Opportunities and challenges for financing women's, children's and adolescents' health in the context of climate change.

Women, children and adolescents (WCA), especially in low-income and middle-income countries (LMICs), will bear the worst consequences of climate change during their lifetimes, despite contributing the least to global greenhouse gas emissions. Investing in WCA can address these inequities in climate risk, as well as generating large health, economic, social and environmental gains. However, women's, children's and adolescents' health (WCAH) is currently not mainstreamed in climate policies and financing. There is also a need to consider new and innovative financing arrangements that support WCAH alongside climate goals.We provide an overview of the threats climate change represents for WCA, including the most vulnerable communities, and where health and climate investments should focus. We draw on evidence to explore the opportunities and challenges for health financing, climate finance and co-financing schemes to enhance equity and protect WCAH while supporting climate goals.WCA face threats from the rising burden of ill-health and healthcare demand, coupled with constraints to healthcare provision, impacting access to essential WCAH services and rising out-of-pocket payments for healthcare. Climate change also impacts on the economic context and livelihoods of WCA, increasing the risk of displacement and migration. These impacts require additional resources to support WCAH service delivery, to ensure continuity of care and protect households from the costs of care and enhance resilience. We identify a range of financing solutions, including leveraging climate finance for WCAH, adaptive social protection for health and adaptations to purchasing to promote climate action and support WCAH care needs.

Climate finance opportunities for health and health systems.

Climate change poses significant risks to health and health systems, with the greatest impacts in low- and middle-income countries - which are least responsible for greenhouse gas emissions. The Conference of Parties 28 at the 2023 United Nations Climate Change Conference led to agreement on the need for holistic and equitable financing approaches to address the climate and health crisis. This paper provides an overview of existing climate finance mechanisms - that is, multilateral funds, voluntary market-based mechanisms, taxes, microlevies and adaptive social protection. We discuss these approaches' potential use to promote health, generate additional health sector resources and enhance health system sustainability and resilience, and also explore implementation challenges. We suggest that public health practitioners, policy-makers and researchers seize the opportunity to leverage climate funding for better health and sustainable, climate-resilient health systems. Emphasizing the wider benefits of investing in health for the economy can help prioritize health within climate finance initiatives. Meaningful progress will require the global community acknowledging the underlying political economy challenges that have so far limited the potential of climate finance to address health goals. To address these challenges, we need to restructure financing institutions to empower communities at the frontline of the climate and health crisis and ensure their needs are met. Efforts from global and national level stakeholders should focus on mobilizing a wide range of funding sources, prioritizing co-design and accessibility of financing arrangements. These stakeholders should also invest in rigorous monitoring and evaluation of initiatives to ensure relevant health and well-being outcomes are addressed.

Le changement climatique fait peser des risques considérables sur la santé et les systèmes de santé, affectant principalement les pays à revenu faible et intermédiaire ­ alors qu'ils contribuent le moins aux émissions de gaz à effet de serre. Lors de la Conférence des Nations Unies sur le changement climatique de 2023, la 28e Conférence des Parties a abouti à un accord sur la nécessité d'adopter des approches de financement équitables et holistiques pour résoudre la crise climatique et sanitaire. Le présent document offre un aperçu des dispositifs de financement climatique existants ­ à savoir des fonds multilatéraux, des mécanismes de marché volontaires, des micro-taxes et une protection sociale adaptative. Nous évoquons la possibilité de recourir à ces approches en vue de promouvoir la santé, de générer des ressources supplémentaires pour le secteur de la santé et de renforcer la viabilité et la résilience des systèmes de santé; nous nous intéressons également aux défis que représente leur mise en œuvre. Nous suggérons que les professionnels de la santé publique, les responsables politiques et les chercheurs profitent de cette occasion pour obtenir des fonds climatiques afin d'améliorer la santé et de développer des systèmes de santé durables et adaptés au changement climatique. Souligner tout l'intérêt, pour l'économie, d'investir dans la santé peut aider à inscrire la santé en priorité dans les initiatives de financement climatique. Réaliser des progrès significatifs implique que la communauté internationale prenne conscience des enjeux sous-jacents en matière d'économie politique, enjeux qui ont jusqu'à présent limité le potentiel du financement climatique dans l'atteinte des objectifs de santé. Pour y remédier, nous devons restructurer les institutions financières afin d'accroître l'autonomie des communautés en première ligne face à la crise climatique et sanitaire, et de faire en sorte que leurs besoins soient satisfaits. Les efforts des parties prenantes à l'échelle nationale et mondiale doivent porter sur la mobilisation d'un large éventail de sources de financement, en mettant l'accent sur la conception conjointe et l'accessibilité des modalités financières. Ces parties prenantes doivent en outre investir dans un suivi étroit et une évaluation rigoureuse des initiatives pour veiller à obtenir des résultats pertinents en termes de santé et de bien-être.

