Connecting the Dots Between Climate Change, Health, and Equity: A Workshop in Kathmandu, Nepal

Background Information

Climate change is a public health and equity crisis. Millions of people die globally every year because of health issues linked to climate change. While climate change negatively impacts health worldwide, its effects are particularly acute in South and Southeast Asia. Some key impacts of climate change on health in South and Southeast Asia include increased rates of waterborne and vector-borne diseases, heatstroke and respiratory illnesses, increased risk of malnutrition (particularly among children), and worsening air pollution (Association of Academies and Societies of Sciences in Asia, 2021).

The region’s complex topography, including high mountains, plains, long coastlines, and low-lying islands, increases its vulnerability to extreme weather events. Furthermore, it is important to recognize that the health impacts of climate change in this region are compounded not only by environmental factors but also by pre-existing structural inequalities. Caste, ethnicity, class, gender, age, physical ability, and other social determinants of health intersect to increase the vulnerability of certain populations. The combined effect of increasing natural hazards, changes in biophysical conditions, and these pre-existing socioeconomic and gender-based inequalities accelerates the impacts of climate change on health in South and Southeast Asia. For example, women, the poor, and socially marginalized groups often have less access to health care and are more dependent on climate-sensitive livelihoods, making them disproportionately vulnerable to climate-related health risks.

In this context, the United States National Academy of Medicine (NAM), the Partnership for Sustainable Development Nepal, the Nepal Health Research Council, the Nepal National Academy of Science and Technology, Nepal, SickKids Centre for Global Child Health, the Institute for Global Health & Development at The Aga Khan University, and The Inter-Academy Partnership organized a hybrid workshop, Connecting the Dots Between Climate Change and Health in Kathmandu, Nepal between March 14–15, 2024. This was the first meeting of a larger effort to build a research and innovation hub on climate change and health in South and Southeast Asia.

The workshop brought together high-level delegates, including global leaders, policy makers, scientists, and community implementers, to identify immediate and long-term priorities for the region, focusing on a climate-related health agenda. The objectives of the workshop were to (1) identify urgent needs, challenges, barriers, and opportunities to address the health impact of climate change in the South and Southeast Asia region; (2) highlight and share best practices and policies on addressing the adverse impacts of climate change on health, gender disparities, and equity; and (3) identify opportunities and strategies for regional partnerships to address climate-related health issues.

Meeting Summary

Day 1

Mr. Bhusan Dahal, Nepal journalist, Prof. Dr. Dilip Subba, Nepal National Academy of Science and Technology (NAST), and Dr. Rabindra Prasad Dhakal, NAST, welcomed attendees and described the workshop objectives. The opening session continued with remarks from Hon. Deputy-Prime Minister of Nepal and Minister of Health, Mr. Upendra Yadav, and Hon. Minister of Energy, Water and Irrigation, Mr. Shakti Bahadur Basnet, who emphasized Nepal’s unwavering commitment to climate resilience, focusing on renewable energy sources, sustainable practices, and access to clean energy as a fundamental right, while also stressing the need for action on the climate crisis to secure a brighter future. Dr. Ourania Kosti, Inter-Academy Partnership, Ms. Izabella Koziell, International Centre for Integrated Mountain Development, Dr. Zulfiqar Bhutta, Aga Khan University, Ms. Clare Langley-Hawthorne, Climate Health Foundation, and Dr. Victor J. Dzau, NAM, then shared their perspectives on climate change, health, and equity. They discussed the disastrous impacts of climate change on health, underscored the urgency of tackling the climate and health crisis, and lauded this workshop as an important steppingstone for enhanced collaboration in the South Asian region, between nations, academics, policy makers, and implementers.

