When we think about preparing communities for climate change, investment often centers on physical infrastructure, from stronger buildings and energy systems to flood protection. Less attention is paid to the local health worker called when a farmer collapses from heat exhaustion, or the rural clinic that recognises and treats climate-related illness before it becomes life-threatening.
Across Asia, climate change is increasingly a public health challenge. In China, more than 53,000 cases of heat-related illness across multiple study sites between 2013 and 2022. Each 1°C increase in average daily temperature was associated with a 21% increase in the relative risk of heat-related illness. The World Health Organization estimates that climate change could cause approximately 250,000 additional deaths globally each year between 2030 and 2050 from heat stress, malnutrition, malaria, and diarrhea alone.
As climate impacts intensify, philanthropy has an important role in strengthening the local health systems communities will increasingly rely on.
Rural Primary Care Is Part of the Climate Response
In many rural communities, the first point of care is a village clinic or local health worker. These institutions have deep community relationships and an understanding of local conditions that can take years to develop. Yet they may lack the climate-specific training and practical tools needed to respond to changing health risks.
Three Principles for the Next Generation of Climate-Ready Primary Care
A climate-health pilot underway in Guangdong and Shanghai is exploring how heat-related training, basic supplies, response protocols, and digital learning can be integrated into existing rural health services. The 12-month Climate & Health Rural Emergency Response Pilot brings together the Institute for Sustainable Communities’ climate resilience experience, Bayer Foundation’s support for health innovation, and Pica Health’s rural digital health network to test practical approaches to extreme heat preparedness and generate lessons that can inform climate-ready primary care more broadly.
The pilot builds on a digital health platform reaching approximately 3 million village doctors and 380,000 village clinics across China, creating an opportunity to explore how climate-health knowledge can travel through systems already operating at scale.
While the work is still underway, developing the model has highlighted several ideas that could shape climate-ready primary care across Asia.
- Prepare for Climate Risk Before It Becomes a Health Emergency
The response to extreme heat often begins after someone becomes sick. An analysis of the severe 2023 heatwaves across 420 counties in northern China found increased mortality and called for targeted early-warning systems and protective measures for people most at risk. Rural primary care creates an opportunity to intervene earlier.
Local health workers are well positioned to identify vulnerable people, communicate risks as extreme heat approaches, and encourage preventive action. Preparing them for climate-related illness can expand their role from treating its effects to helping communities recognise warning signs earlier.
For philanthropy, this creates an opportunity to strengthen the preventive role of primary care and test how local knowledge and timely information can help health systems act earlier.
- Treat Local Health Workers as a Source of Climate Intelligence
China is already moving towards more health-informed approaches to heat risk, but better climate intelligence also depends on what health workers see locally. Climate-health programmes often focus on transferring expertise from specialists to local practitioners. Yet knowledge also needs to travel in the other direction.
Village doctors and community health workers see how changing climate conditions affect people in real time. Their experience can reveal who is struggling, how illness presents locally, and where existing guidance falls short.
Stronger feedback loops between frontline practitioners and specialists can turn these observations into better guidance. Digital platforms can extend that exchange across wider networks, allowing experience from one community to inform practice elsewhere.
This turns local health workers into active contributors to climate-health knowledge, rather than simply recipients. For funders, this means recognising local health workers as contributors to climate-health knowledge and investing in systems that learn from their experience.
- Design for Continuous Learning, Not One-Time Training
Climate risk is changing too quickly for a single training course to prepare health workers for every situation they may encounter. Health workers need ongoing opportunities to learn from new cases, exchange experience with peers, and access specialist expertise. This is particularly important in rural areas where specialist knowledge can be difficult to access. Digital platforms can extend expertise, while local networks help practitioners apply it within their communities.
For philanthropy, the opportunity is to invest in systems that keep knowledge moving. Lessons from individual practitioners and communities can strengthen the wider network, allowing health systems to learn as climate risks evolve.
The Philanthropic opportunity at the intersection of Climate and Health
Climate-ready primary care requires health systems that can anticipate emerging risks and continually improve their response. Philanthropy is well positioned to help test these approaches while the field is still developing, giving practitioners flexibility to experiment and generate practical evidence about what works.
Philanthropy is particularly well positioned to help test these approaches while the field is still developing. Flexible funding can give practitioners room to experiment with new models of prevention and shared learning, while generating practical evidence about what works in different settings.
A climate-ready health system should do more than respond effectively when people become sick. It should help communities recognise risk earlier, learn continuously and act before climate hazards become health emergencies.
