Resourcing climate and health priorities: Mapping international finance flows from 2018–2022

Introduction

The climate crisis is causing widespread suffering, displacing families, destroying communities, and threatening livelihoods. Each degree of warming intensifies these impacts, with climate change projected to cause 14.5–15.6 million deaths between 2026 and 2050.

While countries are preparing for climate-related health risks, funding—both domestic and international—remains insufficient. Currently, only 6% of adaptation funding and 0.5% of multilateral climate funding support health-related initiatives, leaving nations struggling to protect public health and build resilient health systems.

To address this crisis, a major scale-up of financing is needed through coordinated public and private investments. Solutions must extend beyond the health sector, integrating cross-sectoral funding and moving past the "zero-sum game" mindset that limits global progress. Greater resource mobilization and additional financing are critical to safeguarding both people and the planet.

The team at SEEK is proud to have developed and contributed to Resourcing Climate and Health Priorities: A Mapping of International Finance Flows from 2018–2022, alongside adelphi, the Rockefeller Foundation, Foundation S, and Reaching the Last Mile. This report provides the most comprehensive analysis to date on self-reported financing for climate and health, and establishes a baseline understanding from which countries, funders, implementers, and advocates can work to strengthen climate and health financing.

This Donor Tracker Insight provides an overview of the report, summarizing its key findings and recommendations, as well as their implications for the climate-health nexus.

Key findings

Data on climate and health financing commitments are self-reported and often use different definitions of what constitutes climate and health funding. This lack of standardization makes it difficult to determine whether commitments represent new financing or simply a reclassification of existing projects, and compare financial flows across funders and sectors due to inconsistent methodologies.

To enable the quantification and tracking of funding, the report defines climate and health finance primarily as international concessional financing commitments that:

• Address the direct health impacts of climate change;
• Support the health sector in adapting to and mitigating climate change; and
• Generate health co-benefits from climate action.

This definition builds on existing frameworks, including the WHO’s 2023 Operational Framework for Building Climate Resilient and Low Carbon Health Systems and the COP28 Guiding Principles for Financing Climate and Health Solutions.

Significant growth in climate and health financing from bilateral donors

Recognition of the climate-health connection is growing among political leaders, health decision-makers, and funders. In 2024, the WHO adopted a resolution on climate and health at the 77^th WHA and made climate response a strategic priority in its 2025–2028 work plan.

Health is also gaining prominence as a topic within climate discussions. Since COP26, 50 countries have committed to climate-resilient health systems through WHO’s ATACH initiative. COP27 launched the Initiative on Climate Action and Nutrition, while COP28 introduced the first Health Day, Climate and Health Ministerial, and the COP28 UAE Declaration on Climate and Health, now endorsed by 150+ countries. COP29 established the Baku COP Presidencies Continuity Coalition to sustain action. Climate and health have also been prioritized by the Indian and Brazilian G20 Presidencies.

Political momentum in climate and health is increasingly backed by concrete financial commitments. At COP28, over 50 partners, including 20+ financing organizations, endorsed the aforementioned Guiding Principles, helping shape US$1 billion in funding from 16 organizations to support climate and health initiatives in the most affected regions.

Accordingly, financing for climate and health increased tenfold from 2018 to 2022. Funders reported committing US$7.1 billion in climate and health finance in 2022, a dramatic increase from less than US$1 billion in 2018. This reflects the growing prioritization of climate and health among leading financial partners.

In 2022, commitments included:

• US$4.8 billion from bilateral donors;
• US$600 million from four MDBs;
• US$1.5 billion from two multilateral health funds;
• US$130 million from philanthropies; and
• US$23 million from multiple climate multilateral funds.

Importantly, bilateral donors are increasingly investing in climate-relevant health projects. The share of climate finance targeting the health sector increased from 1% in 2018 to 9% in 2022—one of the few sectors, alongside education, to see growth from bilaterals.

Tendency towards funding with loans

Much of available funding is provided in the form of loans, which has long-term fiscal consequences for recipient countries. Grants fund development without adding debt, enabling sustainable growth in low-income countries. MDB loans vary widely in their level of concessionality, and not all loans will have the same debt impacts. Depending on their concessionality, loans can strain finances and limit future investment in recipient countries. When a large share of climate or health financing comes as non-concessional loans, recipient countries face difficult trade-offs between investing in urgent needs and maintaining fiscal stability.

Depending on the source of the funding, the percentage of funding available as grants vs. loans varies, with only about a quarter of bilateral donors’ climate and health funding being loan-based, in contrast to over 90% of total climate and health financing from the ADB and IADB consisting of loans. The growth of bilateral donors in the climate and health space is encouraging in this regard, considering the tendency towards grants from bilateral donors rather than loans.

Untapped potential for health benefits and key recipients

Beyond the US$7.1 billion directly supporting health sector climate action, funders committed an average of US$13.5 billion annually for activities in other sectors that could indirectly improve health outcomes. One example of cross-sectoral relevance between climate and health are the effects of air pollution, which has been shown to not only affect respiratory health of populations, but also contribute to the health effects of stunting and wasting in children.

Despite the untapped potential for knock-on benefits, climate financing is not adequately reaching the most impacted countries. Less than 35% of bilateral donor finance is directly channeled to recipient countries; and less than 50% of total funding analyzed under the report flows to LICs, despite their disproportionate vulnerability to climate-related health risks.

Recommendations

To effectively prevent and respond to climate-related health crises, urgent action is needed in five key areas:

Increase Funding for Climate and Health

Scaling up financing for climate and health is both necessary and feasible. Additional financing is essential—climate and health action must not divert resources from other critical climate and health needs. New and existing funders must increase investments aligned with their mandates and priorities, as expanding the evidence base on health impacts of climate change and the return on investment for interventions can help drive more strategic funding decisions.

Align Investment Priorities and Frameworks

A shared understanding of high-impact climate and health interventions is needed across sectors. Understanding vulnerabilities to climate shocks will help prioritize and coordinate resource allocation effectively. Coordination between climate, health, and development finance institutions will enhance progress toward global health and climate goals.

Accelerate Delivery and Improve Access to Funding

Funders must simplify application and approval processes for accessing climate and health finance, and countries should strengthen their funding pipelines to absorb and utilize large-scale investments. Clear, publicly available information on investment priorities, volumes, and key performance indicators will help streamline access.

Channel Funding to Country Priorities

As countries refine their NDCs and NAPs, funders must align investments to maximize impact. Emphasis should be placed on scaling up grant-based finance rather than loans, which exacerbate debt burdens for LICs.

Standardize Definitions and Improve Transparency

Funders and regulatory bodies must develop a consistent taxonomy for reporting climate and health financing. Transparent reporting will enhance accountability and enable tracking of financial flows against actual needs.

Conclusion

The climate crisis is an urgent and existential threat, but well-funded climate action offers a chance to fundamentally transform global health and economic systems. Since COP26, both countries and funders have boosted their commitments to the climate-health connection. Health is set to play a larger role in updated NDCs and the Global Goal on Adaptation, while funding organizations are aligning mandates, investment frameworks, and co-financing strategies.

These efforts demonstrate growing momentum in the climate and health space, but it is crucial for these commitments to result in accessible and impactful financing for the most vulnerable countries and communities. Read the full report, Resourcing Climate and Health Priorities: A Mapping of International Finance Flows from 2018–2022, for more.