Right Honorable Prime Minister Pushpa Kamal Dahal ‘Prachanda’ provided special remarks, emphasizing the critical need for regional partnerships to combat climate change. Prime Minister Dahal highlighted Nepal’s commitment to achieving net zero greenhouse gas emissions by 2025, five years ahead of global targets. He stressed the importance of supporting vulnerable populations—such as the poor, indigenous communities, and youth—who are disproportionately affected by climate change. He also pointed to the downstream impacts of glacial melting and stressed the essential role of the Green Climate Fund in facilitating both adaptation and mitigation efforts. Additionally, Prime Minister Dahal called for greater investment in research, innovation, and indigenous knowledge to inform health care initiatives related to climate impacts. His message centered on hope, collaboration, and a unified vision to address the climate-health crisis. A special vote of thanks was given by Executive Chief of Nepal Health Research Council, Dr. Pramod Joshi, and the inaugural session came to an end.

Theme 1 Session: Interconnected Realities: The Political Economy of Climate and Health

Dr. Popular Gentle, Office of Prime Minister and Council of Ministers, Nepal, Dr. Suresh Tiwari, Oxford Policy Management, Prof. Dr. Srinath Reddy, Public Health Foundation of India, Dr. K. Locana Gunaratna, National Academy of Sciences of Sri Lanka, and Dr. Victor Hoe, University of Malaysia, discussed the political economy of climate and health.

Historically, climate change and health have been viewed as separate issues. It is only recently that climate change and health have come to the forefront.

Dr. Victor Hoe attributed the lack of emphasis on climate and health to countries’ focus on economic growth. He noted that health does not directly generate revenue in the context of economic development. Instead, countries have focused on GDP as a measure of progress.

Prof. Dr. Srinath Reddy continued by identifying five reasons why climate and health has not been a top priority:

1. Contentious debate: Countries engage in accusatory debates, blaming each other for past and present environmental challenges, instead of taking responsibility.
2. Economic growth versus environmental sustainability: Countries view economic growth and environmental sustainability as conflicting objectives. For example, countries view a shift to clean energy as an impediment to economic growth.
3. Lack of solidarity: There is a lack of solidarity within and across countries, regions, and generations, with many feeling that climate change is someone else’s problem. This leads to insensitivity toward the impacts on future generations and a lack of commitment to addressing intergenerational effects.
4. Absence of an integrated ecological perspective: There is a failure to adopt an integrated approach, such as One Health or planetary health, that recognizes the interconnectedness of all forms of life and the impact of environmental factors on health.
5. Siloed science: Scientific research has been compartmentalized and often uses linear approaches that do not address the complexity of adaptive systems. This siloed approach limits both understanding and intervention effectiveness.

Dr. Hoe added that political factors play a significant role, with politicians often focusing on short-term concerns, while climate change requires long-term solutions. As a result, it is important to improve communication about climate change and health to the general public, as they prioritize basic needs over environmental concerns.

Further, speakers discussed efforts to address climate and health in South Asia. While the South Asian region has made progress in modernizing urban areas, Dr. K. Locana Gunaratna noted there has been a neglect of rural areas, particularly in terms of infrastructure, such as health care. It may not be feasible to establish facilities like comprehensive health care centers in isolated villages; therefore, one approach is to identify towns that can serve as central hubs, providing essential infrastructure for a cluster of villages. Prof. Dr. Srinath Reddy highlighted that while India has primarily focused on mitigation measures, there is a growing need to prioritize adaptation to climate change. He emphasized the importance viewing adaptation as a realistic response rather than a surrender to the climate crisis (McKenna, 2022). Additionally, many adaptation efforts can contribute to mitigation. In Malaysia, Dr. Hoe discussed the country’s focus on disaster relief, particularly for flooding, and efforts to promote green financing and reduce single-use plastics. Malaysia has also engaged indigenous communities in climate initiatives but faces challenges in integrating health and adaptation programs.

Dr. Suresh Tiwari described three key challenges to addressing climate and health in the South Asian region:

1. Research and development: There is a need to improve the communication of scientific data to convey the current and future impacts of climate change. Countries like Nepal must increase their investment in research and development to better understand and address these challenges. Nepal currently invests less than 0.5 percent of its GDP in climate-related research and development.
2. Financing: Addressing climate and health challenges (e.g., melting glaciers, landslides, and floods) require adequate financing. However, national policies often lack clear indicators to track whether commitments are being met, making it difficult to assess resource allocation and investment.
3. Global advocacy: Despite being a minor contributor to climate change, Nepal and similar countries need to raise awareness and advocate more effectively on the global stage. For instance, the recent session by Nepal’s prime minister in Dubai highlighted the visible melting of mountains, emphasizing the importance of global responsiveness to these issues.