El cambio climático plantea riesgos importantes para la salud y los sistemas sanitarios, con mayores impactos en los países de ingresos bajos y medios, que son los menos responsables de las emisiones de gases de efecto invernadero. La 28.ª Conferencia de las Partes en la Conferencia de las Naciones Unidas sobre el Cambio Climático de 2023 condujo a un acuerdo sobre la necesidad de enfoques de financiación holísticos y equitativos para abordar la crisis climática y sanitaria. Este documento ofrece una visión general de los mecanismos de financiación climática existentes, es decir, los fondos multilaterales, los mecanismos voluntarios basados en el mercado, los impuestos, los microimpuestos y la protección social adaptable. Analizamos el uso potencial de estos enfoques para promover la salud, generar recursos adicionales para el sector sanitario y mejorar la sostenibilidad y la resiliencia de los sistemas sanitarios. Sugerimos que los profesionales de la salud pública, los responsables de formular las políticas y los investigadores aprovechen la oportunidad de utilizar la financiación climática para mejorar la salud y los sistemas sanitarios sostenibles y resilientes al cambio climático. Destacar los beneficios más amplios de invertir en salud para la economía puede ayudar a priorizar la salud dentro de las iniciativas de financiación climática. Para lograr avances significativos será necesario que la comunidad mundial reconozca los problemas de economía política subyacentes que hasta ahora han limitado el potencial de la financiación para abordar los objetivos de salud. Para superar estos desafíos, necesitamos reestructurar las instituciones financieras para empoderar a las comunidades que se encuentran en primera línea de la crisis climática y sanitaria y asegurar que se satisfacen sus necesidades. Los esfuerzos de las partes interesadas a nivel mundial y nacional deben centrarse en movilizar una gran variedad de fuentes de financiación y priorizar el diseño conjunto y la accesibilidad de los acuerdos de financiación. Estas partes interesadas también deben invertir en la supervisión y evaluación rigurosas de las iniciativas para garantizar que se abordan los resultados pertinentes en materia de salud y bienestar.

Unequal climate impacts on global values of natural capital.

Ecosystems generate a wide range of benefits for humans, including some market goods as well as other benefits that are not directly reflected in market activity1. Climate change will alter the distribution of ecosystems around the world and change the flow of these benefits2,3. However, the specific implications of ecosystem changes for human welfare remain unclear, as they depend on the nature of these changes, the value of the affected benefits and the extent to which communities rely on natural systems for their well-being4. Here we estimate country-level changes in economic production and the value of non-market ecosystem benefits resulting from climate-change-induced shifts in terrestrial vegetation cover, as projected by dynamic global vegetation models (DGVMs) driven by general circulation climate models. Our results show that the annual population-weighted mean global flow of non-market ecosystem benefits valued in the wealth accounts of the World Bank will be reduced by 9.2% in 2100 under the Shared Socioeconomic Pathway SSP2-6.0 with respect to the baseline no climate change scenario and that the global population-weighted average change in gross domestic product (GDP) by 2100 is -1.3% of the baseline GDP. Because lower-income countries are more reliant on natural capital, these GDP effects are regressive. Approximately 90% of these damages are borne by the poorest 50% of countries and regions, whereas the wealthiest 10% experience only 2% of these losses.

Socio-economic predictors of Inuit hunting choices and their implications for climate change adaptation.

In the Arctic, seasonal variation in the accessibility of the land, sea ice and open waters influences which resources can be harvested safely and efficiently. Climate stressors are also increasingly affecting access to subsistence resources. Within Inuit communities, people differ in their involvement with subsistence activities, but little is known about how engagement in the cash economy (time and money available) and other socio-economic factors shape the food production choices of Inuit harvesters, and their ability to adapt to rapid ecological change. We analyse 281 foraging trips involving 23 Inuit harvesters from Kangiqsujuaq, Nunavik, Canada using a Bayesian approach modelling both patch choice and within-patch success. Gender and income predict Inuit harvest strategies: while men, especially men from low-income households, often visit patches with a relatively low success probability, women and high-income hunters generally have a higher propensity to choose low-risk patches. Inland hunting, marine hunting and fishing differ in the required equipment and effort, and hunters may have to shift their subsistence activities if certain patches become less profitable or less safe owing to high costs of transportation or climate change (e.g. navigate larger areas inland instead of targeting seals on the sea ice). Our finding that household income predicts patch choice suggests that the capacity to maintain access to country foods depends on engagement with the cash economy. This article is part of the theme issue 'Climate change adaptation needs a science of culture'.

The missing risks of climate change.

The risks of climate change are enormous, threatening the lives and livelihoods of millions to billions of people. The economic consequences of many of the complex risks associated with climate change cannot, however, currently be quantified. Here we argue that these unquantified, poorly understood and often deeply uncertain risks can and should be included in economic evaluations and decision-making processes. We present an overview of these unquantified risks and an ontology of them founded on the reasons behind their lack of robust evaluation. These consist of risks missing owing to delays in sharing knowledge and expertise across disciplines, spatial and temporal variations of climate impacts, feedbacks and interactions between risks, deep uncertainty in our knowledge, and currently unidentified risks. We highlight collaboration needs within and between the natural and social science communities to address these gaps. We also provide an approach for integrating assessments or speculations of these risks in a way that accounts for interdependencies, avoids double counting and makes assumptions clear. Multiple paths exist for engaging with these missing risks, with both model-based quantification and non-model-based qualitative assessments playing crucial roles. A wide range of climate impacts are understudied or challenging to quantify, and are missing from current evaluations of the climate risks to lives and livelihoods. Strong interdisciplinary collaboration and deeper engagement with uncertainty is needed to properly inform policymakers and the public about climate risks.

