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Searchable Case Studies for Climate Change Adaptation

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Communities across the United States are anticipating, planning, and preparing for the impacts of climate change. Below are examples of municipal, state, or tribal communities that have taken action.

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See how Rhode Island helps municipalities address climate vulnerabilities in wastewater treatment facilities through a statewide financing program.

Water Quality, Water Utility, Getting Started, Sector Specific Adaptation Planning

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See how the Alaskan Native village of Shaktoolik funded the development of a community shelter in response to coastal climate risks. Water Quality, Water Utility, Ecosystem Protection, Water and Public Health, Getting Started, Comprehensive Adaptation Planning, Environmental Justice Local, State, Tribal AK 2
Learn how New York State provides matching grants to communities to implement climate adaptation projects. Water Quality, Extreme Heat and Public Health, Water and Public Health, Getting Started, Comprehensive, Sector Specific, Environmental Justice State, Local NE 1
Learn how Hawai'i is preparing its highways for climate impacts. Sector Specific, Getting Started State PI 1
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Learn how State government and a nonprofit partnered to support urban forestry initiatives, improve tree equity, and enhance climate resilience. Water Quality, Air and Public Health, Extreme Heat and Public Health, Water and Public Health, Environmental Justice Local, State NE 2
Learn how New Hampshire’s regional Rockingham Planning Commission helps communities prioritize resources to respond to sea-level rise. Sea Level Rise Local NE 0
See how several Northeast Indiana counties—Noble, LaGrange, Steuben, and DeKalb—developed debris management plans with the Northeast Indiana Solid Waste Management District (NISWMD). Waste, Disaster Debris Local MW 0
Learn how King County, Washington is helping municipalities address climate change in local government services, including solid waste management. Sector Specific Adaptation Planning, Waste Local NW 0
See how federal, state, tribal, county, and city governments are working to meet water supply and ecosystem restoration needs of the Yakima River Basin. Drought, Water Quality, Water Management, Ecosystem Protection, Change in Fish Local NW 0
See how Lake County implemented a no-net-loss wetland acreage policy with a net gain in wetland function goal to improve their water quality and flood storage capacity. Water Management, Ecosystem Protection, Wetland Protection Local MW 0
See how the city of Bridgeport recognized vulnerability to the impacts of climate change on IAQ as part of its BGreen initiative. Indoor Air, Air and Public Health Local NE 0
See the process by which the Boston city government assessed vulnerability and developed an adaptation plan to respond to sea level rise and other climate risks. Comprehensive Adaptation Planning, Sea Level Rise Local NE 0
See how Central New Mexico is working to improve air quality by accounting for future climate change in the city’s transportation plans and ongoing projects. Sector Specific Adaptation Planning, Air and Public Health,
Outdoor Air Quality,
State SW 0
See how the Washington, DC Water and Sewer Authority will use green infrastructure to reduce combined sewer overflows, maintain water quality, and provide adaptive flexibility to changing climate conditions. Stormwater Runoff, Flooding and Storms, Smart Growth, Water Quality, Water Utility Local NE 0
See how a wastewater utility in Washington, DC is protecting their facility by building a sea wall that accounts for higher river elevations and changing climate conditions. Flooding and Storms, Sea Level Rise, Water Utility Local NE 0
See how Boston's Deer Island Water Treatment Facility redesigned their facility to account for expected sea levels and routinely evaluates performance under the best-available climate science. Sea Level Rise, Water Utility Local NE 0
See how Manchester-by-the-sea used a EPA tool to help assess drinking water system vulnerability to sea level rise. Water Utility, Sea Level Rise, Sector Specific Adaptation Planning Local NE 0
See how Iowa City, IA responded to riverine flooding risk by decommissioning a vulnerable facility and expanding service outside the floodplain. Flooding and Storms, Water Utility Local MW 0
See how Iowa City, IA used smart growth strategies to increase climate change resiliency by removing vulnerable structures and managing stormwater along the riverfront. Stormwater Runoff, Water Quality Local MW 0
See how Chicago, IL is improving climate resilience to extreme heat events by engaging vulnerable communities and improving disaster response protocols. Air and Public Health, Environmental Justice Local MW 0
See how Chicago, IL assessed public health vulnerability to extreme heat events and is adapting by utilizing green infrastructure to reduce urban heat island hotspots in anticipation of future climate risk. Extreme Heat and Public Health Local MW 0
See how Salt Lake City is implementing strategies that are reducing air pollutants in anticipation of increasing threats from climate change. Outdoor Air Quality, Air and Public Health Local SW 0
See how a Tampa, FL water utility reduced vulnerability and evaluated climate threats to sea level rise exacerbated saltwater intrusion. Source Water Impacts, Water Utility, Saltwater Intrusion, Drought Local SE 0
See how California is improving resiliency to particulate matter threats by planning to adapt to increased climate threats from wildfires. Air and Public Health, Outdoor Air Quality, Sector Specific Adaptation Planning State SW 0
See how South Florida counties and municipalities partnered to develop a comprehensive sea level rise assessment. Saltwater Intrusion, Water Utility, Sea Level Rise Regional SE 0
See how New York City, NY assessed climate risk from extreme heat and is undertaking efforts to reduce current and future vulnerability. Air and Public Health, Sector Specific Adaptation Planning, Extreme Heat and Public Health Local NE 0
See how Camden, NJ water utility used an EPA tool to assess the climate risks from projected precipitation increases and vulnerability of greater combined sewer overflows. Stormwater Runoff, Flooding and Storms, Water Utility, Water Quality Local NE 0
See how Pennsylvania is planning to adapt to climate threats to water quality criteria and protect ecosystem health, particularly for cold water fisheries. Change in Fish, Erosion and Sedimentation, Stormwater Runoff, Ecosystem Protection, Water Quality State NE 0
See how a water utility in Washington state partnered with experts to redesign and rebuild a water utility to adapt to sea level rise and other changing climate conditions. Source Water Impacts, Flooding and Storms, Drought, Water Utility, Saltwater Intrusion, Adaptation Planning Local NW 0
See how Charlotte Harbor National Estuary Program and Southwest Florida Regional Planning Council assessed the sea level rise climate vulnerability of marshes and wetlands and identified potential adaptation strategies. Estuary, Wetland Protection, Water, Ecosystem Protection Regional SE 0
See how a water utility in Fredericktown, MO used an EPA tool to assess climate vulnerability for their source water from drought, erosion and sedimentation. Erosion and Sedimentation, Source Water Impacts, Flooding and Storms, Water Utility, Water Quality, Drought Local MW 0
See how the state of Maryland used a modeling tool to assess the vulnerability of salt marshes to projected sea level rise. Wetland Protection, Ecosystem Protection, Water State NE 0
See how Minnesota has assessed projected public health risks from climate change across the state. Water and Public Health, Air and Public Health, Waste and Public Health, Sector Specific Adaptation Planning State MW 0
See how the Southern Nevada Water Authority used an EPA tool to better assess climate vulnerability to drought and harmful algal blooms. Algal Blooms, Source Water Impacts, Drought, Water Utility Regional SW 0
See how New York City has used its vulnerability assessment to anticipate and prepare for changing conditions by using adaptation strategies to reduce extreme heat vulnerability. Air and Public Health, Extreme Heat and Public Health Local NE 0
See how Massachusetts has surveyed local health departments to assess vulnerability to expected climate changes. Water and Public Health, Air and Public Health, Waste and Public Health, Sector Specific Adaptation Planning State NE 0
See how American Cyanamid Superfund Site responded to disaster by rebuilding facilities to account for expected climate changes. Waste, Contaminated Site Local NE 0
See how the San Juan Bay Estuary Program assessed climate risk to the bay and identified adaptation strategies to reduce ecosystem vulnerability from changing climate conditions. Estuary, Wetland Protection, Ecosystem Protection, Water, Sector Specific Adaptation Planning, Environmental Justice Local SE 0
See how the Metropolitan Washington Council of Governments developed an adaptation plan with policy options for the consideration of its local jurisdictions. Comprehensive Adaptation Planning Regional NE 0
The Minnehaha Creek Watershed District, responsible for Minneapolis, Minnesota, considered climate projections to better understand climate threats and vulnerability to stormwater management capabilities. Stormwater Runoff, Flooding and Storms, Water Utility, Water Quality Regional MW 0
Barre City, Vermont used the Analysis of Brownfield Cleanup Alternatives Checklist to better understand the climate vulnerability of a redevelopment project on a brownfield site. Waste, Contaminated Site Local NE 0
See how the Quinault Indian Nation is considering climate (sea level rise, storm surge, and river flooding) and non-climate (tsunami) risks together to form a village relocation plan. Comprehensive Adaptation Planning, Sea Level Rise, Flooding and Storms, Environmental Justice Tribal NW 0
See how a simple checklist helped Augusta, GA, better understand the climate vulnerability of a Brownfields redevelopment project. Waste, Contaminated Site Local SE 0
See how San Francisco is working to transform brownfields property into greenspace. Waste, Contaminated Site Local SW 0

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  • Published: 19 March 2019

Climate change adaptation in South Africa: a case study on the role of the health sector

  • Matthew F. Chersich   ORCID: orcid.org/0000-0002-4320-9168 1 &
  • Caradee Y. Wright 2  

Globalization and Health volume  15 , Article number:  22 ( 2019 ) Cite this article

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Globally, the response to climate change is gradually gaining momentum as the impacts of climate change unfold. In South Africa, it is increasingly apparent that delays in responding to climate change over the past decades have jeopardized human life and livelihoods. While slow progress with mitigation, especially in the energy sector, has garnered much attention, focus is now shifting to developing plans and systems to adapt to the impacts of climate change.

