Climate change, in the form of intensified droughts and floods, stronger and more frequent storms, extreme heat, and rising sea levels, challenges economic growth and development. Many countries, especially low and middle-income countries at greater risk from climate change, are developing plans for adapting to climate change in a variety of sectors, including health, agriculture, infrastructure, and transportation. To improve the effectiveness of climate resiliency and risk management, U.S. Agency for International Development (USAID), its mission offices, and its partners developed the Adaptation Thought Leadership and Assessments* (ATLAS) activity. ATLAS works with foreign governments, non-governmental organizations, and research institutions to prepare country-specific climate adaptation assessments to provide an evidence base for in-country action. ATLAS also aims to build capacity through tailored decision-making tools, in-country workshops, guidance on best practices, and support for data collection and knowledge management.
Climate change increases risks of diarrheal and infectious diseases, health consequences of air pollution, and food insecurity and malnutrition, all of which limit a country’s ability to achieve physical and mental health. “Climate variability and change has profound impacts on public health, and limits countries’ ability to achieve sustainable growth,” said Colin Quinn, Ph.D., climate integration lead for the USAID Africa Bureau. “We have to identify climate risks to public health and how to improve resilience in the public health sector to help already struggling countries achieve their cross-sectoral development goals.”
By recognizing climate change as a threat and integrating climate adaptation throughout the development process, countries are better equipped to achieve economic growth and safeguard public health. Focusing primarily in sub-Saharan Africa, ATLAS produces multi-lingual climate adaptation assessments and technical studies to evaluate adaptation options and determine best practices for addressing those risks posed by a changing climate. These tools help host-country decision makers and practitioners strengthen health systems and target specific health concerns and solutions.
Drawing from historical epidemiological and climate data in southern Africa, ATLAS conducted studies on temperature and precipitation changes in Botswana, Ethiopia, Madagascar, Malawi, Mozambique, and Senegal. Due to increased temperatures and sporadic rainfall, these extreme weather events are increasing the risk of undernutrition, malaria, and diarrheal diseases. ATLAS, with the expertise of researchers and partners, is generating reports and sharing findings with host countries, while building on research capacity as a way to increase resiliency and future planning of health systems.
In Malawi, one of the countries analyzed, a changing climate is influencing malaria transmission. According to the ATLAS report on climate and malaria incidences in Malawi, researchers are finding links among temperatures, rainfall, and incidences of malaria, suggesting future projections that higher temperatures will contribute to higher risks of seasonal transmission. The report details recommendations for meeting malaria elimination targets previously set by countries and development partners; adapting epidemiological approaches in surveilling and tracing the disease; and building on health services in areas of health worker trainings and research capacity.
The ATLAS activity in Ethiopia, which concludes in the coming months, suggests warmer temperatures are expanding the geographic range of mosquitoes that carry malaria and, therefore potentially increasing malaria transmission. Their work has inspired the development of an early warning detection system that uses real-time health and satellite weather data to protect and warn citizens of impending malaria risks.
“In the Highlands of Ethiopia, there used to be very few cases of malaria,” said Quinn. “Now, as temperatures are increasing, we are seeing more malaria in those areas, which is especially dangerous for those who do not have malaria immunity compared to people who live in the Lowlands. As more people are exposed, it is going to be a greater public health challenge with societal impacts that we and the Ethiopian government need to prepare for.”

The ATLAS Final Report was published in April 2020.
(Photo courtesy of USAID)
The culmination of these reports is reflected in the recently published ATLAS Final Report. The final report documents ATLAS’ last five years’ work to build capacity for climate adaptation in the health sector. This has included not only training of health care workers and improvements in the use of climate and health data; the report details efforts to directly increase funding for the health sector through global climate adaptation funds like the Green Climate Fund and the Global Environment Facility/Special Climate Change Fund. These findings should not only better prepare countries for climate shocks and stresses, but also help advance their self-reliance. Along with the health sector, the final report summarizes efforts within transportation, urban planning, and water management sectors.
The ATLAS activity formally comes to an end this year. “I hope we can continue this work,” said Quinn. “We are just in the infancy stage. Because there are so many climate-sensitive public health challenges, adapting to climate change in the public health sector can have huge benefits, maybe more so than any other sector.”
NIEHS Climate Adaptation Efforts
While USAID climate adaptation efforts have focused on building capacity and activities in specific countries the agency supports, NIEHS has been addressing climate adaptation through a broad range of funding efforts and collaborations. As one example, NIH has provided in-kind support to a Collaborative Research Action through the Belmont Forum, an international partnership that mobilizes funding of environmental change research. NIEHS, in collaboration with the National Oceanic and Atmospheric Administration, the National Science Foundation, and the U.S. Global Change Research Program, helped to lead the scoping of that research effort.
Separately, NIEHS and the Fogarty International Center are funding the development of collaborative research centers in low- and middle-income countries through the Global Environmental and Occupational Health (GEOHealth) program. These centers, or hubs, are furthering environmental and occupational health research, including climate change research, by building regional research capacity and enhancing data management, policy support, and training. Initial hubs include locations in sub-Saharan African countries Ethiopia, Gambia, Ghana, and Uganda. NIEHS hopes that capacity building efforts such as ATLAS and GeoHealth can help expand further funding opportunities to advance climate vulnerability research.
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Climate Change and Human Health Literature Portal
NIEHS is excited to announce the release of its updated Climate Change and Human Health Literature Portal as part of the Institute’s annual Global Environmental Health Day on July 1, 2020. This convenient knowledge management tool organizes a vast database of curated, global peer-reviewed research resources on climate change and human health. The Portal has been updated and expanded with new content and search and download features to help users across various disciplines, sectors, and knowledge levels to quickly access relevant literature for their needs and answer their questions about the human impacts of climate change.

The comprehensive database brings together biomedical and earth science literature, including more than 10,000 peer-reviewed articles, assessments, and scientific papers published between 2007 and 2019. Users have the opportunity to search by key terms or refine queries by using descriptive filters to generate results on specific exposures, health impacts, geographic locations and features, or other details. The Portal also includes papers covering special topics such as co-benefits of mitigation and adaptation and social justice within the context of climate change.
Search results are provided with abstracts, links to open-access or validated-source PDFs where available, and a resource description listing the curated tags and filters associated with the publication. Results can be saved and exported via a number of formats to facilitate user review, sharing via email and social media, and bibliometric analysis. Explore the Portal, and share your thoughts and feedback with the team.