Climate-hit South Asian countries need a health system overhaul

People in the Global South are disproportionately affected by fossil fuel pollution. Climate finance needs to help them adapt to the challenges.

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Public finance has to be mobilised for funding critical health system adaptation, because the private sector’s role in building community capacity for adaptation has been limited, and privatization often hampers the provision of critical health services at the community level. Most of the onus of primary health care should be placed on the government, as health care is a fundamental right. 

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With a more locally led approach, health care should be decentralised - making primary health care much more accessible to the people living on the frontline. As exemplified by Nepal’s local adaptation plan of action (LAPA), local administrations across South Asia should create and implement their own adaptation action plans in line with vulnerability and risk assessments. Adequate resources should be delegated to communities and hospitals to tackle the known risks.  

Community awareness needs to be built about the health risks and how these are linked to the burning of fossil fuels and climate change. It is a two-way street. Local communities are best able to identify what kind of risks and hazards they face during disasters, and the government should design the adaptation response in line with that knowledge. A large body of local health workers has to be trained to ensure last-mile connectivity, while the health care system should also address inequality and inequity built into social categories like caste, gender, age, and so on.

South Asia is expected to face about a quarter of the deaths due to climate impact while losing 1.2 to 2.8 percent of its regional GDP due to economic loss and damage. It is time that climate-vulnerable South Asian countries stepped up their work on the growing health challenges coming from climate-induced disasters and pollution. They need to work closely with each other across boundaries - from ensuring cross-border early warning systems to having a broader regional approach to disease outbreaks.