We applied systematic review methods to assess progress with climate change adaptation in the health sector in South Africa. This case study provides useful lessons which could be applied in other countries in the African region, or globally. We reviewed the literature indexed in PubMed and Web of Science, together with relevant grey literature. We included articles describing adaptation interventions to reduce the impact of climate change on health in South Africa. All study designs were eligible. Data from included articles and grey literature were summed thematically.

Of the 820 publications screened, 21 were included, together with an additional xx papers. Very few studies presented findings of an intervention or used high-quality research designs. Several policy frameworks for climate change have been developed at national and local government levels. These, however, pay little attention to health concerns and the specific needs of vulnerable groups. Systems for forecasting extreme weather, and tracking malaria and other infections appear well established. Yet, there is little evidence about the country’s preparedness for extreme weather events, or the ability of the already strained health system to respond to these events. Seemingly, few adaptation measures have taken place in occupational and other settings. To date, little attention has been given to climate change in training curricula for health workers.

Conclusions

Overall, the volume and quality of research is disappointing, and disproportionate to the threat posed by climate change in South Africa. This is surprising given that the requisite expertise for policy advocacy, identifying effective interventions and implementing systems-based approaches rests within the health sector. More effective use of data, a traditional strength of health professionals, could support adaptation and promote accountability of the state. With increased health-sector leadership, climate change could be reframed as predominately a health issue, one necessitating an urgent, adequately-resourced response. Such a shift in South Africa, but also beyond the country, may play a key role in accelerating climate change adaptation and mitigation.

The impacts of global changes in climate are rapidly escalating in South Africa. Unless concerted action is taken to reduce greenhouse gas emissions, temperatures may rise by more than 4 °C over the southern African interior by 2100, and by more than 6 °C over the western, central and northern parts of South Africa [ 1 , 2 ]. Extreme weather events are the most noticeable effects to date, especially the drought in the Western Cape and wildfires, but rises in vector- and waterborne diseases are also gaining prominence. Global warming, which manifests as climate variability, has already been implicated in increased transmission of malaria, Rift Valley Fever, schistosomiasis, cholera and other diarrheal pathogens, and Avian influenza in the country [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Studies have documented the considerable impact of high ambient temperatures on mortality in the country, with mortality rises of 0.9% per 1 °C above certain thresholds, and considerably higher levels in the elderly and young children [ 11 , 12 ]. Food security is under threat, with, for example, crop yields likely to decline in several provinces, with concomitant loss of livestock [ 13 ]. Moreover, any negative impacts of climate change on the country’s economy will have major implications for people’s access to food, which is largely contingent on affordability. Food access is already tenuous given the existing levels of poverty and as ownership of arable land is highly inequitable, reflecting the particular history of the country [ 14 ].

The impact of rises in temperature are especially marked in occupational settings, particularly in the mining, agriculture and outdoor service sectors [ 15 , 16 , 17 ]. Impacts, including measurable mortality effects, are heightened in those living in informal settlements, where houses are often constructed of sheets of corrugated iron [ 18 , 19 , 20 ]. In addition, heat increments are pronounced in many schools and health facilities as these have not been constructed to withstand current and future temperature levels [ 21 , 22 ]. Importantly, all the impacts of climate change affect mental health, in a nation where already one sixth of the population have a mental health disorder [ 23 ].

While climate mitigation efforts, especially a reduction in carbon-based power production, have garnered much attention, focus is shifting to more direct, and shorter or ‘near’ term actions to counter the impacts of climate change [ 24 , 25 , 26 ]. These actions – commonly called adaptation measures – range from building the resilience of the population and health system, to preparing for health impacts of extreme weather events and to reducing the effects of incremental rises in heat in the workplace and other settings [ 27 ].

Most importantly, the effectiveness of adaptation pivots on reducing levels of poverty and inequities, especially in women and other vulnerable groups. Simply put: if an individual’s or household’s socio-economic status is robust, they will have a greater ability to withstand shocks induced by climate change. In South Africa, however, about a quarter of the population are unemployed and over half live below the poverty line [ 28 ]. Poverty reduction initiatives, such as the highly successful social grants system [ 29 ], thus lie at the heart of health adaptation. These initiatives already reach 17.5 million vulnerable people in South Africa [ 30 ], could be further extended to counter balance the disproportionate effects of climate change on vulnerable groups [ 31 ]. Equally, having a resilient health system is central to effective climate change adaptation.

While health professionals can play a critical role in advocating for stronger mitigation efforts such as a shift from brown to green energy (the government envisages that in 2030, still two thirds of energy production in the country will be coal-based [ 32 ]), the contribution of the health sector mostly centres around climate change adaptation. Several features of an effective health-sector adaptation response bear mention [ 33 ]. Firstly, national- and local-level policy frameworks and plans are required, supported by adequate resources. In particular, emergency incident response plans are needed for events such as heat waves, wildfires, floods, extreme water scarcity and infectious disease outbreaks [ 34 ]. These response plans set out the procedures to follow in the case of such events and the responsibilities of different actors. Secondly, communication is a key component of adaptation strategies, targeting a wide range of audiences, and using social and other media. Long-term communications strategies, such as “Heat education” campaigns, can raise awareness of the health risks of heat waves, and help prepare individuals and communities to self-manage their responses to increased heat [ 35 ]. Then, more short-term response communication is needed when an actual extreme weather event is forecast, making the public aware of an impending period of risk and what steps are needed to ameliorate that risk. Thirdly, the effectiveness of adaptation interventions rests on the strength of data systems and surveillance. Aside from providing warnings of extreme weather events, heightened surveillance is required of diseases associated with environmental factors, together with concerted efforts to systematically document the effectiveness of adaptation responses and to identify opportunities for improving services.

There is clearly a real opportunity to bring the credible voice and considerable resources of the health sector to bear on climate change policies and programmes [ 36 , 37 , 38 ]. It is important to assess the extent to which this is occurring and gaps in this response. Some reviews have examined this issue in South Africa [ 39 , 40 , 41 ], but none have done so recently, or employed systematic review methodology. This study fills that gap and presents lessons from the response in South Africa that might be applied in other countries and, indeed, globally [ 42 ]. In recent decades, South Africa has played a leading role in tackling public health issues affecting the African region, especially in the HIV field. The country has the potential, drawing on its research and programme expertise, to play a similar role in climate change adaptation, galvanising action in other parts of the continent. Thus, while the impacts of climate are somewhat unique to each country and even within different parts of a country, lessons drawn from this case study may provide useful insights for other countries in the region.

The paper is divided into two thematic areas. The first covers policy frameworks relating to climate change adaptation, as well as data monitoring and surveillance of climate change adaptation in the country. The second reviews the level of preparedness and actions already taken for extreme weather events, rises in temperature and infectious disease outbreaks. Topics indirectly related to health, such as food security, are not addressed in the paper, though remain of key importance.

Review methods

We systematically reviewed literature indexed in PubMed (Medline) and Web of Science for articles that address climate change adaptation in South Africa. Full details and the PRISMA Flow Chart are described elsewhere [ 43 ]. The Pubmed search strategy included free text terms and controlled vocabulary terms (MeSH codes), specifically: (((((“South Africa”[MeSH]) OR (“South Africa”[Title/Abstract]) OR (“Southern Africa*”[Title/Abstract]))) AND “last 10 years”[PDat])) AND (((“global warming”[Title/Abstract] OR “global warming”[MeSH] OR climatic*[Title/Abstract] OR “climate change”[Title/Abstract] OR “climate change”[MeSH] OR “Desert Climate”[MeSH] OR “El Nino-Southern Oscillation”[MeSH] OR Microclimate[MeSH] OR “Tropical Climate”[MeSH])). This strategy was translated into a Web of Science search.

