A Science Policy Framework for the Climate Determinants of Health

The World Health Organization (WHO) has called climate change the single biggest health threat facing humanity. With warming at approximately 1.14°C above preindustrial levels and set to increase, the Intergovernmental Panel on Climate Change (IPCC) predicts with very high confidence that climate-related illness will also rise. Under high-emissions scenarios, this science-policy body warns that severe weather — droughts, floods, heatwaves, wind, and wildfires among them — will occur with greater frequency and intensity, posing serious threats to human well-being. While this extreme weather is fast becoming a new normal, policy has not kept pace. Globally, policies are needed to future-proof public health against the impacts of warming that, much like threats to public health, have no territorial bound. 

To address this urgent need, Perry World House (PWH) and Penn Climate at the University of Pennsylvania are organizing a series of convenings to put Penn’s world-renowned research into the hands of policymakers addressing climate-driven determinants of health. Since 2021, PWH has hosted in-depth discussions on island vulnerability to climate change, as well as on the global challenges of extreme heat, food security, climate anxiety and mental health, and the changing landscape of vector-borne disease. Most recently, on 14 April 2026, PWH with Penn Climate hosted a convening on the margins of the International Monetary Fund and World Bank Spring Meetings to discuss how to further bridge the science-policy gap to inform responses to climate change impacts on health. 

The session drew experts from an array of multilateral and medical institutions along with representatives from Maldives, France, Germany, and Italy who collectively discussed challenges along with opportunities for action. At the start, they outlined why climate change is a threat multiplier to planetary health. They highlighted, inter alia, its impacts on human physical and mental well-being, healthcare infrastructure, and animal health. Their interventions underscored the realities faced by small islands and low-lying territories where critical infrastructure, like hospitals, is in close proximity to shorelines and therefore vulnerable to storm and tidal surges. They noted how unpredictable rains and changing monsoon seasons are threatening food security while also creating breeding grounds for mosquitoes that host infectious diseases like dengue and chikungunya. Meanwhile heatwaves, the deadliest of all climate-driven hazards, are compounding air pollution and other health stressors worldwide. While experts did point out progressive responses, for instance, in Canada on national vulnerability assessments, and in India on early warning systems, mental health and heat action plans, they largely agreed that climate threats to human health remain dangerously under-surveilled, researched, and addressed in formal policy. 

In subsequent discourse, they outlined several pathways and recommendations for action, summarized below. 

Pathways for Action

Creating Strategic Frameworks and Preventative Systems

To transition from reactive measures to collective readiness, a One Health approach is recommended, emphasizing the interdependence of animal, human, and environmental health. This framework could be particularly effective for addressing antimicrobial resistance and zoonotic diseases through the ‘integrated surveillance’ of humans, animals, and the environment. Preventive systems should also focus on early warning signs for both humans and animals to save lives and protect infrastructure. At the local level, this involves community response systems and the training of local providers to ensure a state of readiness before disasters occur. 

Integrating Science, Policy, and Political Leadership

Nations require science diplomacy to bridge the gap between medical research and the policy needed to protect communities. To make this operational, political leadership should focus on practical steps, such as mapping specific community health risks and building technical capacity for health systems to respond to climate shocks. Furthermore, academia can assist by building the necessary infrastructure for data collection and providing evidence-based interventions to inform policy. Finally, integrating climate and health education into school curricula and using clear, efficacious messaging can help empower youth, who are already mobilizing for mutual aid and disaster support, to become central parts of the solution.

Sub-national and Local Action

Leadership must also prioritize engagement with sub-national and local actors, as the actual delivery of climate health solutions occurs in communities. For example, recent pilot programs in Philadelphia have demonstrated the impact of deploying open-air, solar-powered heat shelters at bus stops. These shelters provide active cooling relief during extreme heat events without placing additional strain on the power grid. By supporting such localized innovation, national frameworks can ensure that protection is delivered directly to those most vulnerable to rising temperatures.

