Fazila, a midwife from Sindh Province, Pakistan, told the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) that she knew exactly how to prepare for the 2022 monsoon season. She and her mother evacuated their village after storing their belongings on high ground. But that year, the rains were different. When Fazila and her mother returned, their village was completely submerged, and their belongings and home destroyed. Along with their neighbors, they took refuge in tents among stagnant floodwater, a breeding ground for malaria-carrying mosquitoes.
Record-breaking 2022 monsoon floods in Pakistan led to a fourfold increase in confirmed malaria cases in sixty districts. An often-seasonal disease, malaria thrives in warmer, wetter environments where mosquitoes reproduce faster. And, likely due to climate change, a considerable proportion of these cases came from mosquitoes carrying the more deadly version of the disease, typically found in hotter sub-Saharan Africa.
Climate change will not only exacerbate the global malaria crisis but also pose a profound challenge to improving public health outcomes worldwide. Rising global temperatures and altered weather patterns will displace populations, disrupt healthcare access, and increase disease transmission. These effects are not theoretical. Individuals and communities around the world are feeling the health consequences of climate change today. It is vital to recognize the impact of climate change on community health, empower communities to mitigate damage and build nimble, inclusive institutions capable of addressing the intersecting crises of climate and health.
As climate change intensifies scarcity and conflict over resources, it displaces people and spreads disease. In Syria, extreme drought has forced more than 1.5 million farmers to move to overcrowded cities. Water shortages and degraded land have exacerbated existing government rights abuses and civil unrest. With over 12 million displaced Syrians, often in tightly packed refugee camps, tuberculosis is free to proliferate. Tuberculosis thrives in conflict-torn regions where the absence of healthcare workers, drug supply chains, and robust health infrastructure hamstrings prevention, diagnosis, and treatment efforts. When climate effects like drought compound conflict and displacement, airborne exposure in refugee camps and high-density, urban migrant populations accelerate disease transmission.
The fight against climate-related health crises is especially vital, considering that those least responsible for climate change will bear the brunt of its effects. On an international scale, this means that the largest historical emitters, the countries of the Global North, will avoid or adapt to the worst climate impacts while many least-developed nations will face devastation. Pacific island nations such as Tuvalu, with small populations and low carbon footprints, may be submerged and cease to exist. Tuvalu’s foreign minister demonstratively addressed the 2021 Kyoto Protocol Conference of the Parties while knee-deep in water.
On an individual scale, climate-related disasters will draw innocent individuals into intersectional plights. Cyclones in South Asia exacerbate existing human trafficking issues. For example, in 2020, when the catastrophic Cyclone Amphan tore through West Bengal, one family fell on such hard times that they agreed to let a man give their seventeen-year-old daughter a job in the city. Instead, the man trapped her in a coercive realm of the sex trade. As climate change leads to more frequent and intense cyclones, stories like this will become even more common.
Institutional capacity to confront the overlapping crises of climate and health and the inequities they produce should be informed by a human dignity lens. A human dignity lens recognizes people’s innate capabilities, gifts, and potential to contribute to society. It also acknowledges the fundamental human desire for recognition, or identity, as Stanford University’s Francis Fukuyama has written about. A dignity-informed approach requires inclusive institutions capable of creating tangible solutions. This lens will help transcend deadlock, fragmentation, and ideological divisions in multilateral bodies to advance substantive solutions.
Confronting climate change and disease especially requires this approach. Current efforts of the Global Fund to empower communities to combat public health challenges serve as a practical model for doing so. The Global Fund supports community health workers like Nhin Kpă from La Rsươm, Vietnam. Nhin Kpă travels by motorbike to teach members of his community—who live in poverty and subsist off of planting and harvesting from the surrounding forest—how to prevent malaria and protect themselves from the disease, referring patients to health facilities for testing and treatment when needed. The Global Fund catalyzes Nhin Kpă to care for and support his own community instead of imposing its view of community needs. It recognizes the worth of community members as health workers, implementing partners, and, of course, as patients and families.
Similarly, the Global Fund helped facilitate MOSASWA, a trilateral anti-malaria effort by the governments of Eswatini, Mozambique, and South Africa in the wake of Cyclone Freddy, which acutely devastated Mozambique earlier this year. Fueled by worsening climate change, cyclones leave stagnant floodwater in their wake—the perfect breeding ground for malaria-carrying mosquitoes. The Global Fund-supported response rapidly provided displacement centers with flood relief equipment, food, and mosquito nets, curbing deaths from this climate-driven disease. By supporting efforts in the region to provide malaria aid, the Global Fund upheld country leadership and the ability of states and communities to protect themselves, which will save lives in the future.
The far-reaching effects of climate change on global health—including malaria and tuberculosis surges—underscore the pressing need to consider human agency, adequately recognize marginalized communities, and support strong multistakeholder institutions to confront climate-related health crises directly. With these principles in its DNA since 2002, the Global Fund empowers governments, civil society organizations, and communities to confront major infectious disease killers now accelerated by climate effects. As climate change continues to exacerbate public health challenges, leveraging, scaling, and replicating that model is critical.
Mark P. Lagon is Senior Fellow at the Trinity Forum, Adjunct Professor in the Master of Science in Foreign Service Program at Georgetown University, and former U.S. Ambassador-At-Large to Combat Trafficking in Persons.
Jude Farley is an undergraduate at Brown University.
Image: Salvacampillo / Shutterstock.com