As COP30 begins on Monday (November 10, 2025) in Belém, Brazil, a new international report from adelphi, Europe-based independent think‑and‑do tank, has spotlighted a critical gap in global climate funding. The report warns that the world is critically under-investing in health systems needed to withstand climate impacts.  

Despite growing consensus that climate and health financing are inseparable, the report titled, ‘The Nexus of Adaptation and Health Finance: Mapping multilateral climate funds’ investments and national needs’, reveals that just 0.5% of all multilateral climate funding, approximately U.S. $173 million since 2004, has been allocated to support health systems in vulnerable countries. This is in marked contrast to the U.S. $2.54 billion in health adaptation needs identified by National Adaptation Plans (NAPs).  

The report finds that countries vulnerable to climate impacts are already facing mounting health threats, from heat and deadly diseases to collapsing health and infrastructure. Despite this, and despite improvements in recent years, multilateral funding continues to overlook health needs caused by climate impacts.  

Mathilde Wilkens, co-author of the report, said, “The climate crisis and its impact on human health are severe and life-threatening. It is already impacting health, especially in Sub-Saharan Africa and South Asia. Linking multilateral climate funds’ investments with countries’ national needs and priorities in the health sector as well as prioritizing investments in vulnerable countries is key for leveraging change towards resilient health systems.” 

adelphi’s analysis underscores that while an overwhelming 87% of the 67 NAPs submitted to the UNFCCC include health objectives, and 39% specify dedicated health budgets, less than 0.1% of these requirements have been financed.  

Countries across the world have recognised the importance of addressing the health and climate nexus, and states such as Nepal and Bangladesh have demonstrated strong planning for climate-resilient healthcare. Without new investment, however, implementation will stall.  

Md. Shamsuddoha, chief executive at the Center for Participatory Research and Development-CPRD, Bangladesh, said, “As one of the world’s most climate-vulnerable countries, Bangladesh faces escalating health threats from climate change, from infectious diseases to heat stress and mental health impacts, which threaten the wellbeing of million.” 

Mr. Shamsuddoha added, “In order to safeguard communities and advance our National Adaptation Plan goals in regards to public health, it is necessary to scale up multilateral climate funds for Bangladesh’s health sector, as well as bolster integrated risk analysis and reporting. Strengthening climate-resilient health systems and early warning capacities will be key to protecting lives and driving resilient development.” 

The report focuses exclusively on projects supported by multilateral climate funds, noting that it excludes bilateral or private sector contributions. Its regional breakdown paints a troubling picture, although the Green Climate Fund provides more than 70% of the health-adaptation funding, two-thirds of those investments flow to East Asia and the Pacific, one-quarter to Sub‑Saharan Africa, and not a single country, specific health adaptation project has been supported in South Asia. This is despite the region being projected to bear an estimated 18% of future climate-related health impacts. Fragile and conflict-affected states, where health systems are most at risk, have received merely 4% of adaptation finance.  

COP30, now being hailed as the “Adaptation COP”, runs from November 10 to 22, during which the Brazilian presidency is expected to launch the Belém Health Action Plan, intended to place health at the center of adaptation negotiations.  

The adelphi report urges negotiators to take advantage of this platform and ensure health systems receive targeted, grant-based support that does not exacerbate debt burdens. It calls for full alignment of climate and health investment priorities, the foundation for stronger and more targeted national adaptation planning. The experts have recommended improved access to international finance for all relevant stakeholders, increased grant-based finance that does not worsen the debt spiral for developing countries, stronger cross-sectoral and cross-organizational collaboration on the health and climate nexus and finalization of ambitious indicators for the Global Goal on Adaptation at COP30, for both health and means of implementation.