Dr. Popular Gentle further highlighted that the impacts of climate change on health are severe, yet this is an area where knowledge remains limited due to inadequate research. He emphasized that climate finance investments for health are minimal; for instance, recent research in Nepal shows that less than 5 percent of adaptation funding is allocated to addressing health impacts. He also noted that the most vulnerable populations—particularly the poor, women, and socially excluded groups—are disproportionately affected, given their low adaptive capacity, limited access to health facilities, and dependence on climate-sensitive livelihoods. Ensuring that equity and justice remain central to climate action is essential at all levels.

Theme 2 Session: Research and Innovation

Dr. Maureen Lichtveld, University of Pittsburgh, Dr. Rabindra Dhakal, NAST, Dr. Shabana Khan, Indian Research Academy, Dr. Biraj Karmacharya, Dhulikhel Hospital, and Dr. Bishesh Khanal, Nepal Applied Mathematics and Informatics Institute for Research, discussed research and innovation to address the climate and health crisis.

Dr. Maureen Lichtveld provided an overarching perspective on transdisciplinary climate and health research—applying science to advance public health. One of the central themes was the need to address climate and health through a multifaceted approach that incorporates various disciplines. Dr. Lichtveld emphasized the intersection of environmental, human, and animal health, highlighting the One Health concept. She explained that climate change affects all three areas, necessitating a comprehensive understanding and response. In addition, she discussed the concept of community vulnerability, illustrating how climate change affects multiple factors that impact community health. Dr. Lichtveld introduced the idea of the public health exposome, which considers not only chemical stressors but also the role of the community in shaping health outcomes. This concept underscores the interconnectedness of environmental and human health. Furthermore, Dr. Lichtveld discussed the importance of precision public health, which involves delivering the right interventions to the right populations at the right times. She emphasized the need for research to inform targeted interventions that address specific community needs related to climate and health. She concluded by emphasizing the importance of community engagement in implementation science, highlighting the need to work closely with communities to develop and implement tailored climate and health strategies.

Building on this overarching perspective, speakers discussed the research and innovation capacity of the South Asian region and lessons from COVID-19.

Dr. Rabindra Dhakal discussed the research and development ecosystem in Nepal. He described the unique capacity of NAST, which owns the highest-altitude lab globally and supports a wide range of ongoing projects from optimizing the use of medicinal plants to precision medicine. Further, Dr. Dhakal showcased several innovations developed during the COVID-19 pandemic, underscoring Nepal’s capacity for innovation to address complex challenges amid rapidly evolving contexts. Finally, he described an ongoing effort in Nepal, the National Digital Innovation Network, which aims to connect innovators and facilitate information sharing about ongoing projects.

Dr. Shabana Khan described the challenges of climate change and health in South Asia, emphasizing the region’s frontline position in facing these issues. She highlighted the unique aspects of South Asia, including its high population density, dependence on agriculture, and diverse sociocultural and political systems, which pose challenges for integrated solutions. Dr. Khan also discussed lessons from the regional impacts of COVID-19, highlighting the reactionary response and the lack of a comprehensive reporting system in South Asia. She emphasized the need for improved research visibility and science communication. She cited the case study of rising air pollution in Delhi exacerbating other health conditions as an example of the need to improve research communication to encourage people to take precautionary measures to mitigate the harmful effects of air pollution.

Dr. Biraj Karmacharya discussed the role of academia in addressing climate change and health in Nepal. He emphasized academia’s role as a dynamic hub for knowledge generation, research, innovation, and policy engagement. Dr. Karmacharya noted the importance of interdisciplinary research and the need for academia to step out of its comfort zone to contribute scientific expertise to inform local, national, and international climate negotiations. He also highlighted initiatives, such as the Consortium of Academic Institutions for Public Health in Nepal and the modular course on planetary health and sustainability in the Master of Science in Public Health curriculum, as examples of academia’s efforts in this field.

