Last week, over 40 000 delegates – including world leaders, United Nations (UN) officials, climate experts, journalists, representatives from non-governmental organisations and youth advocates – have gathered at the 29th Conference of the Parties to the UN Framework Convention on Climate Change (COP29) in Baku, Azerbaijan.
Together, they are evaluating progress and tackling urgent climate challenges projected to cause 14.5 million additional deaths and US$1.1 trillion in extra costs to health-care systems. With a strong focus on climate finance, COP29, known as the “Finance COP”, aims to secure greater financial commitments – including in global health – to aid communities at risk from vulnerabilities.
The World Health Organisation (WHO) Regional Director for the Western Pacific, Dr Saia Ma’u Piukala, and other high-level UN and government officials are at COP29 calling for financial commitments and urgent actions to improve health facilities’ resilience to climate change. The WHO Western Pacific Region includes 37 countries and areas, including large Asian countries and small Pacific islands that are particularly vulnerable to climate change.
Across the Western Pacific Region, rising sea levels, extreme weather events and environmental degradation pose serious risks to health infrastructure and community well-being. The toll of climate inaction is striking – an estimated 3.5 million lives are lost each year to environmental causes in the Western Pacific region alone.
Health facilities across the Western Pacific region – especially in low-lying Pacific communities scattered across more than 10 000 islands including Kiribati, Marshall Islands and Tuvalu – face health risks from rising seas and increasingly frequent extreme weather events such as tropical cyclones. A recent study of hospitals in 14 Pacific Island countries found that 62 percent are located within 500 metres of the coast or a river, leaving them vulnerable to inundation. According to a recent UN report, sea levels in the Pacific are projected to rise to levels 10–30 percent higher than the global average. In addition to coastal flooding, rising sea levels also threaten food security and population mental health.
“Investing in climate-resilient health facilities is not a luxury. It is a lifeline,” Dr Piukala warned. “We urgently need accessible and equitable climate-health financing for the Pacific. Current funding is simply insufficient to meet the unique needs of these Small Island Developing States. I am here at COP29 to help change that.”
Dr Piukala delivered the keynote speech in a side event at COP29’s Moana Blue Pacific Pavilion.
He presented the recently endorsed five-year regional vision for WHO’s work with governments and partners, Weaving Health for Families, Communities and Societies in the Western Pacific Region. It prioritizes climate-resilient health systems, focusing on the capacity to anticipate, prepare for and respond to climate-related health risks while embracing sustainable practices and green technologies.
This approach goes beyond physical infrastructure; it involves strengthening early warning systems for infectious disease outbreaks, selecting technology best suited to local contexts, and ensuring health services remain accessible and functioning during all phases of emergencies.
Dr Piukala explained that “the vision draws inspiration from the tradition of weaving − a shared practice across the Region. “Just as individual strands are woven together to create a mat that is strong and resilient, our collective determination and actions can build a health system that is strong enough to withstand the challenges climate change throws at us,” he said.
During the event, Dr Piukala was also joined by regional partners including Sefanaia Nawadra, Director General of the South Pacific Regional Environment Programme (SPREP); Karen Mapasua, Director of the Land Resources at the Pacific Community (SPC); as well as Pacific ministers and youth champions. Together they discussed the Region’s climate vulnerabilities and the importance of youth-led actions for a sustainable future.
“No one will invite you into the climate change space, it is our common space. Health Ministers and leaders need to guide us in what health and climate means for the Pacific,” said Nawadra.
In her concluding remarks, Mapasua said: “What this really takes is partnerships and critical relationships to ensure that the weave on our mat is tight.”
Throughout COP29, the WHO Western Pacific Region delegation headed by Dr Piukala will lead and take part in key discussions focused on enhancing climate resilience in urban areas and islands with particular vulnerabilities.
Highlights include sessions on “Climate Resilience in Cities” and “Building Climate-Resilient Health Systems in Small Island Developing States (SIDS)” on 16 November, which will address strategies for adapting to extreme weather, sea-level rise and other climate impacts, along with strengthening health systems on remote islands.
On 18 November, a session on “Building Resilience to Heat Extremes in Urban Settings” will focus on heat-related health risks. It will be followed by a high-level roundtable to launch the Baku COP Presidencies Continuity Coalition for Climate and Health and introduce the Baku guiding principles on human development for climate resilience.
On 19 November, Dr Piukala will participate in a full-day session on the Alliance for Transformative Action on Climate and Health (ATACH), which is currently uniting 85 countries to advance climate-resilient health systems globally.
