COP31: World leaders must urgently step up climate action to protect health

Geneva, 3 November 2026 - COP31 must put health at the centre of climate action, turning negotiations and declarations into concrete action for the world’s most affected communities, says Médecins Sans Frontières/Doctors Without Borders (MSF).

“Climate action must be urgently stepped up to reflect the scale of the emergency. The window of opportunity to avoid a potentially catastrophic future is rapidly closing,” says Dr Maria Guevara, MSF international medical secretary.

“The health and humanitarian impacts of climate change are real and they will grow as the world heats up. Every fraction of degree of warming is a matter of life or death for people in many places in the world,” says Dr Guevara. ​

At COP31, MSF is calling for ambitious action to cut greenhouse gas emissions and provide urgent support to enable the most affected countries to adapt and cope with the increasing health impacts. ​

Across MSF’s projects, teams are witnessing firsthand the health impacts of the climate crisis. For many communities, climate change is compounding existing vulnerabilities linked to poverty, displacement, conflict and limited access to healthcare.

In Somalia this year, people are experiencing a severe drought following four consecutive failed rainy seasons, which is triggering widespread displacement and malnutrition due to crop failures. In Baidoa displacement sites, almost half of children under age five screened by MSF were acutely malnourished in July this year.

“For us, climate change is not something in the future. It is already here,” says Yahya Mohamed, who is from Baidoa and is field communications officer for MSF in Somalia. ​

“We see it in the hospital, in children with malnutrition, and in families who lost everything to the drought and came to Baidoa with nothing. The people of Somalia did very little to cause it, but we are the ones living with the consequences. Decisions made at the COP31 needs to reach places like Baidoa.” ​

South Sudan is also facing severe and overlapping climate shocks, including droughts in some areas and extreme flooding in others, which have devastated harvests and contributed to malnutrition. ​

Madagascar has this year experienced back-to-back cyclones, in addition to prolonged droughts and erratic seasons. These climatic risks deepen food insecurity, spread diseases such as malaria and severely undermine access to healthcare, leaving those already at risk even more exposed. In response, MSF provides nutritional support and works in partnership with local communities to provide health care, while preserving the natural environment and livelihood of people in the area.

In Kiribati in the Pacific, rising sea levels are threatening homes with inundation and contaminating the groundwater table with saltwater. This reduces people’s access to quality drinking water which increases the risk of diarrheal diseases, while the lack of clean water also impacts hygiene, prompting the spread of skin and eye infections. Meanwhile drought reduces the availability of fresh food, compounding longstanding nutrition challenges including undernutrition along with high rates of obesity and non-communicable diseases.

The climate impacts facing many of the communities MSF supports are also predicted to be exacerbated by El Niño, increasing the risk of health and humanitarian crises.

“The declaration of El Niño as a Grade 3 emergency and the growing calls to formally recognise climate change as a global health emergency all point to the same reality: this is not a looming threat, but an emergency that is already unfolding and must be addressed,” says Dr Guevara.

MSF works in more than 70 countries globally, the majority of which are among the most exposed to the health impacts of climate change, and the least ready to respond. Many of these countries also hold little responsibility for causing the climate crisis yet are disproportionately bearing its impacts.

Dr Guevara says that already vulnerable communities are hit the hardest. “They are paying with their health and their lives for a problem they did not create. This is a profoundly unjust situation as the people most affected are not the ones who created this problem in the first place.” ​

For countries like these on the frontline of climate change, COP31 must help translate commitments into clear adaptation plans that ensure communities and health systems are prepared for the impacts of climate change. ​

“This means having health services that can adapt to the changing and growing needs: clinics that can withstand climate shocks, that have reliable water and energy, prepared health workers, and sufficient medicines and medical material. The most impacted countries are repeatedly asking for financial support to deal with the increasing impacts, but they are not receiving it,” says Dr Guevara. ​

MSF is calling for climate finance to be scaled up, so that countries can be prepared to respond to climate impacts, and rebuild health systems after a disaster. Finance must be new, rather than drawing from existing aid budgets, and actually reach the people and communities who are experiencing the heaviest impacts.

“At COP31, we need to see decisions that translate into real support for the most impacted countries and communities. What we are seeing today is simply too little and too slow.” ​