Dr. Bishesh Khanal presented on the role of artificial intelligence (AI) in climate health, focusing on the work of Nepal Applied Mathematics and Informatics Institute for Research (NAAMII). NAAMII’s approach emphasizes excellence in scientific research, education and outreach, and industry innovation. Examples of NAAMII’s scientific research include AI-assisted cancer screenings and 3D reconstruction of biplanar X-rays, showcasing the potential of AI in health care. The organization also prioritizes education and outreach, aiming to build skills in computing sciences and AI while preparing society for the digital future. NAAMII’s work highlights the multidisciplinary and multiscale nature of health care, climate, and AI integration.

Theme 3 Session: Ways of Knowing: Research-Policy-Impact

Dr. Mohammad Perwaiz Iqbal, Aga Khan University, Dr. Saroj Jayasinghe, University of Colombo, Dr. Bimal Raj Regmi, Nepal, Dr. Aliya Naheed, International Centre for Diarrhoeal Disease Research, and Dr. Popular Gentle, who provided regional perspectives on the impact of the climate and health crisis in different parts of South Asia, discussed what impact might look like in the future.

Dr. Mohammad Perwaiz Iqbal’s presentation provided a regional perspective from Pakistan. He highlighted the devastating effects of recent floods in Sindh and Balochistan, which submerged one-third of the country, leading to loss of homes, lives, and livestock, as well as disease outbreaks. Dr. Iqbal also discussed other climate-related challenges in Pakistan, such as melting glaciers, water scarcity, and decreasing forest cover, emphasizing the urgent need for mitigation and adaptation measures. He called for nationwide initiatives like a clean green campaign and emphasized the importance of education, awareness campaigns, and community engagement in addressing the health impacts of climate change. Dr. Iqbal outlined several mitigation efforts, including reforestation and water conservation projects like the restoration of underground waterlines in Cholistan. He also highlighted health impacts of climate change, such as increased incidence of waterborne diseases, necessitating nationwide public health and environmental campaigns.

Dr. Saroj Jayasinghe provided a regional perspective from Sri Lanka. Dr. Jayasinghe emphasized the necessity of generating empirical evidence and promoting indigenous knowledge in crafting resilient climate action plans. He advocated for a transdisciplinary approach that integrates academic efforts with practical applications and engages directly with affected populations to coproduce locally relevant solutions. Dr. Jayasinghe emphasized the need to share best practices and policies and an improved science-policy interface, calling for the establishment of networks and partnerships among stakeholders to achieve this aim. In terms of progress, notable strides have been made in Sri Lanka: the National Science Foundation has implemented a research track specifically for transdisciplinary studies, the Sri Lanka Association for the Advancement of Science recognized and promoted this approach in a recent session, and the National Academy of Science of Sri Lanka has initiated a preliminary project with the Inter-Academy Partnership to develop a program focusing on the science-policy interface.

Dr. Bimal Raj Regmi provided a regional perspective from Nepal. He described the impacts of climate change in the region, including rising temperatures, increases in extreme weather events, as well as the negative effects on food supply and nutritional security. He noted the challenges presented by South Asia’s unique topography on eco-regions and nature-based livelihoods, highlighting issues such as poverty, marginalization, and low adaptive capacity due to socioeconomic conditions. Further, he underscored that groups including the poor, indigenous, marginalized, women, children, and older adults in South Asia are disproportionately impacted by climate change. To respond to the climate and health crisis, he emphasized the need for future strategies to build on existing science and knowledge, factor in climate risks and vulnerability, and design tailored adaptation interventions. Additionally, he advocated for a comprehensive government approach that integrates policy, planning, and institutional capacity with effective budgeting, monitoring, and innovative financing to encourage private sector involvement.

