Current medical research funding and frameworks are insufficient to address the health risks of global environmental change

Abstract

BackgroundThree major international agreements signed in 2015 are key milestones for transitioning to more sustainable and resilient societies: the UN 2030 Agenda for Sustainable Development; the Sendai Framework for Disaster Risk Reduction; and the Paris Agreement under the United Nations Framework Convention on Climate Change. Together, these agreements underscore the critical importance of understanding and managing the health risks of global changes, to ensure continued population health improvements in the face of significant social and environmental change over this century.BodyFunding priorities of major health institutions and organizations in the U.S. and Europe do not match research investments with needs to inform implementation of these international agreements. In the U.S., the National Institutes of Health commit 0.025 % of their annual research budget to climate change and health. The European Union Seventh Framework Programme committed 0.08 % of the total budget to climate change and health; the amount committed under Horizon 2020 was 0.04 % of the budget. Two issues apparently contributing to this mismatch are viewing climate change primarily as an environmental problem, and therefore the responsibility of other research streams; and narrowly framing research into managing the health risks of climate variability and change from the perspective of medicine and traditional public health. This reductionist, top-down perspective focuses on proximate, individual level risk factors. While highly successful in reducing disease burdens, this framing is insufficient to protect health and well-being over a century that will be characterized by profound social and environmental changes.ConclusionsInternational commitments in 2015 underscored the significant challenges societies will face this century from climate change and other global changes. However, the low priority placed on understanding and managing the associated health risks by national and international research institutions and organizations leaves populations poorly prepared to cope with changing health burdens. Risk-centered, systems approaches can facilitate understanding of the complex interactions and dependencies across environmental, social, and human systems. This understanding is needed to formulate effective interventions targeting socio-environmental factors that are as important for determining health burdens as are individual risk factors.

Transdisciplinary Research Priorities for Human and Planetary Health in the Context of the 2030 Agenda for Sustainable Development

“…There is a mismatch between the growth in understanding of the magnitude and patterns of health risks associated with global environmental change and the speed of research and technology development into understanding recent and projecting future changes in the Earth system [2]. Research investments continue to be inadequate across all countries, impeding information on both understanding of current impacts and projected risks, and on the evidence-based policies and programs needed to prepare for and manage changing burdens of disease [7,8]. The COVID-19 pandemic dramatically highlights the challenges to and vulnerabilities of population health and health systems and highlights the value of systems-based approaches for risk management that integrate across sectors.…”

Strengthening the global response to climate change and infectious disease threats

“…The discipline of climate and health has been systematically deprived of funding for training, research, and other activities, including development and testing of interventions. 8 There is a conspicuous lack of investment in climate and health from major global health funders including the BMGF and the NIH. Although funders such as the Wellcome Trust have tentatively engaged climate and health programming, their investments have been relatively timid in ambition and limited in scope.…”

“…Nations should acknowledge and invest in strategies to further elucidate links and tackle climate related health risks. The discipline of climate and health has been systematically deprived of funding for training, research, and other activities, including development and testing of interventions 8. There is a conspicuous lack of investment in climate and health from major global health funders including the BMGF and the NIH.…”

“…The global health response has largely been characterized by scepticism and watchful inaction. The world’s largest global health funders, including the US National Institutes of Health (NIH) 8 and the Bill and Melinda Gates Foundation (BMGF), still lack specific climate and health programming, let alone programming focused on climate change and infectious diseases. Climate change remains a vanishingly small element of the portfolio of funders like the European Commission and the Wellcome Trust that have stepped into the breach.…”

Estimating the Health‐Related Costs of 10 Climate‐Sensitive U.S. Events During 2012

“…Nationally, public health preparedness for climate-sensitive health impacts is inadequate, with limited resources designated for strategic resource deployment, public education, and outreach to vulnerable communities (Brown, 2016;Ebi et al, 2016;Eidson et al, 2016;Gilmore & St. Clair, 2018;Grossman et al, 2019;Salas et al, 2018;Sheehan et al, 2017). At the state and local levels, there is considerable variability in public health capacity to respond to climate change (Carr et al, 2012;Roser-Renouf et al, 2016;Shimamoto & McCormick, 2017).…”