Stories

Tag: COP29

  • Health at COP29: Workforce crisis meets climate crisis

    Health at COP29: Workforce crisis meets climate crisis

    Health workers are already being transformed by climate change. COP29 stakeholders can either support this transformation to strengthen health systems, or risk watching the health workforce collapse under mounting pressures.

    The World Health Organization’s “COP29 Special Report on Climate Change and Health: Health is the Argument for Climate Action“ highlights the health sector’s role in climate action.

    Health professionals are eyewitnesses and first responders to climate impacts on people and communities firsthand – from escalating respiratory diseases to spreading infections and increasing humanitarian disasters.

    The report positions health workers as “trusted members of society” who are “uniquely positioned” to champion climate action.

    The context is stark: WHO projects a global shortage of 10 million health workers by 2030, with six million in climate-vulnerable sub-Saharan Africa. Meanwhile, our communities and healthcare systems already bear the costs of climate change through increasing disease burdens and system strain.

    Health workers are responding, because they have to. Their daily engagement with climate-affected communities offers insights that can strengthen both health systems and climate response – if we learn to listen.

    A “fit-for-purpose” workforce requires rethinking learning and leadership

    WHO’s report acknowledges that “scale-up and increased investments are necessary to build a well-distributed, fit-for-purpose workforce that can meet accelerating needs, especially in already vulnerable settings.” The report emphasizes that “governments and partners must prioritize access to decent jobs, resources, and support to deliver high-quality, climate-resilient health services.” This includes ensuring “essential protective equipment, supplies, fair compensation, and safe working conditions such as adequate personnel numbers, skills mix, and supervisory capacity.”

    Resources, skills, and supervision are building blocks of every health system.

    They are necessary but likely to be insufficient.

    Such investments could be maximized through cost-effective, scalable peer learning networks that enable rapid knowledge sharing and solution development – as well as their locally-led implementation.

    The WHO report calls for “community-led initiatives that harness local knowledge and practices.”

    Our analyses – formed by listening to and learning from thousands of health professionals participating in the Teach to Reach peer learning platform – suggest that the expertise developed by health professionals through daily engagement with communities facing climate impacts is key to problem-solving, to implementing local solutions, and to ensure that communities are part and parcel of such solutions.

    Why move beyond seeing health workers as implementers of policies or recipients of training?

    We stand to gain much more if their leadership is recognized, nurtured, and supported.

    This is a notion of leadership that diverges from convention: if health workers have leadership potential, it is because they are uniquely positioned to turn what they know – because they are there every day – into action.

    Peer learning has the potential to significantly accelerate progress toward country and global goals for climate change and health.

    By making connections, a health professional expands the horizon of what they are able to know.

    At the Geneva Learning Foundation, we have seen that such leadership emerges when health workers are empowered to:

    • share and validate their experiential knowledge;
    • develop, test, and implement solutions with the communities they serve, using local resources;
    • connect with peers facing similar challenges; and
    • inform policy based on ground-level realities.

    Working with a global community of community-based health workers, we co-developed the Teach to Reach platform, community, and network to listen and learn at scale. Unlike traditional training programs, Teach to Reach creates a peer learning ecosystem where:

    • Health workers from over 70 countries connect directly to share experiences.
    • Solutions are crowdsourced from those closest to the challenges.
    • Knowledge flows horizontally rather than just vertically.
    • Local innovations are rapidly shared and adapted across contexts.

    For example, in June 2024, over 21,000 health professionals participated in Teach to Reach 10, generating hundreds of real-world stories and insights about climate change impacts on health.

    The platform has proven particularly valuable in fragile contexts and resource-limited settings, where traditional capacity building approaches often struggle to reach or engage health workers effectively.

    This approach does not replace formal institutions or traditional scientific methods – instead, it creates new pathways for knowledge to flow rapidly between communities, while building the collective capacity needed to respond to accelerating climate impacts on health.

    Already, this demonstrates the untapped potential for health workers to contribute to our collective understanding and response.

    But we do not stop there.

    As we count down to Teach to Reach 11, participants are now sharing how they have actually used and applied this peer knowledge to make progress against their local challenges.

    They cannot do it alone.

    This is why we ask global partners to join and contribute to this emergent, locally-led leadership for change.