Recommendations

• Establish Integrated Surveillance Systems: Develop a technical pan-surveillance infrastructure that monitors humans, domestic animals, wildlife, and the environment (such as mosquitoes) within a single communicative system. By following models like those in Italy and Canada, these systems provide the specific datasets needed to catch early warning signs of vector-borne shifts (like the spread of dengue or chikungunya) before they escalate into cross-species pandemics.
• Support One Health Coordination: Utilize the One Health framework as a high-level policy lever to align governments, academia, and industry on the systemic interdependence of species health. This strategic coordination prioritizes proactive, low-cost interventions, such as mass animal vaccinations (e.g., for rabies) that cost less than $1 billion compared to $10 billion in human healthcare burdens, and champions land-use policies that improve agricultural efficiency to simultaneously mitigate greenhouse gas emissions.
• Deploy Layered Heat Mitigation: Effective heat resilience requires a comprehensive framework that includes adaptive heat action plans, early warning systems, and climate-resilient infrastructure design. Within this broader context, nations could implement a tiered urban cooling strategy that moves beyond traditional shading and tree planting to include active, resilient solutions. This includes deploying solar-powered, open-air heat shelters in high-traffic areas like bus stops, which provide active relief without connecting to the electrical grid. These systems should utilize specialized cool surface technology designed to prevent condensation in high-humidity environments, ensuring cooling remains available even during peak power demand or total blackouts.
• Conduct Psychosocial Risk Assessments: Improve data collection and analysis on the climate change determinants of mental health. National adaptation plans could provide frameworks for gathering data on psychosocial metrics related to climate-driven anxiety, trauma, and displacement stress. Emphasis should be on monitoring the mental health of high-risk populations, while also creating engagement programs that convert anxiety into action. This ensures mental health is treated as a core health metric and is integrated into disaster preparedness rather than being delayed until after a crisis occurs.
• Design Climate-Smart Health Infrastructure: Build resilient hospitals and medical facilities specifically designed to withstand impacts like shoreline flooding and tidal surges. These climate-smart hubs must incorporate renewable energy to ensure power stability during grid failures and integrate air quality monitoring with low-energy cooling technologies (such as cooling surfaces) to protect patients from rising heat and pollution without overstraining local energy and grid systems. Along with upgrading facilities, systems should train medical staff to anticipate and treat climate-driven morbidities like heat stroke, burns, and pollution-induced asthma. 
• Adopt Labor-Centric Health Protections: Create frameworks that communicate and address risks to lives as well as livelihoods. Focus on protecting vulnerable workforces, such as waste, construction and agricultural workers, from weather extremes and emerging diseases. Address also the climate-driven economic impacts of lost productivity and healthcare burdens, which can become direct liabilities for both businesses and the broader economy.
• Expand Sub-National and Community Action: Sub-national implementation must go beyond generic heat strategies to include city-specific, locally driven action plans. This ensures that interventions reach people where they are, using language and cultural frameworks that resonate with the local community. Effective action requires a move away from siloed approaches toward an integrated system where early warning and response are built directly into the community infrastructure.
• Incentivize Circular Food Systems: Adopt land-use policies that promote upcycling food waste as livestock feed, a strategy that significantly reduces non-enteric methane (waste-related emissions) by diverting organic waste from landfills. This circular approach not only helps mitigate the 50% of agricultural methane produced by livestock but also improves the economics of production and food security by creating more efficient, sustainable agricultural cycles that lower greenhouse gas emissions.
• Engage the Philanthropic and Private Sectors: Establish partnerships with the philanthropic community to share the burden of convening and project implementation at the local level. By also engaging private health and energy firms, the global system can secure concrete deals and funding for mini-lateral frameworks that sustain policy momentum and innovation, ensuring that infrastructure projects and labor-centric health protections are not solely dependent on constrained public funding sources.