You can access the slides from Paul’s presentation here.
We encourage you to join the conversation at @CentreHealthSec. You can also follow Save the Children’s work on Twitter at @SaveChildrenAus and LinkedIn.
You can access the slides from Paul’s presentation here.
We encourage you to join the conversation at @CentreHealthSec. You can also follow Save the Children’s work on Twitter at @SaveChildrenAus and LinkedIn.
Please note: We provide transcripts for information purposes only. Anyone accessing our transcripts undertake responsibility for assessing the relevance and accuracy of the content. Before using the material contained in a transcript, the permission of the relevant presenter should be obtained.
The views presented in this podcast are the views of the host and guests. They do not necessarily represent the views or the official position of the Australian Government.
Dr Stephanie Williams 00:01
Welcome to Contain This. I'm Dr Stephanie Williams, Australia's Ambassador for Regional Health Security. I'd like to acknowledge the traditional owners and custodians of country throughout Australia and our region. We recognise the continuing connection to land, waters, and community and pay our respects to Elders past, present, and emerging. Here at the Global Health Division at the Department of Foreign Affairs and Trade, we launched a new learning series this year. And I'm pleased to bring you the second of two insights from our latest seminar on climate change, health, and international development. Our first climate and health episode featured Professor Kathryn Bowen from the University of Melbourne. You can catch up with that in our feed. Today, we will hear from Paul Mitchell, the Principal Climate Change Adviser for the international NGO, Save the Children. He will illustrate the financing and implementation challenges with examples from across his organisation's emerging climate project portfolio. Paul slides will be available in the show notes. Enjoy the presentation.
Paul Mitchell 01:03
Hi, I'm Paul Mitchell. I work for Save the Children. So I have the enviable role of leading Save the Children's climate work globally, particularly our engagement with global climate finance mechanisms. I'm gonna talk a little bit about what we're doing in this space and give you a couple of examples. One at either end of the scale. So one at the micro side of integration, and one of the macro side of grabbing hold of some of this amorphous two percent of climate finance and dragging into doing really interesting health stuff in various places.
But I guess first of all, some people have often asked why Save the Children would engage on the issue of climate change. Like we work in health work, in education, child protection, humanitarian response, but why climate change. So half of the world's children live in places that are already climate vulnerability hotspots, nd that will only grow as an overall number and as a percentage of the world's children as climate change impacts intensify over time. That graph that Kathryn showed earlier, that graph is really an infographic that has been shown earlier came from a piece of research, at least in part that was done by the University of Brussels, in collaborating with Save the Children. And off the back of that we released an advocacy report called Born into the Climate Crisis. And what we looked at was the difference in lifetime exposure, the number of events, that a child born in 2020 would experience versus the grandparent born in, say, 1960. And it is incredibly stark. These are the global averages you can see up there. So double the amount of wildfires on average, globally, right up to seven times the number of heat waves. So not just seven heat waves but seven times however many their grandparents may have had. And when you get to the country level it's even more stark. In a place like Afghanistan, it's like 15 times the number of heat waves that their grandparents would have experienced in their lifetimes. So it's really stark. And so when people say why Save the Children and climate change, I say what else would we do? Like there is nothing else that we would do, we cannot achieve a world that is safe for children if we do not address the impacts of climate change.
So we have a global strategy on climate change. There are kind of four things that we do institutionally as an organisation, in case you haven't heard of us. We've been around for, like 110 years. So we've been doing this stuff for a while. But health, education, effectively child protection, and then this amorphous kind of safety net, resilient families thing, which looks at social protection measures, which have a health impact obviously, and a range of other issues. And then of course, humanitarian support, which kind of sits over the side. And the strategy helps to guide our investments as an institution into various components of the sectors and where we can kind of gain the most impact from a climate perspective. The phrase being bandied around most today has been systems approach, right? Kathryn talked about it, talked about it from Abt, everyone's been talking about a system approach, it's really critically important. And I was going to say before everybody else did say Save the Children takes a system approach, because of course we do, right? But it's really complicated when taking a systems approach. And when we talk about climate finance, which I will in a little bit, it's really hard for climate finance, to take a systems approach. It's really good at directing money at a very specific problem to fix. It's really bad at directing money to a systemic problem.
I wanted to give you two examples of the kinds of stuff that we're doing. The first one is in PNG, and this is part of the ANCP program, the Australian NGO cooperation program, which is a flexible funding mechanism that the Australian program provides to NGOs that are Australian based and ACFID accredited to do stuff that is aligned in some way with the overall country strategies. So in PNG, we have a health program. And this is doing a range of different things, health outreach, vaccinations, etc, etc. But one thing it is doing is helping the health centers in remote and rural areas become more resilient to the impacts of climate change. And in fact, actually, just to do what they should be doing anyway, by increasing their access to energy. Now, you all know PNG to varying degrees. You know that there is no way on earth, the entire country will ever be grid connected, it just isn't going to be possible. The amount of money you would spend doing it and the amount of disruption and environmental destruction you would cause doing, it isn't really worth the benefits of doing it, particularly when we can leapfrog the old technologies and we can have distributed off grid systems. So this program worked in 32 rural health centers, and it provided them with solar panels, and generators, and battery systems. And so what that has enabled is immunisation services, which previously couldn't be delivered because there was no cold chain, no refrigeration available, right? Well, no reliable refrigeration, and 24 hour services, because your panels, charge your battery, your battery runs your light at night. So now, if a woman is, inconveniently, giving birth after dark, that can be provided at the local health center. Right? Whereas before, I don't know what you did, but you couldn't do it. So you just cross your legs and hope, I don't know, right? But there's a significant impact on people's lives right there.