In total, 820 titles and abstracts were screened by a single reviewer after removal of 34 duplicate items. To be included, articles had to describe adaptation interventions to reduce the impact of climate change on health in South Africa. All study designs were eligible and no time limits were imposed. We excluded articles that were not in English ( n  = 3), only covered animals or plants ( n  = 345), were not on South Africa ( n  = 273), were unrelated to health ( n  = 57) or to climate change ( n  = 56), or were only on climate change impact ( n  = 34) or mitigation ( n  = 31). In total, we screened 86 full text articles for eligibility, 21 of which were included (Fig.  1 ). We also included literature located through searches of article references (one additional paper) or through targeted internet searches. Thereafter, we extracted data on the characteristics of the included articles, including their study design and outcome measures (Table  1 ). In analysis, we grouped studies on similar topics and, where possible, attempted to highlight commonalities or differences between the study findings. Policy documents were located by searching the website of the National Department of Environmental Affairs ( https://www.environment.gov.za ) and the National Department of Health ( http://www.health.gov.za/ ), and by asking experts familiar with these policies in South Africa.

figure 1

PRISMA Flow Diagram for Review of health-related adaptation to Climate Change in South Africa

Engagement of the health sector in climate change policies, planning and data systems

We located 14 journal articles on health sector engagement. With these limited number of records, results are presented as a narrative, rather than as a comparison of findings in different parts of the country or across population groups. We first discuss national and local policies and practices, and then turn to assess the climate and health monitoring systems in the country.

In recent years, the national government has developed a series of documents covering key legislative and strategic aspects of adaptation. In 2018, the government released a draft of the National Climate Change Response White Paper which sets out the different ways in which climate change considerations can be integrated within all sectors, including health. This document updates the 2011 White Paper on this topic. More recently, the draft National Climate Change Bill was made available for comment [ 24 ]. Little reference is made to human health and scanty detail is provided on actual implementation of the policies. Additionally, in 2017, the second draft of the South African National Adaptation Strategy was made open for public comment [ 25 ]. This is a ten-year plan, which describes key strategic areas, with measurable outcomes. The strategy acts as a reference point for all climate change adaptation efforts in South Africa, providing overarching guidance across the various sectors of the economy. As such, it seeks to ensure that different levels of government and the private sector integrate and reflect climate change adaptation. The implementation priorities for health are listed as water and sanitation, early warning systems for effective public health interventions during extreme weather events, and occupational health.

While national policies set the stage for lower levels of government and funding prioritisation, much of the actual planning for climate change adaptation occurs at the provincial and local government level. Most importantly, each local area government is charged with developing an Integrated Development Plan every five years, involving many sectors, including health [ 44 ]. Health implications of climate change are mentioned in some of these plans, but not all [ 45 , 46 , 47 ]. A survey of Environmental Health Practitioners ( n  = 48), who are at the forefront of implementing these plans, provides insights of the degree to which climate change priorities have been incorporated within these plans [ 48 ]. Though almost all felt that they should play a supportive or leading role in addressing climate change, only half had a budget allocated for climate change and health-related work, and only a third had ever participated in climate change-related projects. Another study involving fieldwork in a range of settings in South Africa reported that, for climate change adaptation plans to be successful, local communities need to be more involved in their design and implementation [ 49 ]. A further study in eThekwini Municipality, KwaZulu-Natal Province noted that few climate change advocates had emerged among local politicians and civil servants, and that decisions made at the local government level seldom took climate change issues into account [ 50 ]. A case study of the Integrated Development Plan in the same municipality examined the working relations between the local government, civil society and private sector actors on climate change initiatives, forming a ‘network governance’ structure [ 51 ]. Having a ‘network’ helped local government shift from ruling by regulations and authority, to a ‘softer approach’, one that ‘enabled’ solutions to climate challenges. For their part, however, the private sector found it challenging to incorporate climate-sensitive actions into their modus operandi and may require financial incentives to adopt mitigation and adaptation measures. Concerns remain that the private sector - and indeed the public sector – view environmental issues as constraints to profit and development, rather than as contributors [ 50 ].

While it appears that national and local policy and planning frameworks can influence programmes and funding allocations, at least to some extent, their impact needs to be monitored closely, using appropriate indicators. These data can help decision-makers to identify programmatic areas to target, researchers to analyse and benchmark programme performance, and civil society and communities to gauge service provision in their area. The growing and shifting burden of climate-sensitive diseases, however, means that the district- and national-level indicators currently used for monitoring disease and service provision may be less relevant in this new era.

A review in 2014 emphasized the need for developing new tools for incorporating data from climate monitoring systems, for example temperature and rainfall, into Demographic Health Information Systems (DHIS) in South Africa, and vice versa [ 39 ]. The tremendous potential of integrated weather-health data is, however, constrained by differences in spatial, temporal and quality of these respective data sources. While weather data are recorded hourly and in small geographical units, [ 52 , 53 ] health data are often only available in monthly units and at district level. Analysing climate data at those resolutions results in a considerable loss of information and thus predictive ability. Challenges in collecting health data – often paper-based – means that these data are often of poorer quality than climate data, though deficiencies in climate data are not uncommon in South Africa [ 12 ]. Despite these limitations, combining climate and health data can assist with seasonal forecasting, and early warning systems for infectious diseases and other climate-related conditions.

The Infectious Diseases Early Warning System project (iDEWS) project, involving Southern African and Japanese researchers, aims to advance all these efforts, and to develop early warning system for a wide range of infectious diseases, based on climate predictions [ 54 ]. Such applications have been developed to support malaria programming in the country [ 55 ], where temporal patterns in temperature, rainfall and sea surface temperature can forecast changes in malaria incidence and the geographical expansion of disease outbreaks [ 3 , 56 , 57 ]. Further, as shown in a study in Cape Town, close monitoring of ambient temperature, can predict spikes in incidence of diarrhoeal disease, allowing health services to prepare for rises in admissions and outpatient visits [ 9 ]. Similarly, another study across several provinces noted that anomalous high rainfall precedes outbreaks of Rift Valley fever by one month and that this finding can be used to forewarn epidemics in affected areas of the country [ 58 ].

In addition to applications around infectious diseases, health and climate data are analysed in multiple-risk systems, such as the South African Risk and Vulnerability Atlas (SARVA) [ 59 ]. This spatial database allow for visualisation of the drivers, exposures, vulnerabilities, risks and hazards across different locations. SARVA provides more than just data outputs, however, and has developed a range of practical climate services for the agriculture sector, for example. Additionally, Heat–Health Warning Systems in the country, based on increasingly sophisticated meteorological systems, have long lead-times, and can alert decision-makers and the public of forthcoming extreme heat events, triggering a graded set of pre-specified actions [ 52 , 60 ].

While adaptation is classically defined as the ability to deal with change, it also encompasses the capacity to learn from it. Doing so requires investments in research and analytical systems, especially among public health practitioners. Of concern, a collaboration across several countries, including South Africa, noted that climate change and environmental health, in general, have not been mainstreamed within curricula at medical schools [ 61 ]. The group noted that, given the limited capacity in this area, international assistance maybe required to develop curricula and teaching materials. Other studies in have documented considerable gaps in knowledge on climate change among university students across disciplines and the limited ability of these future leaders to engage with others on the topic [ 62 , 63 ]. Overall, the research outputs by South Africa scientists on climate change has grown (around 600 academic publications in 2015), but only 3%, or about 20, of these publications make reference to health [ 64 ]. Of more concern, a report of the Lancet Countdown on health and climate change group, using a narrower search strategy, located only about 20 papers related to climate change and health in the whole of Africa in 2017, constituting well under 10% of the total 300 such papers worldwide [ 65 ]. Reviews have also noted that little interdisciplinary work between meteorology and health has been done [ 66 ]. But, perhaps most importantly, research investigating the performance of interventions to reduce the health impacts of climate change are largely absent [ 40 , 67 ].

Response to extreme weather events and gradual increments in temperature

We located only 8 studies applicable to this section of the review, limiting our ability to provide a comprehensive analysis on the topic at hand. This section covers disaster preparedness and responses, including of the health system, and the population groups, occupations and housing types most vulnerable to heat exposure.