Dr. Aliya Naheed provided a regional perspective from Bangladesh. She stressed the importance of listening to and learning from communities to identify priorities and tailor solutions that they trust and accept. For example, she noted that communities along South Asia’s coastal belts identify water salinity as a primary concern. Further, Dr. Naheed emphasized the need to communicate with policy makers. The absence of health considerations in Bangladesh’s climate action plans reflects policy makers’ lack of information about the issue. Finally, she stressed the urgency of rapidly scaling solutions across the region. The United Kingdom National Institute for Health and Care Research-supported Global Health Research Center, which focuses on global communicable diseases and climate change across Bangladesh, India, and Indonesia, is an example of a collaborative approach to expedite problem solving. Each country in the Center has chosen to focus on a specific issue (water salinity, heat and food systems, and air pollution, respectively) and each member has agreed to adopt successful solutions found in one country.

Closing

Dr. Gentle concluded the day by stressing the necessity of strong political commitment and effective collaboration to address climate challenges. He pointed out the differential impacts of climate change, noting the particular vulnerabilities of women, children, and outdoor workers, and called for placing equity and justice at the center of climate action.

Day 2

Keynote

In his keynote speech, Dr. Jonathan Patz, University of Wisconsin, Madison, discussed the health benefits achievable through climate action, emphasizing the vast impact of climate change on health. He detailed the many ways climate change negatively impacts health, citing a recent review that found more than 1,000 pathways through which climate affects health (Mora et al., 2022). For example, he cited the relationship between climate-sensitive diseases and rising temperatures, which increase risks from disease vectors such as mosquitoes. Other impacts include glacier melting in high elevation countries (e.g., Nepal), water scarcity and its impacts on agricultural productivity, and extreme weather events.

Dr. Patz underscored the urgent need to reduce fossil fuel emissions, in line with international climate agreements, to stabilize global temperatures and improve public health. Advocating for a shift toward renewable energy and plant-based diets, Dr. Patz pointed out that, with the plummeting cost of solar power and the economic feasibility of renewables and batteries, there is no excuse to continue reliance on fossil fuels. Targeted climate action could save millions of lives globally. For example, he highlighted how air pollution (primarily stemming from burning fossil fuels) contributes to approximately 5.1 million premature deaths annually. Efforts to promote green transportation could reduce greenhouse gas emissions and reduce physical inactivity which causes around 3.9 million premature deaths yearly. Furthermore, adopting a universal healthy diet could prevent 11 million premature deaths each year (Willett et al., 2019). He concluded by suggesting that framing the discourse around the health benefits of climate action provides compelling incentives for policy makers to pursue environmental sustainability, which will significantly improve public health in the short term during the transition to a clean energy economy.

Grand Challenges Canada

Joe Torres, Grand Challenges Canada Foundation, outlined the role of Grand Challenges Canada as an innovation platform and its focus on supporting adaptation strategies through health initiatives impacted by climate change. He discussed the 2022 landscaping exercise that revealed a need for better frameworks to evaluate the climate’s impact on health, especially through an intersectional lens. He emphasized the importance of directing funds toward locally led organizations in low- and middle-income countries, which are most affected by climate challenges. He also highlighted the potential for collaboration and partnership to scale innovations and improve health outcomes in the context of climate change. He noted the gap in interdisciplinary funding for specific work in the climate and health nexus, with a specific need for more funding in climate adaptation.

Climate Change, Health, and Equity: Today’s Global Grand Challenge

Dr. Amy Thein, Myanmar, Dr. Meghnath Dhimal, Nepal Health Research Council, Prof. Dr. Janak Koirala, Nepal Health Research Council, and Dr. Sameer Mani Dixit, Centre for Molecular Dynamics Nepal discussed different facets of the climate and health crisis and potential solutions and paths forward.

Climate change stands to impact agricultural production and yield. Because numerous livelihoods depend on agriculture in South Asia, it is vital to focus on climate-smart agriculture. Dr. Amy Thein discussed the core principles of climate-smart agriculture in Myanmar, which include sustainable increases in agricultural productivity, adaptation to climate change, and mitigation of greenhouse gas emissions. She highlighted the implementation of climate resilience varieties and farming practices, such as zero tillage and water-saving technologies. Dr. Thein emphasized the role of microfinance and green investments in enhancing the adoption of climate-adaptive practices, noting the interconnectedness of public health and agricultural stability.

