Addressing the health impacts of climate change

The relationship between climate and health is complex and diverse. Vector-borne diseases, like malaria, are spreading due to changing climatic conditions. Air pollution, linked to climate change, causes around 7 million premature deaths each year.

NIHR is funding critical research in these areas. Our £20 million RIGHT 5 award will strengthen health service delivery in LMICs, in the context of extreme weather events. Our award-holders are working with policymakers to develop robust and resilient health systems. In this feature, we highlight the impact of other awards on climate-related health factors, and look ahead to the future.

Across Africa, nearly 1 billion people rely on polluting fuels such as wood, charcoal and kerosene. These fuels are used for cooking, lighting and heating their homes. Household air pollution from burning these fuels causes around 700,000 premature deaths each year.

Women and children are particularly vulnerable, due to traditional domestic roles around cooking. Using these fuels is also a major source of forest degradation and climate change.

NIHR Global Health Research Unit - CLEAN-Air Africa is a partnership between UK researchers and health authorities and institutions in Kenya, Tanzania, Rwanda, Uganda and Cameroon. It is co-led by the University of Liverpool and Kenya Medical Research Institute (KEMRI).

This Unit is building on the success of the previous NIHR Global Health Research Group award from 2018-21. They are undertaking in-depth research, policy research, engagement and training.

They have established the Air Pollution Centre of Excellence at KEMRI. This has a state-of-the-art air quality assessment laboratory.

“Through the Centre, CLEAN-Air (Africa) is now steering efforts to scale adoption of clean energy in Kenya including chairing the Ministry of Health’s Technical Working Group on Energy, Air Pollution and Health. This ensures that health is at the heart of policy decision making in the country”.
Dr James Mwitari, KEMRI, Co-Director of CLEAN-Air Africa.

The project monitored air pollution in homes and school kitchens. They found that switching from polluting fuels to using liquid petroleum gas (LPG) improves women and children's health.

“We have demonstrated that rapid transition to clean cooking with LPG in sub-Saharan Africa meets the immediate public health priority with climate, gender and environmental co-benefits. Our research has shown the benefits of both financial and technological innovation in assisting a rapid, equitable transition to clean cooking fuels.”.
Dr Elisa Puzzolo, Co-Director of CLEAN-Air Africa

Working with the Ministry of Health, CLEAN-Air Africa has trained 2,500 instructors across all 47 counties in Kenya. These instructors will train 120,000 community health workers. The team aims to reach Kenya’s entire population.

The team has engaged closely with the First Lady of Kenya in her work championing clean cooking in the country. They recently launched a training programme to teach women about air pollution and its impact on health. They are helping women get access to clean cooking equipment through table banks, a communal savings and lending system.

In the aftermath of a climate disaster, healthcare facilities can be overwhelmed. This makes it difficult to prioritise and provide vital healthcare.

The NIHR Global Health Research Group on Gastrointestinal Infections is improving childhood health outcomes in Eastern and Southern Africa. The team responded rapidly to a cholera outbreak after a cyclone hit Malawi in March 2023.

After analysing the source of the outbreak, the Group’s research informed the development of a cholera vaccination campaign in Malawi. Their findings were communicated to the public in Malawi via radio interviews. The Group now works closely with Malawi’s Ministry of Health to inform disease prevention.

Looking ahead - beyond COP28

Sunday 3 December 2023 was the inaugural Health Day at the COP28 climate conference. NIHR Chief Executive Professor Lucy Chappell took part in discussions on strengthening climate resilience in global health systems. She met with NIHR global health researchers, and advocated for NIHR initiatives on health and climate change.

Also in December, Prof. Chappell gave the keynote address at the Research for Greener Surgery conference. This was organised by the NIHR Global Surgery Unit at the University of Birmingham. Over 200 delegates shared innovations to reduce the carbon footprint of surgery and anaesthesia. They announced new NIHR-funded trials to build the evidence base for sustainable surgery.

This year also saw the launch of the NIHR Global Health Research Centre for Non-communicable Diseases (NCDs) and Environmental Change. This is a 7-year £10 million consortium co-led by Imperial College London and the George Institute in India.

The Centre delivers high-quality, equitable services for NCDs prevention and care. They have a focus on marginalised populations most impacted by environmental change. It offers research, training and policy advice for health equity in LMICs.

In 2024, NIHR is investing over £20 million in research to strengthen health service delivery and resilience in LMICs. This funding is within the context of extreme weather events.

This work is part of NIHR’s Research and Innovation for Global Health Transformation (RIGHT) programme. The research will provide evidence for policymakers in LMICs. This will help them to strengthen health services during and after climate-change-induced events. These include flooding, extreme heat and disease outbreaks caused by extreme weather.

“We urgently need to address the emerging disease patterns driven by climate change, including vector and water borne diseases, emerging and new disease outbreaks and increased burden of chronic conditions such as respiratory conditions and mental health.”

Prof. Lucy Chappell, Chief Scientific Adviser to the Department of Health and Social Care and CEO of the NIHR