The government of South Africa has developed Disaster Management Frameworks and a National Disaster Management Centre, [ 25 , 68 ] whose responsibilities include directing the country’s responses to disasters and strengthening cooperation amongst different stakeholders. There are, however, concerns that disaster risk reduction systems operate in isolation from other climate change adaptation initiatives in the country, rather than drawing on the strengths of each group [ 69 ]. While there are robust ‘Heat Health’ warning systems in the country, it appears that actual action plans or responses to heat waves require further development [ 35 , 70 ]. Some steps have been taken to develop these systems in local government areas and the private sector. A case study examining preparedness for flooding in the city of Johannesburg provides useful examples of potential synergies between the health and other sectors, but also notes considerable political barriers to cross-sectoral actions [ 71 ]. Another example of preparedness was noted in a report by a mining company that operates in several parts of the country. The company had developed substantial information, communication and technology capacity for risk assessments, and warning systems for flooding and other climate-related disasters [ 72 ].

Efforts to prepare the health system for extreme weather events or infectious disease outbreaks are hampered by weaknesses in health systems, especially in human resources for health in South Africa [ 28 ]. The recent experiences with the Listeriosis outbreak, the largest and longest lasting epidemic documented worldwide to date, brought these concerns to the fore, in particular the country’s ability to mount a swift and systematic response to disease outbreaks [ 73 ]. There were major challenges in collecting data on patient outcomes during the epidemic, for example, where the mortality status was unknown for as many as 30% of affected patients [ 74 ]. This outbreak and recent extreme weather events present many opportunities for learning. It seems, however, that these learning opportunities are often missed. A review of the responses to droughts in the country over the past century found that there have been few attempts to learn from previous droughts, and that responses to each event were largely developed de novo, rather than shaped by long-term planning and lessons from previous similar events [ 75 ].

Several populations groups and geographical areas in South Africa are especially vulnerable to the impacts of climate change. The Draft National Adaptation Strategy in 2017 and the White Paper of 2011, which presented the South African Government’s strategic vision for an effective climate change response mentions the importance of placing women and other vulnerable groups at the centre of adaptation actions. These documents, however, do not expand on this concept and no evidence was located on the differential effectiveness of adaptation interventions among women in the country, and efforts to specifically tailor adaptation measures accordingly [ 31 ]. This is concerning as many of the health and social burdens in the country are underscored by harmful gender norms, with, for example, the country has one of the highest rates of sexual violence worldwide and a very gendered HIV epidemic [ 76 ]. Few studies were located on adaption in occupational settings, many of which may become ‘moderate to high risk’ workplaces as temperatures rise [ 15 ]. A study in Johannesburg and Upington (where daily maximum temperatures may exceed 40 °C) found that outdoor workers experienced a range of heat-related effects [ 17 ]. These include sunburn, sleeplessness, irritability and exhaustion, leading to difficulty in maintaining work levels and output during very hot weather. Aside from commencing work earlier, during the cooler part of the day, no measures had been taken to protect the workers, who believed that sunglasses, wide-brimmed hats and easier access to drinking water would improve their comfort and productivity. In the mining sector in South Africa, several studies have reported that workers’ comfort and productivity can be raised with interventions such as ventilation cooling [ 77 , 78 , 79 ]. Of note, insulation within many hospital buildings has been found wanting, but little had been done to address the problem [ 80 ]. Some hospitals have taken steps to increase use of natural ventilation to adapt to temperature increases and as part of efforts to curb use of air conditioning [ 81 ]. Natural ventilation also reduces transmission of multi-drug-resistant tuberculosis, important as the country has one of the highest rates of tuberculosis worldwide [ 82 ].

Improvements in specific types of housing, especially in informal settlements, could reduce the considerable heat-health impacts of these structures, which include mortality [ 18 , 19 ]. We identified several studies on urban health in South Africa, but these did not extend to documenting the health benefits of energy efficient buildings, green spaces, public transport, car-free zones and active transport [ 71 , 83 , 84 ]. Further, many school classrooms in the country are constructed of prefabricated asbestos sheeting and corrugated iron roofs or made from converted shipping containers. A study in several parts of Johannesburg showed that heat-related symptoms are common in these structures [ 21 ]. The authors postulate that improving these structures would increase comfort for scholars and could raise educational outcomes.

The review sums the body of evidence on climate change adaptation in South Africa. We note that some steps have been taken to develop a multi-pronged strategy that cuts across health and other disciplines, and that helps adapt to the already substantial and future impacts of climate change in the country [ 42 , 85 ]. Such steps are being supported by efforts to build the resilience of vulnerable groups, who have limited ability to adapt to droughts, flooding, changes in biomes and other events [ 84 ]. While key policy frameworks are in place, it is difficult to gauge whether these have been actualized at national and local level. Increased efforts to include civil society advocates, local communities and the private sector may accelerate progress with policy implementation. In South Africa, highly-detailed data are available on weather conditions at very fine spatial and temporal resolution. Health data generally have lower resolution and quality. Additional spatial and temporal disaggregation of health information could provide invaluable data, for example, to help identify critical heat-stress thresholds in different settings and to monitor the effectiveness of action response plans. In the meantime, more evaluations, including ‘dry runs’ are needed of the health aspects of emergency response plans to extreme weather events [ 60 ]. Gaps were also noted in research infrastructure and in efforts to reduce heat exposures in some housing types and occupational settings.

The case study presented here provides useful perspectives for other countries in sub-Saharan Africa. Most especially, the findings could feed into the work of the Clim-HEALTH Africa network, which aims to share expertise, and to inform climate-sensitive policies and planning across the region [ 86 ]. While the network has already supported the development of several adaptation plans, the evidence presented here may contribute to future iterations of these plans and other network initiatives.

Strategies for extreme events – and indeed for all interventions related to climate change – need to be informed by an analysis of the implications for those living in poverty, migrants, women and children, among other groups. We noted little evidence of specific ‘targeting’ of adaptation responses to vulnerable groups. There may, for example, be benefits to specifically targeting women, as opposed to men, in early warning systems and disaster reduction plans. This approach is supported by evidence that, as with many other social interventions, it is most effective to distribute relief kits and house building grants to women [ 87 ]. In tandem with other adaptation initiatives and targeting, the overall functioning of the health system needs to be fortified, though there is much uncertainty about how this might be done [ 88 , 89 ]. The goal is to ensure that health facilities remain operational during extreme weather events, serve as places of refuge and support, and can summon the additional capacity required to deal with the impacts of extreme events. An external evaluation of the recent response to the Listeriosis outbreak might identify important lessons for improving the response to future outbreaks or extreme weather events. Potential links between climate change and that outbreak as well as future outbreaks also warrant investigation [ 73 ]. The health sector is also responsible for developing and testing heat-health guidelines for specific settings and populations, such as guidelines for sports events, which stipulate the temperature thresholds at which different sport activities should be cancelled.

Going forward, there are many opportunities to strengthen data monitoring and surveillance systems on climate and health. The Lancet Countdown has developed indicators to monitor national-level progress on climate change in the health sector [ 90 ]. Six of these pertain to adaptation and correspond broadly to the sections of this paper: 1. National adaptation plans for health; 2. City-level climate change risk assessments; 3. Detection and early warning of, preparedness for, and response to health emergencies; 4. Climate information services for health; 5. National assessment of vulnerability, impacts and adaptation for health; and 6. Climate-resilient health infrastructure. This paper suggests that additional work is required in each of these areas in South Africa. These indicators – and the full Lancet Countdown framework – could be used to benchmark the country’s progress against other nations and to pinpoint the specific areas requiring attention [ 91 ]. Monitoring data could be used to produce annual estimates of the burden of disease and health costs that would be averted by more vigorous climate change mitigation or adaptation efforts [ 92 ]. Such disease prediction models have been used with great effect in the HIV epidemic [ 93 ], where they generated considerable pressure on the government and international donors to prioritise actions and resource allocations accordingly. Additionally, given the vulnerabilities of food security to climate change in South Africa, close monitoring is needed of under-nutrition, agriculture and marine productivity [ 14 , 94 ].

An adequate adaptation response is contingent on the progressive accrual of robust evidence. This, in turn, depends on earmarked funding for research on climate change and health, agile and responsive research systems and, indeed, an adequate number of capacitated researchers. Given the growing attention paid to this field, high-quality evidence with compelling findings could rapidly foment policy changes. Moreover, if the quality and volume of research were raised, it will become possible to make evidence-based national policies, as in other health fields. The health sector in South Africa, with its considerable research capacity, is well placed to lead such efforts. To achieve this, however, researchers in other health fields, such as HIV, for example, would need to take on projects on climate change. As a first step, it may be useful to convene consultations of experts in health, the environment and related fields to develop broad plans for taking advantage of opportunities for cross-learning and action. Some targeted research funding for joint health and environmental projects on climate change could have a considerable impact. The iDEWS project offers an important example of such an initiative [ 54 ]. In the long run, research in this field could be sustained by allocating more time to climate change topics in training programmes for health workers and public health practitioners.