    How different is this ‘ask’ from that of global partners asking health workers to contribute to the climate change and health agenda?

    WHO’s COP29 report makes a powerful case that “community-led initiatives that harness local knowledge and practices in both climate action and health strategies are fundamental for creating interventions that are both culturally appropriate and effective.”

    Furthermore, it recognizes that “these initiatives ensure that climate and health solutions are tailored to the specific needs and realities of those most impacted by climate change but also grounded in their lived realities.”

    What framework for collaboration?

    The path forward requires what the report describes as “cooperation across sectors, stakeholders and rights-holders – governmental institutions, local authorities, local leaders including religious authorities and traditional medicine practitioners, NGOs, businesses, the health community, Indigenous Peoples as well as local communities.”

    Our experience with Teach to Reach demonstrates how such cooperation can be facilitated at scale through digital platforms that enable peer learning and knowledge sharing. Key elements include:

    • a structured yet flexible framework for sharing experiences and insights;
    • direct connections between health workers at all levels of the system;
    • rapid feedback loops between local implementation and broader learning;
    • support for health workers to document and share their innovations; and
    • mechanisms to validate and spread effective local solutions.

    WHO’s recognition that health workers have “a moral, professional and public responsibility to protect and promote health, which includes advocating for climate action, leveraging prevention for climate mitigation and cost savings, and safeguarding healthy environments” sets a clear mandate.

    This WHO report highlights the need for new ways of supporting community-led learning and action to:

    1. support the rapid sharing of local solutions;
    2. build health worker capacity through peer learning;
    3. connect communities facing similar challenges; and
    4. enable health workers to lead change in their communities

    Reference

    Neira, M. et al. (2024) COP 29 Special Report on Climate Change and Health: Health is the Argument for Climate Action. Geneva, Switzerland: World Health Organization.

    Image: The Geneva Learning Foundation Collection © 2024

  • Critical evidence gaps in the Lancet Countdown on health and climate change

    Critical evidence gaps in the Lancet Countdown on health and climate change

    The 2024 report of the Lancet Countdown on health and climate change “reveals the health threats of climate change have reached record-breaking levels” and provides “the most up-to-date assessment of the links between health and climate change”.

    Yet its treatment of experiential knowledge – particularly the direct observations and understanding developed by frontline health workers and communities – reveals both progress and persistent gaps in how major global health assessments value different forms of knowing.

    The fundamental tension appears right at the start.

    The report notes a significant challenge: “A global scarcity of internationally standardised data hinders the capacity to optimally monitor the observed health impacts of climate change and evaluate the health-protective effect of implemented interventions.”

    This framing privileges standardized, quantifiable data over other forms of knowledge.

    Yet paradoxically, the report recognizes that “health workers are already intimate witnesses to the impacts of climate change on the health of the communities they serve, possessing valuable knowledge that should inform both science and policy.”

    This recognition of frontline experience as a valid source of knowledge is significant, even if not fully integrated into the report’s methodology.

    Health workers’ experiences are not merely anecdotal but represent a crucial form of evidence gathering and early warning that conventional research methods cannot match.

    When a nurse in Bangladesh notices changing patterns of heat-related illness in specific neighborhoods, or when a community health worker in Kenya observes shifts in disease transmission seasons, they are detecting signals that might take epidemiological studies decades to formally document.

    Can we afford to wait?

    As the report acknowledges that we face “record-breaking threats to their wellbeing, health, and survival from the rapidly changing climate,” why wait for traditional longitudinal studies to validate what health workers are already seeing?

    Explore the value of health workers’ experiential knowledge: Jones, I., Mbuh, C., Sadki, R., Eller, K., Rhoda, D., 2023. On the frontline of climate change and health: A health worker eyewitness report. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.10204660

    Their observations, if their significance and value were fully recognized, could provide vital early insights into emerging health threats and guide rapid, life-saving adaptations.

    This is especially critical given the report’s call to alarm that climate change impacts are “increasingly claiming lives and livelihoods worldwide” and that “delays in climate change mitigation and adaptation have intensified these impacts.”

    The humanitarian imperative to act quickly makes health workers’ experiential knowledge not just valuable but essential – they are the canaries in the coal mine of our climate crisis, and their insights could help bridge critical evidence gaps while more traditional research catches up.