There were the lessons that we've learned through the implementation of this project. It's really important to take a local scale level assessment, right? So we can't just say, okay, all of these 33 health centers will get 15 solar panels and a battery to size. What if the roof isn't big enough to fit 15 Solar panels, right? What if it's not strong enough? Do we have to ground mount them? Where do we put them? Where can the batteries go? If that's a safe place that it's not exposed to the elements, if it's that kind of battery? So making sure that technology is fit for purpose, to the location, and not just to PNG but each individual health center is critically important. Making sure that we're bringing along officials with us. Officials, and I would add here, and communities, because if you don't know what's going on, and you have no ownership of it, right? So solar panels are pretty robust, they don't need a lot of maintenance, but they do need a little bit. If it's a drought, and it's dusty, then the solar panels aren't going to produce as much energy as they would if they were clean. If it's raining as it is normally, then that's fine. But otherwise, you might need to clean them and have an operations and maintenance regime. Same thing with the batteries, someone needs to be around and understand what's going on in order to make sure that you don't end up with broken solar panels being used as coffee tables or something like that, right. It's great recycling, but not very helpful for the purpose of our design. Making sure that you can get what you need to the place where it needs to be in the time that it needs to be there. And factoring the cost plus plus plus into that is really important. And then working with the program donors to make sure they understand that yes, it's not the same costs, putting a solar panel on a clinic near Port Moresby, versus putting a solar panel on a clinic in East Bouganville, right? Like it's completely different costs. And you need to kind of understand that from the donor perspective, and we need to be able to explain that as a program. Okay, so that's that one. That's the microscale.
At the other end of the scale, Save the Children is accredited to an institution called the Green Climate Fund, which is the world's largest climate finance mechanism. It's the financing arm of the Paris Agreement, which I assume most of you have heard of. It's a big, complicated, multilateral mechanism. Now health is an issue that the Green Climate Fund is interested in. It has been in operation since 2016. It has not funded a single health focused project in that entire time. It's not contributing to the 2% that Kathryn mentioned of global climate finance that is focused on health - zero, zilch. So one of the things that we are trying to do as a as an entity is bring forward health focused projects. And it's more challenging than you might think. Because it's not straightforward. Funds, like the Green Climate Fund, and other global climate finance mechanisms like to see a really straight line. So it's getting hotter, there's a drought, crops are failing, let's do climate resilient crops. Okay, it's getting hotter, people are getting sick, so we do health system strengthening? I don't know, right? It looks like development. So it's much more difficult to argue that case.
So what we're doing, I'll give you example of Laos. We're building large scale climate and health projects across the region and beyond. So in Laos and in Indonesia, in Malawi and in Senegal. We are building off the back of some not-health focused work that we're implementing currently in Vanuatu. So right now we're implementing the world's largest locally led adaptation project that's ever been done anywhere, in Vanuatu, about a $35 million project. It will reach 50% of the rural and remote populations of Vanuatu. And it includes a lot of work around food security, and nutrition, but it's not a health-focused program. But it's a big investment in health.
So this one in Laos will be the first one that is, in fact, a health focused project. What it's doing, or what it will do really is four things. And they all make perfect sense. And if you took climate out of it, it would still all make perfect sense. So it's strengthening the governance of the health system, right. From a climate perspective, it's ensuring that health information systems and climate information systems and early warning systems talk to each other, which is a total no brainer, but it really isn't happening very well in many places at all. And it's something you would want to do anyway, even in a world without climate change, you kind of want to know if a flood is coming and the impacts it might have so that you can prep the health system to respond. It's then this kind of amorphous outcome wording really is around increasing the resilience of infrastructure in remote rural locations in Laos, to withstand the impacts of climate change. Now that's got a WASH focus, it's making sure that the health centers that are needed are protected from floods or from extreme rainfall, that they continue to operate in an effective and efficient manner during climate emergencies or climate-related extreme weather events. But also during other times where it may be a drought, right? So you want to make sure you've got sufficient water, so that climate responsiveness within infrastructure, and then things like procurement systems, making sure that they're also working in line with the climate. Can you get the things you need to the place, they need to be in the time that they need to be there when you've got the Mekong flooding, or you've got extreme rainfall or dam bursting, or whatever it might be. And then the last one, then is taking all of this stuff and working at a community level. So there's been some talk earlier around health NAPs or health national adaptation plans. And they're fantastic where they exist, but it doesn't mean anything at the community level.