While the review highlights some important findings, the limited number of papers located suggests that the country has some way to go to fulfilling its potential leadership role on the continent, and indeed globally. One area that health practitioners in South Africa could lead on is the promotion of a ‘meat tax’, given their pioneering work on the ‘sugar tax’ [ 95 ]. Curbing the intake of ruminant meat is a key climate change mitigation strategy and would lower cancer risks, among other health benefits [ 96 ]. This is important in South Africa, where an estimated total of 875,000 tons of beef are consumed annually [ 97 ], producing 648 gigagrams of methane [ 98 ]. The principal arguments for a sugar tax – and indeed for tobacco and alcohol taxes – hold for ruminant meat: harm to self and others, and the considerable cost burdens on broader society [ 99 ]. In this case, the harms are mediated through environmental destruction, a change in climate and cancer, amongst others [ 95 ]. Such policies are, however, likely to be vigorously opposed by the meat industry in South Africa, and public health and environmental and social justice experts in the country will need to rally together [ 26 ]. Bringing together the complementary skills of these experts has the potential for powerful synergies and for drawing additional researchers into the climate change and health arena. Similarly, broadening the scope of climate change adaptation to encompass existing programmes that have an indirect impact on climate change adaptation would also increase the number of climate adaption workers. This would also assist in mainstreaming climate change into existing health programmes, and highlight additional ways that the health sector has successfully responded to the problem. Increased attention to these successes might demonstrate the extent to which the sector is leading the field and its potential contribution to overall adaptation efforts in the country.

The study has some limitations. The limited number of papers included in the review ( n  = 22) and the heterogeneous nature of the evidence constrained our ability to draw overall conclusions about the adaption response to date. Likely many additional studies on the topic are published in grey literature sources or unpublished and would thus not be in our search. Moreover, the search would not have located studies of interventions by the health sector that indirectly reduce the impact of climate change, but have not been framed as such. These intervention may include socio-economic initiatives that build financial resilience of households, improvements in housing and control of infectious diseases.

In fact, explicitly framing existing programmes that have an indirect impact on climate change adaptation as contributing to climate change adaptation.

The review highlights several important gaps in adaptation practices. While policy and planning frameworks for climate change at national, provincial and local level do make mention of health priorities, the health sector does not yet appear to be viewed as an essential platform for adaption measures, and health concerns appear to be accorded low priority. We did, however, note several important examples of health sector involvement in adaptation initiatives within local area government and in occupational settings. Importantly, there have been few rigorous evaluations of the effectiveness of actual interventions on climate adaptation for the health sector; most studies are descriptive in nature. Perhaps the largest knowledge gap is evidence around the effectiveness of disaster management systems and the level of preparedness of these systems for extreme weather events. The lack of studies on that and other topics may reflect the nascent nature of the field and that the priority given to climate-sensitive conditions in training for health workers and public health practitioners has not reflected the present and future burden of these conditions.

Clearly, interventions targeting the direct impacts of climate change need to occur in tandem with actions to shore up the resilience of the population and health system. Many health sector initiatives targeting those areas already contribute to climate adaptation, albeit indirectly so. Highlighting the successes of these initiatives and explicitly framing them as part of climate adaptation could mainstream climate change into existing programmes and provide examples of the ways in which the country is already successfully responding to the problem. Reframing in this manner may generate the leadership and momentum necessary for making rapid advances in this field.

Indeed, increased health sector leadership and lobbying may prove pivotal in advancing the adaptation field per se. The explicit framing of climate change adaptation and mitigation as critical to protecting the health of the nation may secure a more vigorous policy and programmatic response by government, and strengthen the engagement of civil society and communities [ 36 ]. Health could be placed firmly at the centre of policies for climate change adaptation and mitigation. Equally, effective leadership would mainstream climate change considerations into all policies for health [ 37 ]. High-quality research, involving a range of disciplines and backed by local and international funding, could go a long way to securing these changes.

While the country has led the way globally in HIV and several other arenas, it has yet to fully assume a leadership role in this field. With increased focus, the health sector could use its considerable influence to advocate for policy change and improved climate governance: it’s time for health to take a lead.

Abbreviations

Demographic Health Information System

Human Immunodeficiency Virus

Infectious Diseases Early Warning System project

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Acknowledgements

Neville Sweijd, Helen Rees, Fiona Scorgie for technical inputs.

This research received no external funding.

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Empowering citizen-led adaptation to systemic climate change risks

  • Tom H. Oliver   ORCID: orcid.org/0000-0002-4169-7313 1 ,
  • Prosper Bazaanah 2 ,
  • Jeff Da Costa   ORCID: orcid.org/0000-0002-1575-1320 1 , 3 ,
  • Nabajyoti Deka   ORCID: orcid.org/0000-0003-0316-5700 4 , 5 ,
  • Andre Z. Dornelles 1 ,
  • Matthew P. Greenwell   ORCID: orcid.org/0000-0001-5406-6222 1 ,
  • Magesh Nagarajan 5 ,
  • Kavin Narasimhan 6 ,
  • Emmanuel Obuobie 2 ,
  • Marian A. Osei   ORCID: orcid.org/0000-0003-3481-7222 2 &
  • Nigel Gilbert   ORCID: orcid.org/0000-0002-5937-2410 6  

Nature Climate Change volume  13 ,  pages 671–678 ( 2023 ) Cite this article

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The increasing impacts of climate change instigate the need for adaptation. However, most adaptation initiatives focus on actions by government or businesses, despite growing calls for communities on the frontline of climate risks to be involved in planning and selecting strategies. Here we appraise a pilot process using participatory systems mapping with citizens to identify (1) diverse threat vectors for local climate impacts and (2) context-relevant interventions to protect households and communities while (3) considering synergies and trade-offs with other socially desirable outcomes. We tested the pilot process in communities in the Lower Volta Basin in Ghana, the Assam region in India and Southern England. From participants’ perspectives, the process increased awareness of and preparedness for climate change impacts and raised essential learning points for upscaling citizen-led adaptation approaches. These include understanding multiple outcomes of interventions, barriers and enablers to implementation, and sensitivity of co-design to regional geography and socio-cultural context.

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Acknowledgements

We thank all the dedicated participants involved in the workshops across the three countries. The project was funded by a UKRI UK–India partnership (Ref.: 2021COPA&R13Oliver).

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School of Biological Sciences, University of Reading, Reading, UK

Tom H. Oliver, Jeff Da Costa, Andre Z. Dornelles & Matthew P. Greenwell

CSIR-Water Research Institute, Accra, Ghana

Prosper Bazaanah, Emmanuel Obuobie & Marian A. Osei

Department of Geography and Environmental Science, University of Reading, Reading, UK

Jeff Da Costa

Faculty of Management Studies, Delhi University, New Delhi, India

Nabajyoti Deka

Indian Institute of Management Nagpur, Nagpur, India

Nabajyoti Deka & Magesh Nagarajan

Department of Sociology, University of Surrey, Guildford, UK

Kavin Narasimhan & Nigel Gilbert

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T.H.O., N.G., M.N. and E.O. led the study design and planning with inputs from P.B., J.D.C., N.D., A.Z.D., M.P.G., K.N. and M.A.O. All co-authors participated in the workshops using participatory systems mapping and subsequently contributed to the article writing and review.

Corresponding author

Correspondence to Tom H. Oliver .

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This study has been approved by the School of Biological Sciences Ethics Committee at the University of Reading (reference SBS21-21 03).

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The authors declare no competing interests.

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Nature Climate Change thanks Jeff Birchall, Eranga Galappaththi and Edmond Totin for their contribution to the peer review of this work.

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Extended data

Extended data fig. 1 individual country reports..

Detailed Background to the country case studies can be found in the reports shown below, available for download at https://www.empower-project.org/resources/ .

Extended Data Fig. 2 Responses to evaluation survey of UK participants after the EMPOWER workshops.

These responses assess the degree to which they felt the project helped them make plans for climate change adaptation and improved their understanding of potential climate change impacts.

Supplementary information

Supplementary information.

Supplementary Tables 1–5, Box 1 and Discussion.

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Oliver, T.H., Bazaanah, P., Da Costa, J. et al. Empowering citizen-led adaptation to systemic climate change risks. Nat. Clim. Chang. 13 , 671–678 (2023). https://doi.org/10.1038/s41558-023-01712-6

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Health system adaptation to climate change: a Peruvian case study

Affiliations.

