Tropical Cyclone Eline struck Mozambique in 2000, bringing weeks of heavy rainfall and devastating floods. When telecommunications executive Blaise Judja-Sato visited the country at the request of the legendary advocate Graça Machel to assess how introducing satellite telephones could help, he found destroyed infrastructure and supply chains that prevented many communities from accessing essential health services.
It was Judja-Sato’s firsthand experience of systemic challenges in the face of environmental catastrophe that led to the founding of VillageReach, an organization dedicated to building responsive health systems that improve access to vital medicines and care for the hardest-to-reach communities, even during times of crisis.
Climate Crisis Looms
Today, the challenges are no longer just about remote geography; they are increasingly driven by climate change, which disproportionately impacts the health and wellbeing of the under-reached, especially in low- and middle-income countries (LMICs). While global efforts to mitigate climate change – such as reducing greenhouse gas emissions by transitioning to renewable energy and improving energy efficiency – are crucial in the long term, the reality is that the impacts of climate change are already being felt acutely, particularly across Africa.
Even if mitigation efforts become more aggressive, the health impacts of climate change are unfolding now. Adaptation strategies that reduce the impact of current and future effects of climate change are required to build climate-resilient health systems. These include increasing the responsiveness of health systems so that they remain functional even when there are shocks and stresses, and developing innovative ways to deliver health care in the face of environmental disruptions.
The urgency of this dual approach – mitigation and adaptation – is underscored by the growing body of evidence detailing the devastating health consequences of climate change. The World Health Organization (WHO) estimates that climate change is already responsible for approximately 13 million deaths per year and rising. Extreme weather events lead to injury, displacement and the spread of infectious diseases. For instance, flooding can contaminate water sources, leading to outbreaks of diarrheal diseases like cholera. Rising temperatures and altered rainfall patterns expand the geographical range and breeding seasons of disease vectors like mosquitoes, contributing to surges in malaria and dengue fever cases.
A Local Focus on Adaptation
VillageReach works with governments and partners across Africa to adapt their health systems to this new climate reality. Our Climate & Health approach centers on building more climate-resilient health systems that can adapt and respond to climate-induced shocks and stressors.
In Malawi, the telehealth solution Chipatala cha pa Foni (CCPF, “Health Center by Phone” in English) offers a powerful adaptation strategy. In regions prone to climate-related disasters that can render roads unusable and isolate communities, a national health hotline provides a vital, uninterrupted link to health care information and support. This ensures that even when physical access is compromised, individuals can still receive crucial advice, referrals and potentially life-saving guidance. The successful transition of CCPF to a government-run program demonstrates the sustainability and scalability of such adaptive solutions.
Likewise, VillageReach’s work in strengthening Public Health Emergency Operations Centers (PHEOCs) in countries like Mozambique directly addresses the need for climate adaptation. As extreme weather events become more frequent and intense, robust PHEOCs are essential for effective preparedness and response. These centers enable governments to coordinate resources, monitor changes to disease patterns and outbreaks, and disseminate critical health information during and after climate-related emergencies. By bolstering these operational capacities, health systems are better equipped to withstand climate shocks and protect vulnerable populations.
A Global Response is Needed
While all of VillageReach’s core countries, the Democratic Republic of the Congo, Malawi and Mozambique, have committed to developing climate-resilient health systems through the WHO Alliance for Transformative Action on Climate and Health, they cannot do it alone.
High-income countries bear the most responsibility for climate change due to their high contribution to greenhouse gas emissions, but LMICs face the most immediate and severe consequences. In vulnerable regions, the death rate from extreme weather events over the last decade was 15 times higher than in other regions. This makes climate change a fundamental health equity issue that requires global action and increased support.
Article 3 of the United Nations Framework Convention on Climate Change emphasizes the responsibility of high-income countries to take the lead in combating climate change, not only as a principle of climate justice but also as a matter of self-interest in an interconnected world. As climate change transcends borders, so too do its health and economic consequences. Failing to respond to climate change is costly. Indeed, the WHO estimates the direct damage costs to health will be between $2-4 billion per year by 2030. Investing in resilient health systems benefits everyone.
Judja-Sato’s founding philosophy was that if you design for the lowest resource environments first, then you have a resilient model that can be adapted and scaled anywhere. This philosophy was codified in VillageReach’s Strategy 2030 vision for responsive systems that ensure health care services are available when and where they are needed, can adapt to changes in demand, better absorb shocks and stresses and routinely factor, and respond to the needs and preferences of communities.
For a healthier and more resilient future, we must do more adapt to the health effects of climate change, which disproportionately affect the communities we work in. Investing in proven climate adaptation strategies is an investment in global health security and a more equitable future for all. Just as VillageReach initially supported governments to overcome geographical barriers, we must now work together to overcome the institutional barriers that prevent us from facing the challenges posed by a changing climate head-on.