Additionally, speakers explored strategies for building resilient health systems and strengthening public health.

Dr. Meghnath Dhimal presented an overview of the health impacts of climate change in Nepal, underlining the disproportionate effects on low-income countries despite their minimal contributions to global emissions. He reported on Nepal’s efforts to integrate climate considerations into public health strategies, including the development of a national health adaptation plan and early warning systems for diseases like dengue. Dr. Dhimal called for more equitable global health policies and increased investment in health system resilience.

Prof. Dr. Janak Koirala spoke on the intersection of human health and the emergence of infectious diseases due to climate change. He detailed how vector-borne diseases are reaching higher altitudes and expanding in range due to changing climate conditions. The presentation underscored the urgent need to address the root causes of these emerging health threats through improved surveillance and global cooperation.

Dr. Sameer Mani Dixit discussed the broader impacts of climate change on infectious diseases, including non-vector-borne diseases (e.g., tuberculosis) and the implications of climate change on antibiotic resistance. He highlighted the importance of local research and leadership in frontline countries to drive global change and the need for better data utilization to inform policy and practice.

The session concluded with a discussion on the vital role of transdisciplinary approaches and international collaboration in tackling the dual challenges of climate change and health equity. Speakers emphasized the importance of integrating scientific research with policy and community action to effectively mitigate and adapt to the adverse effects of climate change, particularly focusing on the health impacts in vulnerable regions.

Theme 4 Session: Community Mobilization in Climate and Health Research and Innovation in South and Southeast Asia

Dr. Donald Warne, Johns Hopkins Center for Indigenous Health, Dr. Carol O’Donnell, Smithsonian Science Education Center, Ms. Saru Pyakurel, Nepal, Eco-Network Global, Dr. Suraj Bhattaraj, Global Health Research and Medical Interventions for Development, and Dr. Victor Hoe, University of Malaysia, discussed the intersection of community involvement, education, and policy in addressing climate change impacts on health. Speakers emphasized the power of community mobilization and education in transforming the response to climate and health challenges.

Dr. Donald Warne discussed the importance of integrating indigenous knowledge into mainstream climate change and health strategies. He discussed the critical role that traditional practices and local wisdom play in sustainable environmental management, advocating for greater inclusion of indigenous perspectives in global health policies.

Dr. Carol O’Donnell described the Smithsonian’s initiatives to engage youth in climate and health issues through educational programs. The Smithsonian Science Education Center, in partnership with Gallup, developed curricula that incorporate science with history, art, and culture, making it accessible for global educators and students. The programs aim to empower youth to undertake community-based projects, such as sustainability expos in the Philippines and the creation of natural mosquito repellents in Panama, thus applying their learning in real-world contexts. To date, the program has worked with 41,000 educators across the globe, reaching 4.7 million students from 88 different countries.

Ms. Saru Pyakurel presented on effective community-based adaptation strategies, such as forest management and the use of traditional knowledge in climate mitigation. She underscored the importance of fostering a culture of community-led solutions to the climate challenge through collaboration, promoting knowledge sharing and learning, building local leadership, and facilitating participatory decision making.

Dr. Suraj Bhattarai addressed the vulnerabilities of urban municipalities to climate-related health impacts. He advocated for an “upstream approach” to public health, which involves addressing the root causes and social determinants of health through systemic changes. This approach aims to create sustainable solutions, such as integrated water resource management systems in the Maldives, to mitigate the impacts of climate change on health. He also underscored the importance of community involvement in climate-health research. This can be achieved through community-based participatory research methods, such as photovoice, which uses photos taken by participants to deconstruct problems and find actionable solutions in a community.

Dr. Victor Hoe discussed the role of citizen science—research conducted with participation from the general public, nonprofessional researchers, or amateurs in various disciplines—in mobilizing community participation in climate and health research. He described how citizen science projects in Malaysia have engaged the public in data collection and research, enhancing scientific capacity and fostering a culture of curiosity and innovation.