So taking that right down to the community level and doing health adaptation planning, and then implementing or supporting the implementation of those plans. So that might mean mosquito nets, it might mean better WASH at the community level, it might mean enhanced early warning systems. Whatever it is, the project will then implement priority actions underneath that, and what it can't do, the community will have a prioritised actionable plan that it can take to the next NGO that wanders in or a government round of funding or whatever it might be. They can say, "you know what, this is what we really need to do”, and there can be action from there.
The last thing I wanted to talk about, were some of the barriers to doing this stuff. And then some potential solutions, and then a sneaky bit at the end where maybe DFAT can play a role. So one of the challenges with increasing the amount of climate in health and health and climate is that it's often not even on the agenda, right? Health is in there. It's a word on a page, but there's no real action on it within the resourcing frameworks that are available. And there's a variety of reasons for that. But it's often because it's not seen as a climate-related challenge, right? You know, there's a storm coming in is going to mess with your infrastructure. There's a climate challenge, but more mosquitoes in an area where maybe they weren't before or there weren't as many before, is that really climate change? Who knows? So, you know, there's some kind of issues there. When we do local level adaptation planning, as an organization and many other organisations faces health doesn't even come up. You can kind of predictably count without even going into a community, the kinds of things that are likely to come up in those consultations. And you need to be inclusive, and you need to be participatory, but we have to find a bit of a balance. Can we lead sometimes, because often people don't know what they don't know. Right? Who is it? Is it Rumsfeld? Sorry, I hate to say that word. The known unknowns and unknown unknowns. Things you don't even know are a problem might be the biggest problem you have. And so how do we bring that into planning sessions without forcing people into an area they might need to go in? So that's an issue.
And that kind of telegraphs into the next one, which is that often we're not speaking the same language, right? We have, you have, people have, theirs one there, they're amazing health expertise, right? We also have amazing climate expertise, we often don't have Kathryn’s, we don't have them both together. And we often don’t have them talking to each other. And it’s a really big challenge. I don’t have a good solution for that other than cloning.
So then climate finance, which we’re not really going to talk about, is really difficult to access, it took us three full years to bleed 26 million US dollars out of the Green Climate Fund for this project in Vanuatu, three years. Now in that time, how many significant cyclones have struck Vanuatu. And in fact, we're working in 29 area councils in Vanuatu with this project. It's a beautiful anecdote but is absolutely horrible. The twin cyclones happened just a few months ago, were a week after we launched the project, one of our staff drew a map of where the 29 area councils are, and the track of the two cyclones and they hit almost every single one of the area councils we are working in. We were working in them for a reason but if this project had been an implementation three years ago, those communities would necessarily have been much better positioned to cope with the impact of that cyclone. We can't change the cyclone, we can't stop the cyclone at this point. But we can do things that help us communities to be much better prepared, and to bounce back much more quickly, including from a health perspective. And that work hasn't been done because we're fighting at the global level to get some of this money to do this work.
Then the last one really is this whole, where do we even start thing, right? It's such a big issue. And it's hard. So what do you do? What you do is you strengthen your infrastructure because that's easy. Climate change is making the river flood more often or flood at a higher rate. So let's build the thing bigger, stronger, harder, faster. It's easy, you can pitch it, it's understandable. But it isn't addressing the systemic issues. And that's why health is so hard. Education is even worse. It's like less than 1% of global climate finance, but that's a whole another issue. Okay, so a few things that we can do. So somebody said that good adaptation is good development or something like that? And yes, sometimes it is but not always, but we can kind of go with that for now. But we have to acknowledge that a lot of what we want to do from a climate change perspective is actually what we need to do anyway. And that's where bilateral donors come in, because that's the stuff that climate finance won't touch. Because it's development, right? It's not adaptation. Kathryn was mentioning quite a lot, the IPCC report, the sixth assessment report. There's another really important that nugget in there that didn't come out of the presentation is that a key pathway to making health systems more resilient is universal access to primary health care. There is no climate finance mechanism in the world that's going to fund that, because that's a development issue. So it's a different bit of our messed up global funding system. So then, I think I've already covered the point around national policy doesn't equal local action.
You actually need to be there in communities on the ground to get this stuff working. Then the point all climate change projects should also be a heath project and vice versa. So our project in Vanuatu is a climate change project, but it will have really significant health impacts on those communities. We're not even counting it's not even in our M&E system but it's there and it's happening, it's really important, and vice versa. Adaptation projects have a really important impact on people's health. And there's that little adage, right that people who are healthier, wealthier, and better educated are inherently more adaptable to changing contexts, including climate change. So all of the work you're doing as an institution on health is actually increasing people's resilience to the impacts of climate change. So that's awesome. We just need to be doing it more intentionally. Because sometimes what we do might have unintended consequences that we're not aware of.
Dr Stephanie Williams 18:24
You've been listening to Paul Mitchell, Principal Climate Change Adviser for Save the Children. It was the second of two insights from our latest seminar on climate change, health, and international development. You can catch up with the episode featuring Professor Kathryn Bowen from the University of Melbourne on our feed. Join us again next fortnight for Contain This, produced by the Indo Pacific Centre for Health Security at the Australian Government's Department of Foreign Affairs and Trade.
Contain This is produced by the Indo Pacific Centre for Health Security. You can follow us on Twitter @centrehealthsec.