  • 1 Centre for Global Public Health, Queen Mary University of London, London, UK.
  • 2 Instituto Universitario de Investigación en Estudios Latinoamericanos, Madrid, España.
  • 3 Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales - CITBM, Universidad Nacional Mayor de San Marcos, Lima, Peru.
  • 4 Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru.
  • PMID: 33263753
  • DOI: 10.1093/heapol/czaa072

Despite mitigation attempts, the trajectory of climate change remains on an accelerated path, with devastating health impacts. As a response to the United Nations Framework Convention on Climate Change call for National Adaptation Plans, Peru has developed a national and decentralized regional adaptation plans. The purpose of this article is to understand the role and priority status of health within the adaptation planning and process. Peru was used as a case study to analyse the policy process in the creation of adaptation plans, encompassing the need to address climate change impacts on health with a particular focus on marginalized people. An actor, content and context policy analyses were conducted to analyse 17 out of 25 regional adaptation plans, which are available. The national adaptation plans (2002, 2015) do not include health as a priority or health adaptation strategies. In a decentralized health care system, regional plans demonstrate an increased improvement of complexity, systematization and structure over time (2009-17). In general, health has not been identified as a priority but as another area of impact. There is no cohesiveness between plans in format, content, planning and execution and only a limited consideration for marginalized populations. In conclusion, the regional departments of Peru stand on unequal footing regarding adapting the health sector to climate change. Findings in the strategies call into question how mitigation and adaption to climate change may be achieved. The lack of local research on health impacts due to climate change and a particular focus on marginalized people creates a policy vacuum. The Peruvian case study resembles global challenges to put health in the centre of national and regional adaptation plans. In-depth cross-country analysis is still missing but urgently needed to learn from other experiences.

Keywords: Climate change adaptation; Peru; health system; policy analysis; vulnerability.

© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: [email protected].

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Economics of Adaptation to Climate Change: Country Case Studies

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The World Bank’s global study on adaptation costs— Economics of Adaptation to Climate Change  (EACC)—released in 2009 found that the price tag of adapting to climate change in developing countries to be $75-$100 billion per year for the period 2010 to 2050. While this equals only 0.2% of the projected GDP of all developing countries, it is as much as 80% of total current ODA. For Sub-Saharan Africa, the study estimated annual adaptation costs of $14-17 billion.

A parallel exercise was done in partnership with policymakers and stakeholders in seven countries to understand what these global costs imply for individual countries. The country studies were done to help decision makers better assess climate change risks and design appropriate adaptation strategies.

The seven country case studies were selected based on overall vulnerability to major climate change impacts, differing environmental, social, and economic conditions, and adequate data at the national level. Country interest and buy-in at high government level was also fundamental to select the countries. Although it was difficult to  ex ante  identify the best set of candidates, as is always the case in similar exercises, it was considered important to have representativeness in terms of continents, size, population and income level of the country, as well as richness of data and local capacity to work with the EACC core team to apply the proposed methodology in the country.

Mozambique ,  Ghana , and  Ethiopia  represent nearly the full range of agricultural systems in Africa. Mozambique is subject to flooding and extreme events, including tropical cyclones. Both Mozambique and Ghana are on the receiving end of water flowing out of major international river basins. With most of their economic activity and population concentrated along the coast and in low-lying deltas,  Vietnam  and  Bangladesh  are Asian countries widely recognized as among the world‘s most vulnerable to climate change, particularly from extreme weather events and flooding, with particular impacts on poorer populations.  Bolivia  is a poor Latin American country traditionally dependent on the Andean glaciers to supply good portions of water demand, and consisting of a wide range of agro-ecosystems—from smallscale family agriculture on the Altiplano (largely composed by native indigenous populations) to largescale commercial agriculture in the lowlands of Santa Cruz. Finally, Samoa  represents a low-lying pacific island at increased risk to sea level rise and storm surge.

Given the impacts, the countries will have to avoid, manage and withstand some of these risks with prioritizing actions on adaptation. The studies have overarching lessons for the near-term and the longer term that may offer useful guidance for policy-makers:

Economic development is a central element of adaptation to climate change  Cost-benefit analysis of several projects, for example, in irrigation suggests that most of these are good for development as well as adaptation. In Ethiopia, robust growth based on infrastructure investment is the first line of defense against climate change impacts.

However, it should not be business as usual.  There is need to invest in human capital, develop institutions, and avoid incentives that encourage development in locations exposed to severe weather risks. Adaptation will require a different kind of development—such as breeding crops that are drought and flood tolerant, climate proofing long-lived infrastructure to make it resilient to climate risks.  For example, in Mozambique, there is need to look at ports like Beira and make sure it is climate-proofed.

Start with actions that make sense even without climate change . All over Africa, these studies show that expanding the road system and increasing the share of paved roads would yield high return by lowering transport costs and expanding markets. They lessen flood impacts and enhance farmers’ ability to respond on changes in agriculture.

Look beyond planned and hard (capital intensive) adaptation to soft (institutions and policies) adaptation . In Ghana, a number of soft measures are recommended over hard ones—including an upgrade of peri-urban slum and controlled development of new ones. In Ethiopia, there is need to look at strengthening social safety nets and crop insurance programs.

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The many stories of adaptation finance

Stéphane hallegatte, ferzina banaji.

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There are multiple stories to be told about adaptation finance. The first is that, despite mounting climate impacts, investments in adaptation are much lower than needed. According to the Climate Policy Initiative, adaptation finance accounted for $63 billion in 2021-22, far short of the estimated $212 billion needed per year by 2030 for developing countries alone. In fact, adaptation finance actually declined in 2023 as a proportion of total climate finance compared to previous years. Certainly, there is much yet to do to get financing flowing at the speed and scale needed to meet the climate crisis, especially for countries and communities most vulnerable to its impacts.

But what we call “adaptation finance” is only a fraction of what is needed to making countries, communities, and people more resilient. In fact, as our Country Climate and Development Reports, now available in close to 50 countries , make clear: reducing vulnerability to climate impacts and building resilience requires three things : more rapid development, more resilient development, and targeted adaptation interventions. Climate finance numbers tend to only capture the latter, while countries need to achieve all three for good adaptation with the first two particularly important for the world’s poorest countries.

Reducing vulnerability to climate impacts and building resilience requires three things: more rapid development, more resilient development, and targeted adaptation interventions.

Take, for instance, first, more rapid development . People living in poverty are always more vulnerable to climate impacts and so reducing poverty is one of the most effective ways to reduce climate vulnerability . While progress on poverty reduction has slowed in recent years, there’s a wealth of evidence now showing that as countries develop they also improve the adaptive capacity of people and communities. For instance, the proportion of the global population with access to safely managed drinking water increased from 62% in 2000 to 74% in 2020 – a marked improvement that reduces overall vulnerability to climate impacts. While every investment in development, access to basic infrastructure and social services cannot be counted as adaptation, it is misleading ignore the resilience gains from development progress. 

Consider, next, more resilient development . Not all development patterns deliver the same level of resilience. There are still far too many cities that continue to grow in flood-prone areas , too many infrastructure assets are not built or maintained to the right standards , and rapid development too often now leads to increased water scarcity or loss of the ecosystems that protect population against extreme events . But here too, there are promising signs of progress as countries and businesses increasingly account for climate risk in investments and business operations, and communities devise plans to build back better after disasters hit. Social protection systems are being more systematically designed to consider their role after disasters, making them better at improving people’s resilience. Countries and cities are more systematically considering risks in defining their urban plans and developing and upgrading infrastructure. In Japan, for instance, firms participate in business continuity planning to address disaster risks in collaboration with the public sector. Many private companies now have explicit investment in resilience. While some of these initiatives started from a social responsibility perspective (like General Motors’ Climate Equity Fund ), they are now increasingly originating from pure business considerations, such as the challenges of climate-impacted supply chain disruptions (such as Nestlé ) or the acknowledgment of climate impacts (for instance, Mahindra & Mahindra Krish-e initiative to build farmers’ resilience). 

Here too the incorporation of risk and resilience in everyday planning and business decisions goes beyond what is recorded or measured as adaptation finance, but delivers clear resilience gains. Every time a building or an infrastructure asset investment ensures the right standards for resilience, or a business plan accounts for climate-related disruptions, or an urbanization plan considers flood risks, or a forest or mangrove is protected from uncontrolled development, this is effectively an investment in adaptation, albeit one not captured by any dataset or adaptation finance tracker. 

