The health systems research community – which coalesces around its professional society Health Systems Global (HSG) – holds a bi-annual conference. The next, in Nagasaki in 2024, will tackle the issues of how health systems can be sustained, justly, protecting both people and planet. A new PLOS Public Health blog from the HSG’s Thematic Working Group (TWG) on Climate Resilient and Sustainable Health Systems notes the importance of this recognition by the health policy and systems community of researchers and practitioners which has been slow to address the magnitude of climate challenges.

The agenda set out in the blog has critical resonance for Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre topics and researchers since the climate crisis has serious consequences for women and SRHR which have only recently begun to be documented and quantified, including groundbreaking work by MARCH members and partners on maternal health and heat. The TWG’s blog notes that many of the critical planetary thresholds identified by climate scientists have already been breached, with more expected, and that health systems – vital social institutions – will face the brunt of the human impacts of these planetary boundary breaches. The health sector as a whole has been slow to respond to the climate crisis, both in terms of mitigation, by greening of medical supply and delivery systems which have a very high carbon footprint, and adaptation – understanding how climate is affecting health and forecasting and planning to respond, whether that is through ensuring maternity wards can be kept cool in extreme heat or siting of hospitals outside flood plains.

However, the tide of recognition appears to be turning. Two years ago, at the 26^th Conference of Parties meeting of the United Nations Framework Convention on Climate Change (COP26) in Liverpool, there was a noticeable increase in the attention given to health issues – albeit small. This was retained at COP27 which saw further incremental gains for gender and health and this year COP28 will have an Inter-ministerial event with health ministers as well as a dedicated Health Day to start the COP. The health policy and systems community now appear to be engaging with issues of health systems adaptation and sustainability.

Now much more work is needed to connect climate, health systems and MARCH issues and to find innovative new ways to expand equitable access to services in the era of climate change. Global climate commitments, and the increase of non-health actors interested in the health-climate nexus, could open up tremendous opportunities for new partnerships – including some that MARCH staff and students have been involved with – and new funding sources to expand access to core sexual and reproductive health and rights (SRHR) services including with environmental protection and conservation groups, which we must be posed to pursue. MARCH researchers should also contribute to breaking down disciplinary siloes and contribute their rich understanding of health systems challenges – and how health systems need to be adapted to the challenges of climate change, to protect MARCH services.

We are in a critical period for MARCH issues, both nationally and globally. Now more than ever it is important for the MARCH Centre and its members to visibly connect MARCH Centre research and activities to these wider global concerns, to be at the forefront of research and action to protect maternal, adolescent, reproductive and child health and contribute to better understandings of how to build health systems resilience in this era of climate crisis.

Read the PLOS Public Health blog.