Implementing COP28 Commitment into Reality

Dr. Caitlin Rublee, University of Colorado, provided an overview of the 28th meeting of the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP28), highlighting the inaugural “Health Day” and the representation of health professionals at the event. She discussed the significance of international collaboration, knowledge translation, and the importance of multidisciplinary networking in climate action. Key future actions include the implementation of national adaptation plans, leveraging frameworks like the Sendai Framework for Disaster Risk Reduction, and the World Health Organization operational framework for building climate-resilient and low-carbon health systems, all aimed at fostering equitable and effective climate action globally.

Defining Scope of Work for Research and Innovation Hub and Unveiling the “Kathmandu Commitments 2024”

The workshop continued with the unveiling of the concept of regional research and innovation hubs to address the climate crisis and its impacts on public health and equity in South and Southeast Asia. These hubs are designed to foster capacity building, facilitate bidirectional knowledge exchange, and integrate research insights into policy making. They aim to strengthen scientific capacity, leverage regional leadership, accelerate local innovations, and scale solutions across the region. The hubs would serve as a strategic platform for collaborative action to accomplish the following objectives:

1. Strengthen regional scientific capacity: increasing the workforce and training, improving surveillance and monitoring, growing community engagement, and facilitating the uptake of research into policy.
2. Leverage regional leadership: creating a shared regional research and innovation agenda that spans borders, disciplines, and sectors.
3. Accelerate innovation: identifying promising innovations from local communities to maximize their impact across a region and a network of researchers and innovators to facilitate collaboration.
4. Scale solutions: sharing lessons and solutions across countries within a region and across regional hubs.

To implement these goals, workshop attendees presented and endorsed the “Kathmandu Commitments 2024.” These commitments prioritize the development of local solutions that incorporate indigenous knowledge, ensure active community involvement, and promote policies that are equitable, effective, sustainable, and scalable. The commitments also emphasize strengthening advocacy and capacity building to enable access to global climate finance and carbon trade, advocating for coherent policy integration at all levels.

Areas of Future Focus/Key Themes

The discussions at this workshop highlighted several critical areas of future focus and key themes essential for addressing the intertwined challenges of climate change, health, and equity in South and Southeast Asia.

• Strengthening regional scientific capacity: One of the primary areas of focus identified during the workshop is the need to enhance regional scientific capacity. This involves investing in workforce training, improving surveillance and monitoring systems, and fostering community engagement to facilitate the uptake of research findings into policy and practice. Adopting a transdisciplinary approach that integrates environmental, human, and animal health is crucial.
• Leveraging regional leadership: The workshop participants stressed the importance of leveraging regional leadership to create a shared research and innovation agenda that spans borders, disciplines, and sectors. This collaborative approach is essential for tackling the complex challenges posed by climate change and health. Establishing regional research and innovation hubs, as discussed, will serve as strategic platforms for fostering capacity building, facilitating knowledge exchange, and integrating research insights into policy making.
• Accelerating innovation and scaling solutions: Accelerating the pace of innovation and scaling successful solutions across the region is vital for addressing the urgent health impacts of climate change. The workshop highlighted several innovative practices, such as climate-smart agriculture, precision public health, and community-based adaptation strategies. These innovations need to be identified, supported, and scaled across the region to maximize their impact.
• Enhancing community engagement and equity: Community engagement emerged as a central theme, with a strong emphasis on understanding the differential impacts of climate change on human health and involving the most impacted populations, including women, children, and indigenous communities, in designing and implementing climate and health programs. This approach emphasizes equity, justice, and human rights, ensuring that interventions are responsive to the diverse risks, vulnerabilities, and capacities of different communities.
• Promoting policy integration and advocacy: The need for coherent and integrated policy frameworks that address climate change and health was a recurring theme. Strengthening the science-policy interface and building strategic collaborations among stakeholders are essential for effective climate action. In particular, researchers and development actors should engage political leaders and parliamentarians to raise awareness and educate them on climate change’s impacts on health to build political will and commitment. The “Kathmandu Commitments 2024,” endorsed during the workshop, reflect a unified approach to developing local solutions, advocating for climate finance, and fostering equitable and sustainable development policies.

