Pandemics and climate change: the impact on health systems and what measures to take to prepare

Climate adaptation and pandemic preparedness and response measures can help health systems respond to both climate and infectious threats. Second new McKinsey research, $7 billion to $25 billion in high-impact investments are needed to promote resilience against climate and infectious threats. Approximately 25% of these investments can directly contribute to strengthening theprimary healthcare in a broad sense, and is placed in the context of global health spending which reached 9,000 billion dollars in 2020.

The global context

More than three billion people live in highly vulnerable environments to climate change, with threats that could be direct, such as extreme heat, and indirect, such as the interruption of health services routinely during extreme weather events. An increase in the frequency and severity of infectious epidemics is also expected, with estimates suggesting that a COVID-19 pandemic-like event has an annual probability of 2-3% – meaning it could occur once every 33-50 years. The climate crisis, which could lead to an increase in epidemics and non-communicable diseases, also threatens to increase pressure on health systems. McKinsey has previously estimated that annual spending of around $35 billion over the next ten years could substantially reduce the likelihood of future pandemics.

the three objectives

McKinsey analysis identifies three main objectives to address threats related to climate risks and pandemics: prepare for health emergencies strengthening infrastructure primary healthcare, develop resilient primary healthcare in the face of climate risksprepare for emergencies health issues linked to or exacerbated by climate change. Investing with a view to creating synergies between these three objectives will create value for the future. The total financial gap estimated to address the issue of climate adaptation alone between 26 and 56 billion dollarswhile the similar figure for pandemic preparedness goes from 11 to 39 billion dollarswith an overlap between the two sectors of between $7 billion and $25 billion.

In McKinsey's analysis, about 25% of spending on pandemic preparedness and climate adaptation contributes directly to primary health care systems. This synergy translates into a significant public savings. In fact, for every $5 of additional funding invested in climate adaptation or pandemic preparedness, it is possible to achieve shared value of between $2.50 and $3.80 for two or more objectives.

Strengthen primary healthcare infrastructure

Synergistic benefits between pandemic preparedness efforts and those related to strengthening primary healthcare infrastructure may include improved levels of coordination and planning mechanisms. For example, investments in integrated data systems and national public health institutes can support nationally coordinated pandemic responses by better linking service delivery units at national, district and local levels. Another example represented by initiatives such as the creation of platforms for the development of antivirals, antibodies and vaccines; this type of synergy illustrated by the growth of vaccine portfolios for alliances such as Gaviwhose portfolio covers 19 infectious diseases (up from four in 2000), with the recent addition of malaria and oral cholera vaccines.

Develop resilient primary healthcare

Strengthening primary healthcare requires, at a minimum, building climate-resilient capacities in the provision of primary care services. This includes, for example, increasing the system's capacity to handle a surge in demand or promoting a supply chain more agile capable of managing climate-related challenges. Climate-resilient infrastructure and technologies can aid this effort, through the development of new technologies and products, for example
digital cures
and new vaccines, such as those for malaria or Lassa fever. At the same time, climate resilience capabilities can also improve the sustainability of healthcare operations, for example by ensuring cross-training of staff in case of emergencies.

Prepare for health emergencies related to or climate change

Health systems will need to focus on strengthening disease diagnosis, emergency preparedness and climate risk infrastructure. This may involve strengthening physical infrastructure to protect against flooding, mapping and the identification of zoonotic viral threats to reduce their risk and plan for potential increases in healthcare demand, such as an increase in emergency room visits following a heat wave. These goals can be further improved by designing strategies to identify and address known diseases exacerbated by climate change. There is further overlap between these activities through regular surveillance activities, which include procedures for notifiable diseases, integrated disease surveillance and response systems, and pathogen surveillance, including genomic sequencing.

Synergistic, high-impact investments

Building global stocks of vaccines, treatments and diagnostics can ensure adequate, timely and effective responses to epidemics. This includes risk areas such as some parts of Sahel Africa, Central Africa and East Africa, where the mortality rate due to climate risks could be 15 times higher than that of less vulnerable countries.
•The increased demand for treatment during the pandemic has led to an increase in the excessive and inappropriate use of antibiotics, which in turn has exacerbated the threat of antimicrobial resistance (AMR). McKinsey's analysis found that there are prevention activities related to antimicrobial resistance that could create value in multiple areas at once. By investing intelligently in all three objectives listed above, such activities could help contain AMR. They could also extend the effectiveness of antimicrobials, for example by strengthening quality, trade, distribution and sales.
•Specialized surveillance programs (e.g., sero-surveillance, genomic sequencing, wastewater surveillance, and vaccine efficacy studies) support achieving all three goals simultaneously. By using specialized surveillance programs, health systems can prepare sufficiently for future risks to respond more accurately and efficiently.

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