Climate change is a force multiplier that drives migration and exacerbates the spread of infectious diseases. Effective health diplomacy is required to address this complex climate-migration-disease nexus. The climate crisis increases the frequency of extreme weather events, such as droughts, wildfires, flooding, and tropical storms, which lead to more environmentally-driven conflicts and instability, driving migration. In 2024 alone, more than 45 million people were displaced due to environmental disasters, which is nearly double the average annual displacement that occurred over the last decade.
Climate migration can result in endemic infectious diseases becoming epidemic, increased environments for pathogens to interact via zoonoses, and potential spillover events into human populations. Over 50% of the currently identified infectious diseases will be aggravated by climate hazards. Additionally, climate-related events contribute to an increase in vector-borne, waterborne, and infectious diseases. As an example, Venezuelan migrants traveling through the Andes experience increased rates of infectious and vector-borne diseases from contaminated water due to flooding or drought. Other migrants’ movement through the Darién Gap in Central American has also caused high rates of respiratory and diarrhea cases, as well as increased spread of Yellow Fever in Panama from Colombia.
At the Alliance, our Pillars of Work embrace the intersectional approach necessary to address this triple threat nexus. In line with our focuses on One Health, Environmental & Climate Change, and Right to Health, we convened expert policy analysts and researchers to share their insights on this multifaceted issue.
The webinar opened with introductory remarks from Katherine Urbáez, Executive Director of the Health Diplomacy Alliance, as she set the stage for by highlighting health diplomacy’s role as a key, practical tool to coordinate at the multi-sectoral level to promote the shared solutions necessary to address this interlinking topic. She emphasized that health diplomacy is vital to facilitate the dialogue and cooperation among diverse actors, including governments, international organizations, civil society, and health services.
Diving into the field-specific experts, the event was moderated by Valerie Doze, Climate Health Intern at the Health Diplomacy Alliance. The discussion was started by Iulia Duca, Programme Officer in the Climate Action Division at the International Organization for Migration (IOM). She emphasized that climate, migration, and health are not isolated issues, but are rather deeply interconnected, influencing and amplifying each other. Thus, a comprehensive approach is necessary to respond in a coherent, inclusive, and cross-sectoral capacity, which IOM recognizes in their work. From drought in the Horn of Africa to floods in Pakistan, people are being uprooting from their homes.
Ms. Duca continued to explain that displacement today is often prolonged, occurring internally, and taking place in fragile contexts where health systems are already under threat. In these environments, the risk of infection, diseases, and outbreaks are amplified, and access to essential health services is negatively impacted. IOM witnesses first-hand how environmental impacts disrupt traditional migration routes, causing people to be pushed into overcrowded informal settlements. She explained how this overcrowding results in forced interactions with new ecological zones, increasing disease transmission risk. These displaced populations also suffer from limited or no access to primary health care, resulting in disrupted vaccinations, inadequate maternal and child care, and improper nutrition, water, and sanitation. Thus, a multi-sectoral approach is needed to address these compounding issues. Ms. Duca stressed the need to mobilize resources and actions through fostering partnerships across diplomacy, health, climate, and migration sectors to invest in more resilient systems that ensure people on the move are not left behind but rather protected, empowered, and included in every decision.
Bringing the infectious disease perspective, the next perspectives were offered by Dr. James Shepherd (MD PhD), a faculty physician in the Section of Infectious Disease, Department of Medicine of Yale University School of Medicine. Dr. Shepherd emphasized that environmental factors bring infectious disease hosts, such as humans, in contact with agents, which are infections. Health diplomacy focuses firstly on hosts, or the human aspect of contracting diseases. Having previously worked for the WHO as a tuberculosis (TB) and HIV specialist in South Asia, he helped with the Global Outbreak and Response Network during the COVID-19 pandemic. Based in a 1,000,000 population camp in Cox’s Bazar, Bangladesh, health diplomacy required them to work with IOM, UNHCR, MSF, Save the Children, Red Cross, Red Crescent, and the Bangladeshi government to assist these forcibly displaced Myanmar natives. He stressed the importance of international cooperation on these efforts, which has since been stymied by the massive shift in US domestic politics. Global health has benefited from the support from the UN, WHO, Gavi, and other large international efforts focused on infectious diseases and climate change. Therefore, he shared thoughts on the potential for organizations to become more collaborative amidst the funding cuts, evolving diplomatically into new ways of working together.
Dr. Shepherd continued to explain how humans in an environment are incredibly conducive to the transmission of infectious diseases, especially when almost no facilities and public health services are provided, which can result in another global pandemic. For instance, human movement from the countryside to unincorporated settlements on the edge of cities can change the complexion of infectious diseases. In Dharavi, a settlement in Mumbai, India, is a fertile place for infectious diseases, such as TB and now, COVID-19, to spread, due to the high population density and lack of sanitary public health facilities.
Bringing his climate-migration experience was Lawrence Huang, a policy analyst with the Migration Policy Institute’s International Program. Having worked on MPI’s Global Initiative on Climate Mobility, he spoke on displacement and migration related to climate and environmental shocks. Research consistently shows that climate change is rarely the sole factor determining people’s movement, but it is usually a threat multiplier of economic, social, political, or health related drivers of mobility. While not the main issue, environment and climate drivers are often hidden behind other factors driving human displacement, such as loss of livelihoods and homes. This intersection of massive disasters leads to internal and cross-boundary movement. Mr. Huang elaborated that climate change and health interact in these situations in terms of vulnerability to infectious diseases and other health shocks, especially as health services can decline during disasters and other climate shocks.
Mr. Huang emphasized the critical missing piece of the work, which is that migrants, refugees, and displaced people are often excluded from climate action, response, and programming. After losing their homes and moving into informal settlements, many migrants are often hit by floods, landslides, and other disasters because the settlements are located in areas without climate resilient infrastructure and systems. He stressed the importance of integrated holistic approaches to solve these compounding crises. As policymaking tends to be siloed, cross-sectoral collaboration is vital.
Our Alliance is committed to leveraging health diplomacy to support member states and relevant stakeholders to increase collaboration across health, migration, and climate policy. This event, by fostering conversations about the gaps in this triple threat nexus, and exploring solutions to address these issues, aligns with our work to build strengthen the global response to health challenges by promoting cross-sector coordination.