Conclusion

The discussions at this workshop highlighted that addressing the climate and health crisis in South and Southeast Asia requires a multifaceted approach that integrates scientific research, innovative solutions, community engagement, and robust policy frameworks. A key challenge is the need for increased funding targeting the intersection of climate and health, as current funding streams remain siloed. Funders must promote transdisciplinary work that can support integrated solutions. By strengthening regional scientific capacity, leveraging leadership, accelerating innovation, enhancing community involvement, and promoting integrated policies, the region can build resilience and ensure sustainable health outcomes in the face of climate change. The  Kathmandu Commitments 2024” provide a strategic roadmap for achieving these goals and fostering a healthier, more equitable future for all.

References

1. Association of Academies and Societies of Sciences in Asia. 2021. The imperative of climate action to protect and promote health in Asia. Available at: https://www.interacademies.org/sites/default/files/2021-11/AASSA_CCH_report_Web_051121.pdf (accessed October 15, 2024).
2. McKenna, T. D. 2022. Trillions are being committed to climate mitigation, but what about climate adaptation? Available at: https://www.weforum.org/agenda/2022/01/trillions-are-being-committed-to-climate-mitigation-but-what-about-climate-adaptation/ (accessed October 15, 2024).
3. Mora, C., T. McKenzie, I. M. Gaw, J. M. Dean, H. von Hammerstein, T. A. Knudson, R. O. Setter, C. Z. Smith, K. M. Webste, J. A. Patz, and E. C. Franklin. Over half of known human pathogenic diseases can be aggravated by climate change. Nature Climate Change 12(9):869–875. https://doi.org/10.1038/s41558-022-01426-1.
4. Willett, W., J. Rockström, B. Loken, M. Springmann, T. Lang, S. Vermeulen, T. Garnett, D. Tilman, F. DeClerck, A. Wood, M. Jonell, M. Clark, L. J. Gordon, J. Fanzo, C. Hawkes, R. Zurayk, J. A. Rivera, W. De Vries, L. Majele Sibanda, A. Afshin, A. Chaudhary, M. Herrero, R. Agustina, F. Branca, A. Lartey, S. Fan, B. Crona, E. Fox, V. Bignet, M. Troell, T. Lindahl, S. Singh, S. E. Cornell, K. Srinath Reddy, S. Narain, S. Nishtar, and C. J. L. Murray. 2019. Food in the Anthropocene: The EAT-Lancet Commission on healthy diets from sustainable food systems. The Lancet 2;393(10170):447–492. https://doi.org/10.1016/S0140-6736(18)31788-4.

Disclaimer

This Discussion Proceedings was prepared by Celynne Balatbat and Gabriela Dugas as a factual summary of what occurred at the meeting and areas of future focus and key themes. The statements made are those of the rapporteurs or individual meeting participants and do not necessarily represent the views of all meeting participants; the planning committee; members of the associated program; the National Academy of Medicine; or the National Academies of Sciences, Engineering, and Medicine.

Reviewers

To ensure that it meets institutional standards for quality and objectivity, this Discussion Proceedings was reviewed by Joe Torres, Global Innovation Fund, and Popular Gentle, Clim Adapt, Kathmandu Nepal, and Gulbali Institute for Agriculture, Water and Environment, Charles Sturt University.

Sponsors

This workshop was held in collaboration with the Partnership for Sustainable Development Nepal, the Nepal Health Research Council, the Nepal National Academy of Science and Technology, Nepal, SickKids Centre for Global Child Health, the Institute for Global Health & Development at The Aga Khan University, The Inter-Academy Partnership, and Rockefeller Center. Any opinions, findings, or conclusions expressed in this publication do not necessarily reflect the views of any organization or agency that assisted in the development of this project.

For additional information, please visit https://nam.edu/event/connecting-the-dots-between-climate-change-health-and-equity/.

Suggested Citation

Balatbat, C., and G. Dugas, rapporteurs. 2024. Connecting the Dots Between Climate Change, Health, and Equity: A Workshop in Kathmandu, Nepal. Discussion Proceedings, National Academy of Medicine, Washington, DC.