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Tag: Indigenous knowledge

  • Climate change and health: what the Lancet Countdown says about the value and significance of local knowledge and action

    Climate change and health: what the Lancet Countdown says about the value and significance of local knowledge and action

    Here is everything that the new Lancet Countdown says about the value and significance of indigenous and other forms of local knowledge, as well as their value for community-led action to respond to the impacts of climate change on health.

    Why does this matter? Read our article: How the Lancet Countdown illuminates a new path to climate-resilient health systems

    On the value of community-led action and the significance of local knowledge

    Defining community-led action by its local context and empowerment

    “Community-led actions are those spearheaded by self-organised individuals within a community, working together for a common goal. Rooted in local societal, cultural, and economic contexts, they can promote equity, empower local actors, and strengthen climate resilience.”

    Community-led action as a driver of meaningful progress

    “Individual, community-led, and civil society actions can drive meaningful progress with substantial health benefits.”

    Grassroots activities growing into formal organizations

    “These grassroots activities can grow into formal organisations with national or international influence.”

    The dependence of community-led initiatives on local actors

    “Despite their capacity to enact change, community-led initiatives depend on the willingness and possibilities of local actors.”

    The advantages of community-led actions over top-down interventions

    “Tailored to local needs, community-led actions are more likely than top-down interventions to maximise health benefits, bypass the limitations of implementing top-down solutions, and can help avoid unintended harms such as gentrification or increased inequalities.”

    The co-benefits of community-led action on mental health and awareness

    “Community-led actions can also foster agency, increase attachment to the local environment, and promote social interactions, all of which help reduce the mental health impacts of climate change and increase awareness.”

    Recommendation for individuals and civil society: Engage in community-led action

    “Engaging in community-led action on health and climate change, supporting equitable inclusion of marginalised communities.”

    Recommendation for individuals and civil society: Create community platforms for collective resilience

    “Creating community platforms on climate change and health, including citizen groups, to safely exchange ideas and concerns, build collective resilience and adaptive capacity, and enable engagement with decision makers.”

    Value of local knowledge: We need more examples of community-led action

    Example of local community and indigenous peoples’ forest management

    “In Nepal, community forests user groups have grown into a state-sponsored and legally mandated initiative, under which local communities, including Indigenous Peoples, manage 37-7% of national forests—augmenting carbon sinks, enhancing food access, and improving livelihoods.”

    Example of farmer-led interventions improving health outcomes

    “Across the Sahel, farmers have implemented Farmer Managed Natural Regeneration… These farmer-led interventions resulted in increased tree coverage, crop yields, drought resistance, and access to traditional medicines, contributing to improved health outcome and poverty reduction.”

    Environmental defenders need protection

    The disproportionate killing of indigenous and minoritized environmental defenders

    “A Global Witness report found that 196 activists were killed in 2023 (57% in Latin America), with minoritised and Indigenous groups disproportionately affected.”

    Protecting environmental defenders to enable community-led interventions

    “Protecting environmental defenders in line with international conventions is critical to enabling community-led interventions, and providing a fertile ground for grassroots initiatives to deliver life-saving progress on health and climate change.”

    On the need for community-led action amid waning political engagement

    The role of health framing in driving community-led action

    “This [health framings of climate change] can be a crucial driver for individual-led and community-led action, especially amid waning engagement from political leaders.”

    Community and individual action as essential when national engagement wanes

    “When national government engagement wanes (indicator 5.4.1), action by subnational governments, corporations, civil society organisations, communities, and individuals can contribute to keeping the planet within inhabitable limits.”

    Recommendation for funders on the significance of local knowledge:

    Recommendation for funders: Support community initiatives to scale action

    “…supporting governmental bodies, civil society organisations, and community initiatives to scale-up health-promoting and inclusive climate change action.”

    On the value of indigenous knowledge

    Respecting indigenous knowledge in global health action

    “To support global health, these actions need to be delivered in ways that are gender-responsive, reduce health inequities, respect and promote the rights and knowledge of Indigenous People, and account for the protection of vulnerable and underserved communities.”

    Recommendation for national governments: Integrate community and indigenous perspectives in policy design

    “Including community perspectives in the design of climate and health policies, with particular focus on the most vulnerable communities and Indigenous people.”

    Recommendation for city governments: Prioritize indigenous knowledge and community-led initiatives

    “Reducing inequities and avoiding unintended harms by integrating community perspectives in all climate change actions and supporting community-led initiatives, with particular focus on vulnerable communities and the priorities and knowledge of Indigenous people.”

    On the need to refocus the apparatus of science on the most vulnerable people and communities

    Scientific evidence generation is concentrated in high-HDI countries, not where impacts are highest

    “Scientific evidence generation is still concentrated in higher HDI countries rather than those most exposed to the health impacts of climate change.”

    Data gaps obscuring the impacts on indigenous people

    “This lack of disaggregated data makes it difficult to capture the disproportionate impacts of climate change on Indigenous people, such as those living in the circumpolar region, which is heating nearly four times faster than the global average.”

    Conflict analysis must be shaped by local dynamics

    “This relationship [between climate change and conflict] is now widely recognised as a complex, multicausal phenomenon shaped by local social and cultural dynamics, economic fluctuations, and geopolitical forces at both the domestic and international levels.”

    On ensuring the relevance of science to support local action

    Harnessing local knowledge for regional stakeholders

    “…harnessing local knowledge and translating findings to meet the needs of local stakeholders.”

    Advancing the local generation of evidence

    “…to advance the local generation of evidence to inform action in one of the world’s most vulnerable regions.”

    Informing action at the local level

    “…make their findings available to inform action at the national and local levels.”

    References

    1. Romanello, M., et al., 2025. The 2025 report of the Lancet Countdown on health and climate change. The Lancet S0140673625019191. https://doi.org/10.1016/S0140-6736(25)01919-1
    2. Sadki, R., 2024. Critical evidence gaps in the Lancet Countdown on health and climate change. https://doi.org/10.59350/nv6f2-svp12

    Image: The Geneva Learning Foundation Collection © 2025

  • 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