Take, finally, targeted adaptation interventions . These are the investments captured by our estimates of climate finance. They are essential, but most of the time they are playing catch up, rectifying mistakes that should not have been made and certainly should not be replicated. Every time we build a new neighborhood in a known flood zone or a road with under-dimensioned drains, or when we destroy a forest or a mangrove that protects us against water scarcity or floods, we are increasing future adaptation investment needs, both draining our limited current adaptation resources and placing a lien on future resources. Retrofitting existing assets is costly and often makes sense only for the most critical assets (see for instance the analysis of priorities for investments in the Brazil Country Climate and Development Report ). It is therefore much more valuable to focus on building new assets right, especially so in low-and middle-income countries where so much infrastructure is yet to be built. 

Every time we build a new neighborhood in a known flood zone or a road with under-dimensioned drains, or when we destroy a forest or a mangrove that protects us against water scarcity or floods, we are increasing future adaptation investment needs, both draining our limited current adaptation resources and placing a lien on future resources.

All this is not to say that more adaptation finance is not needed. More resilient and better development alone will not be enough to protect the world’s population, especially the most vulnerable communities and people.   We will also need to be bracing for and gathering resources for the new challenges that climate change is rapidly creating – for instance, coastal cities that are in locations once considered safe before data on sea level rise showed that they will be exposed to increasing risks. But even with more adaptation finance, we will never be able to protect populations and economies if development investments are insufficient and people keep living in extreme poverty or if development investments continue to create new risks and vulnerabilities because they do not take future climate conditions into account. To truly build adaptation and resilience, all three are essential.

But even with more adaptation finance, we will never be able to protect populations and economies if development investments are insufficient and people keep living in extreme poverty or if development investments continue to create new risks and vulnerabilities because they do not take future climate conditions into account.

What will it take to build the resilience of countries and people across the three dimensions of more development, better development, and targeted adaptation interventions? And beyond the obvious need for more adaptation finance, how can we spend better – not just more – so that development investments deliver more resilience, improving not just the resilience of physical assets but also of communities and people ? 

While successful adaptation and resilience will require a whole-of-society and whole-of-government approach , it will be essential to have better information about climate risks and stronger regulations – especially for land use and new infrastructure. 

Businesses, firms, households, and cities already have clear incentives to adapt – entrepreneurs don’t want their businesses to wash away overnight, farmers want their lands and cattle to flourish, city officials want livable and attractive neighborhoods – but they need help and, critically, information to help them plan for and respond to changing conditions. Making more, better and timely information on climate risks available is key. Climate-informed urban and land use plans – both developing them and enforcing them – hold the key to avoid locking communities into high-risk areas. In fact, good plans can also help drive development to safer places. In Tunis, for instance, sharing where the government was planning infrastructure investment helped guide urban development to low-risk zones . Most developing countries are experiencing an unprecedent urbanization moment which means there is a unique opportunity to build cities for tomorrow’s climate, reducing future climate change impacts and adaptation financing needs. 

Most developing countries are experiencing an unprecedent urbanization moment which means there is a unique opportunity to build cities for tomorrow’s climate, reducing future climate change impacts and adaptation financing needs. 

The good news is that we are not starting from scratch. There are many initiatives to build from, especially those targeting the private sector: advances in developing adaptation and resilience typologies (such as through the work of Climate Bond Initiative ), as well as disclosure and standardization work (such as the International Sustainability Standards Board’s set of disclosure requirements), or guidance on climate-related risk analysis (such as the Gold Standard Adaptation Framework ) or the World Bank’s Resilience Rating System which is helping our teams develop more resilient projects and operations, identify such operations and monitor progress.

There’s also a wider narrative shift underway, with market innovations helping to shift the thinking of adaptation as a cost to bear to highlighting resilience solutions that are growth opportunities for investors , to practical roadmaps laying out financing opportunities, such as the Guide for Adaptation and Resilience Finance developed by Standard Chartered, KPMG and UNDRR ; or the blueprint developed by the Adaptation and Resilience Investors Collaborative . 

Adaptation finance is about more than annual dollar inflows, although obviously this remains vital in an era of worsening climate change. It’s also about making sure that all investments protect people – especially the most vulnerable – from climate impacts now and in the future. It’s about building homes, businesses, schools and hospitals that withstand these shocks and help communities survive and thrive. And it’s about time that more adaptation finance stories get told.

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NASA joined more than 20 federal agencies in releasing its updated Climate Adaptation Plan Thursday, helping expand the Biden-Harris Administration’s efforts to make federal operations increasingly resilient to the impacts of climate change for the benefit of all.

The updated plans advance the administration’s National Climate Resilience Framework , which helps align climate resilience investments across the public and private sectors through common principles and opportunities.

“Thanks to the leadership of the Biden-Harris Administration, we are strengthening climate resilience to ensure humanity is well-prepared for the effects of climate change,” said NASA Administrator Bill Nelson. “NASA’s decades of Earth observation are key to building climate resiliency and sustainability across the country and the world.”

NASA serves as a global leader in Earth science, providing researchers with crucial data from its satellites and other assets, as well as other observations and research on the climate system. The agency also works to apply that knowledge and inform the public about climate change. NASA will continue to prioritize these efforts and maintain an open information policy that makes its science data, software, and research freely available to all.

Climate variability and change also have potential impacts on NASA’s ability to fulfill its mission, requiring proactive planning and action from the agency. To ensure coastal flooding, extreme weather events, and other climate change impacts do not stop the agency’s work, NASA is improving its climate hazard analyses and developing plans to protect key resources and facilities.  

“As communities face extreme heat, natural disasters and severe weather from the impacts of climate change, President Biden is delivering record resources to build climate resilience across the country,” said Brenda Mallory, chair of the White House Council on Environmental Quality. “Through his Investing in America agenda and an all-of-government approach to tackling the climate crisis, the Biden-Harris Administration is delivering more than $50 billion to help communities increase their resilience and bolster protections for those who need it most. By updating our own adaptation strategies, the federal government is leading by example to build a more resilient future for all.”

At the beginning of his administration, President Biden tasked federal agencies with leading whole-of-government efforts to address climate change through Executive Order 14008, Tackling the Climate Crisis at Home and Abroad . Following the magnitude of challenges posed by the climate crisis underscored last year when the nation endured a record 28 individual billion-dollar extreme weather and climate disasters that caused more than $90 billion in aggregate damage, NASA continues to be a leader and partner in adaptation and resilience.

NASA released its initial Climate Adaptation Plan in 2021 and progress reports outlining advancements toward achieving their adaptation goals in 2022 . In coordination with the White House Council on Environmental Quality and the Office of Management and Budget, agencies updated their Climate Adaptation Plans for 2024 to 2027 to better integrate climate risk across their mission, operations, and asset management, including:

  • Combining historical data and projections to assess exposure of assets to climate-related hazards including extreme heat and precipitation, sea level rise, flooding, and wildfire.
  • Expanding the operational focus on managing climate risk to facilities and supply chains to include federal employees and federal lands and waters.
  • Broadening the mission focus to describe mainstreaming adaptation into agency policies, programs, planning, budget formulation, and external funding.
  • Linking climate adaptation actions with other Biden-Harris Administration priorities, including advancing environmental justice and the President’s Justice40 Initiative , strengthening engagement with Tribal Nations, supporting the America the Beautiful initiative , scaling up nature-based solutions , and addressing the causes of climate change through climate mitigation.
  • Adopting common progress indicators across agencies to assess the progress of agency climate adaptation efforts.

All plans from each of the more than 20 agencies and more information are available online.

To learn more about Earth science research at NASA, visit:

https://science.nasa.gov/earth-science//

Rob Margetta Headquarters, Washington  202-358-0918 [email protected]

Mitigating the adverse impacts of climate change on river water quality through adaptation strategies: A Case Study of the Ardak Catchment, Northeast Iran

  • Published: 21 June 2024

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case study adaptation to climate change

  • Morteza Nikakhtar 1 ,
  • Seyedeh Hoda Rahmati 1 ,
  • Ali Reza Massah Bavani 2 &
  • Iman Babaeian 3  

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This study investigates the potential impacts of future climate change on river water quality in Ardak Watershed, Northeast Iran, and proposes adaptation strategies to mitigate adverse effects. The SWAT model is calibrated and verified by Monthly water quality sampling and flow measurements. The premium SWAT-CUP model was utilized for sensitivity analysis and parameter adjustment to simulate runoff, sediment, nitrate, mineral phosphorus, and dissolved oxygen. Future catchment temperature and precipitation were projected using CMhyd statistical downscaling by incorporating four CMIP6 models under SSP scenarios for the near (2025–2049), intermediate (2050–2074), and far (2075–2099) future. The Mianmorgh River experienced increased levels of various pollutants in winter, summer, and autumn but decreased in spring for future periods. In the Abghad River, pollutant levels are expected to increase from late autumn to late winter and decrease in other months. Nitrate increased from the late summer to late winter, then decreased throughout the year. Three adaptation strategies were proposed: reducing rural swage pollutants, creating pasture on 5% of unvegetated land, and combining both. The SWAT model showed responsiveness to the mix scenario, with average reductions of 4—4.5% for suspended solids, 23—16% for inorganic phosphorus, and 16—20% for nitrate for the first strategy. The results revealed that climate change can significantly affect water quality, but its adverse effects can be mitigated with suitable actions. Combined adaptation strategies effectively reduced suspended solids and mineral phosphorus and removed pollutants. Therefore, implementing a combination of effective strategies is more beneficial than individual approaches.

