Multilateral climate funds are putting almost no money into protecting people’s health from climate change. A new briefing by the think tank adelphi finds that only 0.5% of multilateral climate finance, about $173 million since 2004, has gone to health adaptation, even as climate change is projected to cause up to 15.6 million deaths by 2050.
Health gets 0.5% of multilateral climate finance
The analysis reviews two decades of approved projects across major climate funds and compares them with what countries say they need. It concludes that health systems remain a blind spot in adaptation finance. The gap persists despite public pledges that “climate financing is health financing.”
“The climate crisis and its impacts on human health are severe and life-threatening—already impacting health especially in Sub-Saharan Africa and South Asia,” said Mathilde Wilkens, a co-author of the briefing. “Linking multilateral climate funds investments with countries’ national needs and priorities in the health sector as well as prioritizing investments in vulnerable countries is key for leveraging change towards resilient health systems.”
According to adelphi, health-directed adaptation represents 2% of total adaptation commitments by multilateral funds since 2004. The Green Climate Fund accounts for more than 70% of the health-related portfolio. All support identified took the form of grants.
What the briefing analyzed
The study highlights stark regional imbalances. About two-thirds of health adaptation funding went to East Asia and the Pacific, and one-quarter to Sub-Saharan Africa. South Asia did not receive a single country-specific health adaptation project during the period studied, despite expectations that it will face around 18% of future climate-related health impacts.
Country concentration is also high. Samoa received roughly one-third of total health adaptation funds, followed by Malawi and Lao PDR. By contrast, fragile or conflict-affected settings received just 4% of funding, even though health systems in those areas are most exposed to disruption.
Countries are asking for help. Of the 67 National Adaptation Plans submitted by late 2025, 87% include health priorities and 39% set out a dedicated health budget. Together, these plans identify $2.54 billion in needs for the health sector. Only about 0.1% of that is currently covered by multilateral climate finance.
Case examples: Nepal and Bangladesh
Some governments have integrated health risks into climate planning in detail. Nepal’s plan outlines programs on disease surveillance, resilient health facilities, and climate-sensitive water and sanitation. Bangladesh’s plan budgets for climate-resilient health care in cities, heatwave advisories, and mental health monitoring linked to extreme weather. But without new money, the briefing warns, these plans will not move into full implementation.
“As one of the world’s most climate-vulnerable countries, Bangladesh faces escalating health threats from climate change, from infectious diseases to heat stress and mental health impacts, which threaten the wellbeing of million,” said Md Shamsuddoha, Chief Executive of the Center for Participatory Research and Development-CPRD, Bangladesh.
“As this latest report highlights, in order to safeguard communities and advance our National Adaptation Plan goals in regards to public health, it is necessary to scale up multilateral climate funds for Bangladesh’s health sector, as well as bolster integrated risk analysis and reporting. Strengthening climate-resilient health systems and early warning capacities will be key to protecting lives and driving resilient development.”
What’s on the table at COP30
The timing is significant. Governments meet next week at COP30 in Belém, where they are expected to operationalize the Global Goal on Adaptation. The Brazilian presidency plans to launch the Belém Health Action Plan, a package meant to steer countries toward climate-resilient health systems. The adelphi briefing says these discussions offer a chance to align climate and health priorities and set clear benchmarks for progress.
The report also tracks how health shows up in UN planning documents. Many plans list climate-sensitive diseases such as dengue and cholera, the health effects of extreme heat, and damage to clinics and hospitals. Yet the authors note that the step from identifying risks to budgeting specific actions often remains incomplete. They call for stronger cross-sector work so that health measures are woven into water, sanitation, and urban projects.
Funding design matters, the authors add. Half of health adaptation money reached Least Developed Countries, but the smallest share flowed to places with the weakest systems and the highest risks. The briefing recommends more grant-based finance to avoid adding to debt burdens. It also urges funds to direct resources toward country-defined priorities in National Adaptation Plans and Health National Adaptation Plans.
Data gaps still complicate tracking. The study draws on the Climate Funds Update database and the UNFCCC NAP portal, but notes limits in project descriptions and health tagging. The authors argue for more transparency on health components of climate projects and a central, public repository for Health National Adaptation Plans.
The stakes are rising. Heat waves, floods, and shifting disease patterns are already testing health services. Clinics need cooling, power back-up, and flood protection. Health workers need training for heat illness and outbreaks. Early warning systems need to link meteorological alerts with health response.
Recommendations from the briefing
The briefing’s recommendations mirror these needs. Align national health and climate strategies. Improve access to international finance for health actors. Increase grants. Strengthen cooperation across ministries and sectors. Finalize ambitious health indicators under the Global Goal on Adaptation at COP30 to track whether funding reaches people and facilities on the front lines.
The numbers in the report show a mismatch between risk and response. Health is present in most national plans, with billions in identified needs. Yet multilateral funds have put only a small fraction toward protecting people’s health from climate impacts. The decisions in Belém will test whether that changes.
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