The World Health Organization (WHO) calls climate change the greatest single risk to humanity. It is expected to cause an additional 14.5 million deaths and $1.1 trillion in healthcare costs by 2050.
Despite these impacts, health systems are not sufficiently equipped to prevent, mitigate, or respond to the range of risks associated with climate change. Almost all National Adaptation Plans (NAPs) identified climate-exacerbated health risks like water- and vector-borne diseases. However, less than half included even one adaptation measure to address these risks.
To help address this gap, the Brazilian Ministry of Health in collaboration with the WHO and the Alliance for Transformative Action on Climate and Health (ATACH) drafted the Belém Health Action Plan at the Fifth Global Conference on Climate and Health in July 2025. As outlined in this article, this plan is an important signal of health moving from the sidelines to a more streamlined part of COP30.
This article is part of our path to COP30 campaign. Our team and expert partners are sharing articles and research to deepen your understanding of the significance of this year’s UN climate conference. You can explore evidence-based analysis and policy insights as the world gathers in Belém, Brazil.
A closer look at the Belém Plan
The Belém Plan provides a tangible framework for governments to build climate-resilient health systems. It calls for adaptation through improved climate-informed surveillance and monitoring systems; evidence-based policy and capacity building; and the development and production of innovative, climate-resilient health technologies, and supply chains.
Importantly, the Belém Plan aligns with the WHO’s Global Action Plan on Climate Change and Health 2025-2028, which was approved earlier this year at the World Health Assembly. The plan calls for health to be integrated into national and international climate agendas.
The Belém Plan will be put forward for voluntary, non-binding adoption at COP30. If adopted, it will advance the WHO Plan, COP30 Action Agenda, and the Global Goal on Adaption. In fact, several proposed indicators for the Global Goal on Adaptation are designed to monitor implementation of the Belém Plan. However, the Belém Plan is also not the only avenue for addressing health. Some argue that the plan doesn’t address the co-benefits of mitigation nor ensure that health is a central consideration in mitigation efforts. For example, it doesn’t consider how interventions like increasing clean energy use affect air quality and respiratory conditions.
The 2025 report of the Lancet Countdown on health and climate change just published last month provides fresh data on the health co-benefits of mitigation and a just transition to clean energy. Another key concern is that it doesn’t do enough to secure climate finance for health. Notably, this finance gap is likely the biggest challenge facing its effective implementation.
The financial fallout of aid cuts
Earlier this year, there was a sudden and significant loss of development assistance from the United States. In 2023, the country was the largest donor to global health. Assistance for health declined 21 percent from 2024 to 2025, dropping from almost $50 billion to $39 billion.
While funding for health increased in response to the COVID-19 pandemic, this current decline is comparable to levels last seen fifteen years ago. Key global health institutions like the WHO now face budget shortfalls of between 15 and 20 percent. These cuts—alongside cuts from other key funders such as the UK, France, and Germany—could impede adaptation efforts.
Upper middle-income countries may be able to close some of the gap through increased domestic funding and new partnerships. However, low- and lower-middle income countries are unlikely to fill gaps.
These countries already spend 300 times less per capita on health than high-income countries. The current funding crisis underscores the importance of climate financing that addresses healthcare resilience.
The need for multisectoral collaboration
The Belém Plan has a narrower scope than the WHO Plan. Nevertheless, it provides sixty recommended actions for health systems. At a time of unprecedented resource constraints and competing priorities, the plan has the potential to overwhelm ministries of health.
The good news is that there are already several major initiatives underway to help countries prioritize the plan’s recommendations. For example, the WHO and World Meteorological Organization (WMO) are focused on informing health systems with meteorological data and forecasts. This joint program also provides evidence-informed resources and recommendations through the Global Heat Health Information Network.
The Belém Plan’s second action area prioritizes policy and capacity building. At COP30, multilateral development banks (MDBs) are in the spotlight. They are increasingly recognized for their role in strengthening national health systems and health coverage. During the COVID-19 pandemic, MDBs increased their financing for global health more than four-fold, from $2.6 billion to $11.1 billion
In addition, the Development Bank Working Group for Climate-Health Finance launched a Joint Roadmap last June. It recognizes the role of resilient health systems and aims to improve investment in plans that deliver meaningful health co-benefits. Similarly, the Green Climate Fund already supports countries’ climate and health vulnerability assessments. There is a clear need to invest in the health sector’s role in national adaptation plans.
The last action area focuses on innovation and digital health. The COVID-19 response accelerated the integration of digital technologies, such as telehealth and fin tech. Many healthcare and hospital systems in high-income countries rapidly reformed their supply chains and infrastructure to be more resilient. Now, these approaches can also prepare their systems for climate threats. With the right enabling environment and governance, public-private partnerships can accelerate change and new technologies could better address climate-related health risks among the most vulnerable populations.
What’s next?
The Belém Plan sends an important message: successful climate adaptation cannot be achieved without a focus on health systems. It is likely to garner support without facing much friction given its voluntary nature, focus on adaptation, and alignment with the WHO Plan. At the very minimum, its adoption should help better integrate ministries of health in national adaptation planning and implementation. At its best, it will drive funding commitments and multi-sectoral partnerships for health adaptation.
However, proponents of health recognize that the Belém Plan is just one milestone. The real test is in how health features in COP30 negotiations, particularly on mitigation and finance, and moving forward. Continued and improved investment in health is now more important than ever and finding synergies and opportunities to do more with climate finance will help deliver meaningful impact. COP30 should center leadership on health. Now, more than ever, collective efforts are necessary to protect health through mitigation, adaptation, and resilience in the face of climate change.