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Acknowledgements

The authors extend their utmost gratitude to Prof. Karim Abbaspour for all his kind support.

The authors got no support from any organisations for their submitted work. No funding or other aid was received for this study's conduct or the manuscript's preparation.

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“Ali Reza Massah Bavani contributed to the study conception and design. Morteza Nikakhtar performed material preparation, data collection, and analysis. Seyedeh Hoda Rahmati and Iman Babaeian developed the methodology and evaluated the results. Morteza Nikakhtar wrote the first draft of the manuscript, expanded, edited, and confirmed by Ali Reza Massah Bavani. Seyedeh Hoda Rahmati, Ali Reza Massah Bavani, and Iman Babaeian commented on previous manuscript versions. The final content was read and approved by all contributing authors.”

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Nikakhtar, M., Rahmati, S.H., Massah Bavani, A.R. et al. Mitigating the adverse impacts of climate change on river water quality through adaptation strategies: A Case Study of the Ardak Catchment, Northeast Iran. Theor Appl Climatol (2024). https://doi.org/10.1007/s00704-024-05057-8

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Barriers and enablers to climate change adaptation in hierarchical governance systems: the case of vietnam, reframing adaptation: the political nature of climate change adaptation, understanding the implementation gap: policy-makers’ perceptions of ecosystem-based adaptation in central vietnam, country ownership of adaptation: stakeholder influence or government control, the institutional capacity for forest devolution: the case of forest land allocation in vietnam, reconceptualising adaptation to climate change as part of pathways of change and response, related papers.

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The kids are not alright: Countries fail to include children in their climate plans

A study of 160 countries show a third don't mention children at all..

Portrait of teenage girl holding signs during on a demonstration for environmentalism

Kathrin Zangerl is a pediatrician at the Heidelberg Institute of Global Health in Germany, where she is a specialist on how climate change affects children at different stages in their lives. For instance, an infant’s developing lungs make her more susceptible to lasting harm from air pollution. A teenager, on the other hand, might be more likely to become part of the mental health pandemic among adolescents, where climate anxiety is a factor.

In other words, children have differing needs, more vulnerability, and interventions that work for adults might not work for kids.

“Children are not tiny adults,” she said.

So when Zangerl and other researchers combed through the official national climate adaptation plans of 160 countries, they were looking for consideration of the needs and roles of children, especially when it comes to health. How many countries are taking kids into account when they think about climate change?

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In an article published earlier this month in The Lancet , Zangerl and her team revealed their findings: Not many. 

It’s not that national climate adaptation plans have the force of law, but they can guide policymakers and attract focused funding from richer countries to low and middle-income countries. International bodies, like the United Nations, its Framework Convention on Climate Change , UNFCCC , the World Health Organization, and UNICEF , are increasingly urging countries to consider the specific needs of children in their climate policies. 

The numbers were dismaying. 

Nearly a third of the plans  — 28 percent —did not mention children at all. Another third — 31 percent — mentioned children in only one area, such as education. And none mentioned children’s mental health. 

As Zangerl wrote in the article: “Children’s mental health is a crucial public health concern that requires immediate action.”

Sudan, one of the poorest countries in the world, scored the highest in the report for its number of mentions of children in its plan. But Zangerl said that’s grading on a curve. 

“No country comprehensively addressed child health needs,” she said. “A few countries were better than others, but they weren’t really good.” 

“I’m not surprised,” said Tooba Akhtar, a PhD researcher at Trinity College Dublin, who was not involved in this study. She focuses on the development and well-being of children affected by climate change.  

Akhtar and two of her colleagues, Kristin Hadfield and Alina Paula Cosma, wrote a recent open letter to the U.N. Climate Change Secretariat . They looked for evidence supporting programs that would help young children cope with the emotional toll of climate disasters, and found none. 

“Our hunch is that these programs do not actually exist,” Akhtar said. 

This is personal for Akhtar, who grew up in Pakistan. She was recently speaking to a friend working for a nonprofit there, documenting the aftermath of the devastating 2022 floods. Camps for displaced survivors have set up makeshift schools . 

“Who’s attending? Children who are already school-aged. Those under 6 are forgotten.” Akhtar said that simple programs for very young children, like shared book reading, could promote social-emotional skills and parent-child bonding, helping entire families cope with post-traumatic stress. But that’s rarely happening. “The father’s off managing the land that’s been destroyed, the mother is taking care of six other kids.”

Children’s needs, especially young children’s, are left out of climate planning, experts said, because of a lack of advocacy, a lack of funding, a lack of collaboration across government ministries, and a lack of data — conditions which all reinforce each other. 

“The child lobby is really lacking,” in international climate negotiations, Zangerl said. A 2023 report from Save the Children found only 2.4 percent of the money from big international climate funds went to projects that incorporated children’s needs. 

As a result, research into climate impacts on children isn’t well funded, and this, in turn, impacts decision-making. For example, in Europe where Zangerl lives, there’s an enormous amount of research on elderly people dying in heat waves. Far less is known about children’s morbidity, such as the way heat waves experienced in early childhood might not necessarily end a life, but could shorten a life. 

For Zangerl and Akhtar, there are two big arguments for countries to do better at planning for and meeting children’s needs in climate adaptation. 

One is that it’s practical and pragmatic. If we want a healthy, resilient adult population to cope with the worsening effects of climate change in 20 years, we need to invest in children today. And most of the world’s children —   more than 75 percent of all adolescents — happen to be located in low- and middle-income countries that are more susceptible to the impact of climate. 

Education and public health awareness are the most common way that children are being included in these national adaptation plans. This perspective tends to treat children more as a resource to be tapped for the benefit of society, than as a population with needs to be served. Children are being prepared for the green workforce. Or they’re helping disseminate health information.

“In many low- and middle-income countries, the child is the only one who receives formal education,” said Zangerl. “They then teach their wider family and community, and so the multiplier effect of teaching children is really high across the globe.” 

The other argument for including children in a country’s climate plans is different. It’s about fairness and children as a more vulnerable population. 

“Children are inheriting an over-warmed world, and they will live longer in it than previous generations,” said Akhtar, noting that children will be forced to bear the long-term consequences of decisions made before they were born. “Equipping them with the knowledge and skills to mitigate and adapt is essential to help them survive.” 

Zangerl said that when talking about children and climate policy, it’s tempting to keep focused on “risk and vulnerability and protection.” But what’s also important “is agency and empowerment” — having young people as part of the decision-making process on policies that will affect their survival. 

“We’re seeing lots of youth advisory boards and adolescents who are change agents or participating actively” in policymaking and activism, she said, noting that it’s possible to listen to even younger children if you are creative about how you do it.  For instance, she is currently working on a study with children from ages 3 to 6, where they are making art and taking photos to express how they are coping with changes to weather and nature. 

Correction: A previous version of this story misstated the number of countries with climate adaptation plans that mention children.

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The construction and application of a model for evaluating tourism climate suitability in terraced agricultural cultural heritage sites: a case study of longji terraced fields in china.

case study adaptation to climate change

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Hu, L.; Guo, X.; Yan, P.; Li, X. The Construction and Application of a Model for Evaluating Tourism Climate Suitability in Terraced Agricultural Cultural Heritage Sites: A Case Study of Longji Terraced Fields in China. Atmosphere 2024 , 15 , 756. https://doi.org/10.3390/atmos15070756

Hu L, Guo X, Yan P, Li X. The Construction and Application of a Model for Evaluating Tourism Climate Suitability in Terraced Agricultural Cultural Heritage Sites: A Case Study of Longji Terraced Fields in China. Atmosphere . 2024; 15(7):756. https://doi.org/10.3390/atmos15070756

Hu, Luyao, Xiaoyu Guo, Pengbo Yan, and Xinkai Li. 2024. "The Construction and Application of a Model for Evaluating Tourism Climate Suitability in Terraced Agricultural Cultural Heritage Sites: A Case Study of Longji Terraced Fields in China" Atmosphere 15, no. 7: 756. https://doi.org/10.3390/atmos15070756

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