Building resilient and transformative health systems becomes the next frontier of climate action in South and Southeast Asia – United Nations University

Across South and Southeast Asia, climate extremes are colliding with existing weaknesses in health systems, pushing hospitals and clinics beyond capacity. Intensifying heatwaves, floods, cyclones, and droughts are driving spikes in:

• vector-borne diseases (e.g., dengue, malaria),
• water-borne diseases (e.g., cholera, diarrhoeal illness), and
• heat-related illnesses,

while at the same time disrupting supply chains for essential medicines, vaccines and other critical supplies. In low-lying urban settlements and remote rural areas, already overburdened facilities must manage concurrent outbreaks of dengue, cholera and respiratory infections that often follow extreme weather events. This diversion of limited staff, beds and budgets away from routine services-such as maternal and child health care, immunisation campaigns, and management of non-communicable diseases-risks reversing years of progress in health outcomes.

From megacities like Jakarta and Dhaka to smaller coastal and delta towns, the physical backbone of health care is also increasingly fragile. Health facilities, power systems and digital networks are repeatedly damaged or disabled by climate-driven disasters. Unplanned and rapid urbanisation, chronic underinvestment in resilient infrastructure, and fragmented governance structures all heighten vulnerability. As a result, frontline workers are frequently forced to operate in unsafe buildings or with unreliable electricity and communications, creating highly uneven protection across populations and leaving the poorest communities most exposed.

Key emerging stress points include:

• Rising disease burdens as shifting rainfall and temperature patterns expand habitats for vectors and contaminate water sources.
• Service disruptions when floods, storms and prolonged heatwaves cut off access to facilities or force temporary closures.
• Power outages that compromise cold chains for vaccines, disrupt surgical services and shut down intensive care units.
• Damage to facilities in coastal, deltaic and riverine regions where storms, sea-level rise and erosion are most severe.
• Digital system failures that interrupt disease surveillance, early warning systems and access to electronic medical records.

These challenges play out differently across countries:

The Philippines, in particular, faces repeated typhoon strikes that damage hospitals, interrupt power and water supply, and overload emergency and referral systems.

Together, these dynamics underscore the need for climate-resilient health systems that can withstand shocks, maintain core services and protect vulnerable communities as climate risks intensify.

Governments urged to mainstream climate resilience into health planning financing and cross border cooperation

Regional policymakers are increasingly calling for climate risks to be treated as a core public health concern rather than an environmental add-on, with ministries of finance, environment and health pressed to align strategies, budgets and data systems. Emerging policy blueprints propose that national health plans be stress-tested against projected heat extremes, air pollution and disease-vector shifts, and that public expenditure frameworks include dedicated budget lines for climate-proofing hospitals, cold chains and surveillance networks. In parallel, experts urge the integration of climate indicators into universal health coverage schemes, so that insurance packages, benefit designs and social protection measures can buffer vulnerable communities from climate-related illness and income shocks.

Cross-border collaboration is also gaining momentum as climate-linked health threats, such as dengue, malaria and smoke haze, increasingly ignore political boundaries. Governments in South and Southeast Asia are being encouraged to operationalize regional early-warning systems, harmonize disease reporting protocols and develop joint stockpiles of essential medicines for climate emergencies. Priority areas under discussion include:

• Shared surveillance platforms for real-time tracking of climate-sensitive diseases.
• Mutual aid agreements to rapidly deploy medical teams during floods, storms and wildfires.
• Co-financed research on heat stress, air quality and nutrition impacts across borders.

Insights and Conclusions

As the realities of climate change deepen across South and Southeast Asia, the call from researchers is clear: health systems can no longer be treated as passive responders to crises, but must be actively re-engineered to withstand and adapt to a warming world.

The findings from the United Nations University underscore that this shift will demand more than incremental reforms. It will require sustained political will, cross-border collaboration, and investment on a scale that matches the risks at hand-from intensifying heatwaves and floods to emerging disease patterns and food insecurity.

Whether governments and institutions rise to this challenge may determine not only how well the region weathers the next major climate shock, but also whether its most vulnerable communities are protected or left behind. In making health systems a central pillar of climate action, South and Southeast Asia have an opportunity to redefine resilience-not just as survival, but as the foundation for more equitable and sustainable futures.