Health infrastructure and supply chains

As much as health vulnerability to climate change is about people, it is also about the systems that support them. The health system must prepare and adapt to climate impacts.

Like most infrastructure, hospitals, clinics and other medical facilities are susceptible to destruction, damage and disruption during storms and flooding. They risk losing access to energy and water systems. A second climate concern is the need to plan for climate-driven shifts in disease patterns.

Health systems across South-East Asia are already invested in preparing for the climate of the future, but communities and civil society can do much to strengthen and support their work.

Adaptation planners think about the effects of climate change on health systems in two dimensions:

• Immediate impacts, such as cyclones, floods and other disasters. These can damage buildings and operational infrastructure, such as water and energy systems. They can also disrupt sourcing and distribution of medicines and supplies as well as the delivery of care.
• Slow-onset impacts, such as changing rainfall and temperature patterns. These will influence the incidence of disease, and, in turn, the demands placed on hospitals, clinics and other care centres. For example, malaria may occur in new areas or begin appearing at different times of the year. Diseases that were on the decline may suddenly surge. Health personnel will need specialised training to recognise and respond to these new demands.

Disaster resilience for medical facilities starts with strategic site placement and design of buildings as well as installation of backup energy and water supplies. Health sector leaders also need to prepare for the burdens of disaster-related care, including physical injuries as well as subsequent disease outbreaks and mental health problems. They need to plan for ensuring the continuity of services to minimise disruptions to normal preventive care, including vaccine programs. Redundant supply chains are key: they will ensure reliable supplies of vaccines, drugs and other medical supplies.

Another way hospital systems can lead the way on adaptation relates to greenhouse gas (GHG) emissions. Worldwide, healthcare facilities are heavy consumers of energy. With 24-hour operations and use of air-conditioning, refrigerators and specialised medical equipment, it is no surprise that healthcare facilities account for a significant share of the GHG emissions that propel climate change. In 2016, health systems accounted for 4.6% of total GHG emissions. The health sector is already at work trying to reduce GHG and promote green hospitals through increased energy efficiencies, use of green energy and improvements to procurement, supply chain, water and waste management. Increasingly, organisations are trying to address both resilience to climate change and mitigation of emissions together.