    The report’s most thoughtful engagement with alternative forms of knowledge comes in its treatment of Indigenous knowledge systems.

    A panel titled “Indigenous knowledge for a healthy future” explicitly acknowledges that “Indigenous peoples maintain deep connections with the natural environment that are important for the social, livelihood, cultural, and spiritual practices that underpin their health and wellbeing.”

    More importantly, it recognizes that “Indigenous knowledge has been shown to be the key to protect Indigenous health in times of health emergencies when official health systems and governments are unable to provide assistance to Indigenous communities.”

    However, the report also acknowledges that “Indigenous medicine and worldviews are rarely considered within health care or health risk preparedness and response.”

    This gap between recognizing the value of Indigenous knowledge and actually incorporating it into health systems and policies reflects a broader challenge.

    A crucial observation comes in the report’s data discussion: available data are “rarely disaggregated by relevant groups (eg, gender, age, indigeneity, ethnicity, and socioeconomic level)” and “Indigenous knowledge is often overlooked, and Indigenous populations are seldom taken into consideration in the production and reporting of evidence and data.”

    This gap in representation means that crucial experiential knowledge is systematically excluded from our understanding of climate change’s health impacts.

    Perhaps most tellingly, while the report calls for “improved data” to evaluate progress on international commitments, it focuses primarily on standardized quantitative metrics rather than developing new frameworks that could better integrate experiential knowledge.

    This reveals an underlying epistemological bias – while experiential knowledge is acknowledged as valuable, the report’s methodology remains firmly grounded in traditional scientific approaches.

    Looking forward, truly leveraging experiential knowledge in understanding climate change’s health impacts will require more than just acknowledgment.

    It will require developing new methodological frameworks that can systematically incorporate and validate different forms of knowing, while ensuring that frontline voices – whether from health workers, Indigenous communities, or other groups with direct experience – are centered rather than marginalized in our understanding of this global crisis.

    For the Lancet Countdown to fully live up to its mission of tracking progress on health and climate change, future reports will need to more fundamentally rethink how they recognize, validate, and incorporate experiential knowledge.

    The seeds of this transformation are present in the 2024 report.

    Doing so is both necessary to improve science and consistent with The Lancet Countdown’s commitment to “operate an open and iterative process of indicator improvement, welcoming proposals for new indicators… from the world’s most vulnerable countries”.

    References

    1. Romanello, M., et al., 2024. The 2024 report of the Lancet Countdown on health and climate change: facing record-breaking threats from delayed action. The Lancet 404, 1847–1896. https://doi.org/10.1016/S0140-6736(24)01822-1
    2. Jones, I., Mbuh, C., Sadki, R., Eller, K., Rhoda, D., 2023. On the frontline of climate change and health: A health worker eyewitness report. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.10204660
    3. Jones, I., Mbuh, C., Sadki, R., Steed, I., 2024. Climate change and health: Health workers on climate, community, and the urgent need for action. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.11194918
    4. Sadki, R., 2025. WHO Global Conference on Climate and Health: New pathways to overcome structural barriers blocking effective climate and health action. https://doi.org/10.59350/redasadki.21322
    5. Sadki, R., 2025. Climate change and health: a new peer learning programme by and for health workers from the most climate-vulnerable countries. https://doi.org/10.59350/redasadki.21339
    6. Sadki, R., 2024. Knowing-in-action: Bridging the theory-practice divide in global health. https://doi.org/10.59350/4evj5-vm802
    7. Sadki, R., 2024. Strengthening primary health care in a changing climate. https://doi.org/10.59350/5s2zf-s6879
    8. Sadki, R., 2024. World Health Summit: to rebuild trust in global health, invest in health workers as community leaders. https://doi.org/10.59350/343na-80712
    9. Sadki, R., 2024. The cost of inaction: Quantifying the impact of climate change on health. https://doi.org/10.59350/gn95w-jpt34
    10. Sanchez, J.J. et al. (2025) ‘The climate crisis and human health: identifying grand challenges through participatory research’, The Lancet Global Health, p. S2214109X25000038. Available at: https://doi.org/10.1016/S2214-109X(25)00003-8.

    Image: The Geneva Learning Foundation Collection © 2024