme were responsible for conceptualising, organising and delivering the event with support from the Saïd Business School  and Nuffield Department of Primary Care Health Sciences at the University of Oxford.