The humanitarian consequences of climate change and environmental degradation

MSF pharmacist Ajmad Khan explains to a patient how to take his medication. Khan worked as part of an MSF mobile clinic assisting people in Bahl Babbar, a village in Dadu district affected by floods. Pakistan, 2020. © Nasir Ghafoor / MSF


Doctors Without Borders/Médecins Sans Frontières (MSF) medical humanitarian teams from around the world and across multiple disciplines are reflecting on the health and humanitarian consequences of climate change. 

These reflections were shared in a humanitarian policy brief recently published as part of The Lancet Countdown: Tracking Progress on Health and Climate Change 2020. 

“Studies from 2015 to 2020 have shown that climate change had a role to play in 76 floods, droughts, storms and temperature anomalies,” say Caroline Voûte, health policy advisor, and Dr. Maria Guevara, operational advocacy advisor, two of the MSF co-authors. 

Through a series of country snapshots and case studies, MSF doctors, nurses, public health and advocacy specialists warn how human-caused disruptions to the environment will exacerbate existing medical and humanitarian needs, particularly in climate hot spots. 

The authors share first-hand perspectives on the humanitarian response to climate-related migration in Bangladesh, heatwaves and heat-related illness and death in Pakistan, as well as to malaria and flooding in Niger. 

Other snapshots shed light on the benefits of integrating meteorological and climate anticipation in humanitarian response. One example details how medical teams adapted a cholera vaccination strategy in Malawi to help protect people in a fishing community in a lakeside area where environmental changes have made them particularly prone to cholera outbreaks. 

Diverse experiences demonstrate how the dual crises of COVID-19 and climate change are outstripping the capacity of the humanitarian system, MSF authors say, which is already overstretched by the scale of the needs worldwide. 

“The response to COVID-19 has been a dress rehearsal in preparation for a higher mortality pandemic and a ‘slower-burn’ catastrophe: the climate crisis,” say the MSF authors. 

The global political response to COVID-19 presents worrying trends. Governments have shut their borders to people seeking safe haven from persecution and violence and have competed against one another to buy up medical equipment and supplies, further deepening health inequities between high- and lower-income countries. 

States have used COVID-19 as a pretext to further stigmatize and criminalize people made vulnerable by migration and forced displacement, and in some cases, to block and criminalize humanitarian assistance itself. 

Woman surveying flooding damage in Nhamatanda district, Mozambique
A woman in Nhamatanda district surveys the results of flooding and subsequent damage that destroyed homes and infrastructure and displaced thousands of people. MSF supported people in the disaster zone with medical and other critical assistance. Mozambique, 2019.
© Mohammad Ghannam / MSF

MSF is assessing our own carbon footprint and taking steps to incorporate environmentally responsible working methods, products and equipment into our projects. 

“Adapting the way MSF operates could greatly impact the communities it serves, and as such it is working urgently to define and adopt a strategy,” says the brief. 

“Climate change, a human-induced reality, is of great concern to MSF, as it may well alter the dynamics of conflict and the incidence of disease, impacting communities already at risk,” authors say, while recognizing the people MSF assists are among the most vulnerable to the climate crisis and environmental degradation. 

MSF is evaluating how we can address environmental issues most effectively, while maintaining our capacity to save lives and reduce the suffering of people in crisis. Bearing in mind the mounting evidence attesting to impacts of climate change and environmental degradation on health now and in the future, it is vital that MSF and other humanitarian workers prepare themselves to assist those who are and will be most affected. 

Adapting the way MSF carries out our humanitarian work could greatly impact the communities we work with. As such, it is a matter of urgency for MSF to ensure our humanitarian operations are resilient, responsive and environmentally responsible. 


Climate Smart MSF, an incubator project, is one initiative helping to translate commitment into action. It aims to help scale environmental sustainability solutions across MSF’s medical humanitarian response. 

The project has developed a toolkit that allows MSF projects and offices to do rapid and systematic assessments of their carbon emissions and waste production. It includes tips for mitigating the negative environmental impacts. 

The project has also mapped greenhouse gas emissions for global freight transportation and procurement by European supply centres. It is exploring alternative funding sources for MSF that could enable large-scale investment to reduce our carbon footprint and ensure more environmentally sustainable and future-proofed medical humanitarian care.