Chickpeas from a Chilean Region Affected by a Climate-Related Catastrophe: Effects of Water Stress on Grain Yield and Flavonoid Composition.

The Valparaiso region in Chile was decreed a zone affected by catastrophe in 2019 as a consequence of one of the driest seasons of the last 50 years. In this study, three varieties ('Alfa-INIA', 'California-INIA', and one landrace, 'Local Navidad') of kabuli-type chickpea seeds produced in 2018 (control) and 2019 (climate-related catastrophe, hereafter named water stress) were evaluated for their grain yield. Furthermore, the flavonoid profile of both free and esterified phenolic extracts was determined using liquid chromatography-mass spectrometry, and the concentration of the main flavonoid, biochanin A, was determined using liquid chromatography with diode array detection. The grain yield was decreased by up to 25 times in 2019. The concentration of biochanin A was up to 3.2 times higher in samples from the second season (water stress). This study demonstrates that water stress induces biosynthesis of biochanin A. However, positive changes in the biochanin A concentration are overshadowed by negative changes in the grain yield. Therefore, water stress, which may be worsened by climate change in the upcoming years, may jeopardize both the production of chickpeas and the supply of biochanin A, a bioactive compound that can be used to produce dietary supplements and/or nutraceuticals.

Carbon emissions reductions from Indonesia's moratorium on forest concessions are cost-effective yet contribute little to Paris pledges.

International initiatives for reducing carbon emissions from deforestation and forest degradation (REDD+) could make critical, cost-effective contributions to tropical countries' nationally determined contributions (NDCs). Norway, a key donor of such initiatives, had a REDD+ partnership with Indonesia, offering results-based payments in exchange for emissions reductions calculated against a historical baseline. Central to this partnership was an area-based moratorium on new oil palm, timber, and logging concessions in primary and peatland forests. We evaluate the effectiveness of the moratorium between 2011 and 2018 by applying a matched triple difference strategy to a unique panel dataset. Treated dryland forest inside moratorium areas retained, at most, an average of 0.65% higher forest cover compared to untreated dryland forest outside the moratorium. By contrast, carbon-rich peatland forest was unaffected by the moratorium. Cumulative avoided dryland deforestation from 2011 until 2018 translates into 67.8 million to 86.9 million tons of emissions reductions, implying an effective carbon price below Norway's US$5 per ton price. Based on Norway's price, our estimated cumulative emissions reductions are equivalent to a payment of US$339 million to US$434.5 million. Annually, our estimates suggest a 3 to 4% contribution to Indonesia's NDC commitment of a 29% emissions reduction by 2030. Despite the Indonesia-Norway partnership ending in 2021, reducing emissions from deforestation remains critical for meeting this commitment. Future area-based REDD+ initiatives could build on the moratorium's outcomes by reforming its incentives and institutional arrangements, particularly in peatland forest areas.

Health benefits of decreases in on-road transportation emissions in the United States from 2008 to 2017.

Decades of air pollution regulation have yielded enormous benefits in the United States, but vehicle emissions remain a climate and public health issue. Studies have quantified the vehicle-related fine particulate matter (PM2.5)-attributable mortality but lack the combination of proper counterfactual scenarios, latest epidemiological evidence, and detailed spatial resolution; all needed to assess the benefits of recent emission reductions. We use this combination to assess PM2.5-attributable health benefits and also assess the climate benefits of on-road emission reductions between 2008 and 2017. We estimate total benefits of $270 (190 to 480) billion in 2017. Vehicle-related PM2.5-attributable deaths decreased from 27,700 in 2008 to 19,800 in 2017; however, had per-mile emission factors remained at 2008 levels, 48,200 deaths would have occurred in 2017. The 74% increase from 27,700 to 48,200 PM2.5-attributable deaths with the same emission factors is due to lower baseline PM2.5 concentrations (+26%), more vehicle miles and fleet composition changes (+22%), higher baseline mortality (+13%), and interactions among these (+12%). Climate benefits were small (3 to 19% of the total). The percent reductions in emissions and PM2.5-attributable deaths were similar despite an opportunity to achieve disproportionately large health benefits by reducing high-impact emissions of passenger light-duty vehicles in urban areas. Increasingly large vehicles and an aging population, increasing mortality, suggest large health benefits in urban areas require more stringent policies. Local policies can be effective because high-impact primary PM2.5 and NH3 emissions disperse little outside metropolitan areas. Complementary national-level policies for NOx are merited because of its substantial impacts-with little spatial variability-and dispersion across states and metropolitan areas.