According to WHO estimates, climate change that has occurred since the 1970s already causes over 140,000 deaths per year¹. When measuring the health impacts caused by climate change, one need to understand how the main environmental determinants of health (i.e. air, water, food and shelter) are affected by climate change.

This is linked to the fact that some of the major killers, such as under-nutrition, diarrheal diseases linked to poor water quality, indoor air pollution, and malaria, are very sensitive to weather and climate. Even minor changes in weather conditions may therefore be translated in changes in incidence rates, either positively or negatively. Available literature shows that weather and climate have differential effects on women and men, and on boys and girls, and that these differences are shaped by social determinants such as gender norms, roles and relations².

While adverse health effects of climate variability and change will be felt by all countries and populations, the most vulnerable are living in countries where the health systems are least prepared to respond to the risks posed by climate variability and change. This fact highlights the importance of equity, not only between but also within countries, to understand vulnerability and therefore design adaptation and mitigation responses that consider and respond to the different needs and capabilities of the people at stake.

While it is true that gender roles often serve to make women particularly vulnerability to some health risks, this is not always the case. For example, there is evidence from some countries that the rate of suicides in the aftermath of droughts is particularly high among male rural farmers. This may be due to the psychological effects of men being unable to fulfill their traditional role in providing economically for the household³>. Initiatives to build health resilience to extreme weather events should therefore pay particular attention to mental health in this population group.

To understand vulnerability, it is necessary to understand how gender influences the patterns of exposure to the various health risks and also the access to, and control over, resources needed to overcome existing vulnerability. If we consider air quality as an example of environmental determinant of health, effective actions to protect the health of exposed population will have to be informed by an assessment of the different tasks performed by women and men, and boys and girls within and outside the household. In the case of indoor air pollution, which causes approximately two million deaths per year⁴, because women are generally the ones responsible for domestic tasks such as cooking, they and the children they are taking care of, will be more likely to be exposed to harmful pollutants from cooking and heating with solid fuels. Awareness of these differential roles and effects can bring more effective interventions. For example, programmes to provide cleaner household energy need to focus on women as the main consumers – and if they are well designed, can simultaneously mitigate climate change, reduce deaths in children and women, and promote equitable and sustainable development.

Recognizing that the main impacts of climate change will be suffered mostly by those who are more vulnerable and have least capacity to adapt, and that women and men, and girls and boys have different patterns of exposure to health risks, WHO promotes the consideration of gender and other social factors as key determinants of health vulnerability to climate variability and change. In order to support countries to design more effective and equitable programmes, WHO has developed a user guide targeting programme managers already working on health adaptation to climate change programmes. The guide provides practical information and concrete guidance to mainstream gender through all phases of the project cycle, namely identification, formulation and design, implementation and monitoring and evaluation, with a special emphasis on how to conduct a gender-sensitive health vulnerability and adaptation assessment⁵. The user guide on mainstreaming gender in health adaptation to climate change programmes was launched at the last session of the Conference of the Parties (COP) to the UNFCCC in December 2012, in Doha, Qatar. One of the key recommendations highlighted is to collect and report health data disaggregated by sex, to ensure that a gender analysis of health impacts can be conducted. Availability and accessibility of data disaggregated by sex and other social stratifiers, such as age, place of residence and economic status, continues to be a challenge in developing countries. More comprehensive health surveillance is therefore an important contribution to building health resilience to climate change.

Although it is widely accepted that health is one of the most climate-sensitive sector, this is surprisingly not yet reflected in current adaptation funding allocation. The lack of additional financial resources to strengthen the capacity of the health systems to protect the health of the population, and to build resilience to climate change, leaves many countries in the situation of reacting to health impacts, rather than designing effective adaptation interventions informed by iterative, comprehensive and gender sensitive assessments. This reactive approach will likely increase health inequalities and increase the loss and damage from climate change.

As a member of the Global Gender and Climate Alliance (GGCA), WHO is working to ensure that gender considerations are properly reflected in the current climate processes, sustainable development agenda and related funding streams. Gender and health need to be put at the center of any climate response as they are among the main drivers for transformational change and prerequisites for sustainable development.