By: Israel. O. Fawole
AS world leaders gather in Antalya, Türkiye, for the 31st Conference of the Parties (COP31) to the United Nations Framework Convention on Climate Change, the global conversation on climate finance must move beyond the billions promised and examine what these commitments actually deliver for human lives. For Nigeria, this conversation has an important but sometimes underrepresented dimension, public health. Climate change is no longer simply an environmental concern. It is increasingly a health systems challenge, affecting food security, access to safe water, the distribution of infectious diseases, the frequency of extreme weather emergencies, the safety of healthcare infrastructure and the capacity of health workers to provide essential services. Nigeria is already experiencing these interconnected pressures. Flooding, rising temperatures, changing rainfall patterns, drought and environmental degradation are creating and intensifying public health risks. From flood-associated disease outbreaks and water contamination to heat-related illnesses, malnutrition and disruptions to healthcare delivery, the health consequences of climate change are becoming increasingly difficult to ignore.
The 2024 flooding in Maiduguri, Borno State, which affected communities, infrastructure and essential services, was a reminder that climate-related emergencies are not distant projections. They are development and health security challenges requiring immediate institutional and financial responses. Yet, an important question remains: Are we financing Nigeria’s health system to withstand the climate crisis, or are we waiting for climate-related emergencies to overwhelm it before mobilising resources? Nigeria has made the policy commitments. Now comes implementation. In September 2025, Nigeria submitted its Third Nationally Determined Contribution (NDC 3.0), outlining its climate mitigation and adaptation commitments under the Paris Agreement. Importantly, the document gives considerable attention to health adaptation and establishes measurable actions for strengthening climate-resilient healthcare services. Among these commitments are sustainable and reliable clean energy access in 44 government tertiary hospitals by 2030, the renovation of 774 government secondary hospitals to meet energy efficiency and sustainability standards, and the delivery of 2,000 climate-resilient primary healthcare facilities with reliable low-carbon energy sources by 2030.
The NDC also commits to establishing an integrated climate, health and environmental early warning system, with implementation in at least 18 states by 2030. Other priorities include climate and health vulnerability assessments across the 36 states and the Federal Capital Territory, improved healthcare waste management, and capacity development for health workers and communities across the country’s 774 local government areas. Beyond the NDC, Nigeria has developed its Climate Change and Health National Adaptation Plan (HNAP), 2025-2030, under the Federal Ministry of Health and Social Welfare. The plan provides a framework for integrating climate adaptation into health sector planning, infrastructure, workforce development, disease surveillance, emergency preparedness and community health interventions. Its estimated implementation requirement is approximately US$355.4 million for the 2025/2026–2030 period. The broader National Climate Change Action Plan, coordinated through the National Council on Climate Change, also provides an institutional framework for translating national climate priorities into programmes, financing arrangements and measurable outcomes.
Taken together, these frameworks demonstrate that Nigeria has begun to establish the policy architecture for climate-resilient development. However, having a national plan is only the beginning. The more difficult task is ensuring that the plan is adequately financed, implemented across all levels of government and measured against tangible improvements in people’s lives. Climate finance must recognise healthcare as a priority investment. The international climate finance debate has traditionally focused on energy transitions, transportation, agriculture, infrastructure and environmental conservation. These are essential priorities. However, healthcare must receive comparable attention, particularly in countries where health systems already operate under considerable resource constraints. Climate finance should not be viewed exclusively as environmental financing. It is also an investment in health security, human capital, economic productivity and national development. Consider the implications of a prolonged power outage in a tertiary hospital during an extreme weather event. Emergency departments, intensive care units, laboratories, blood banks, vaccine storage systems and operating theatres depend on reliable electricity.
Where health facilities lack dependable power, the consequences can extend directly to patient safety and the continuity of essential services. Similarly, flooding can compromise healthcare infrastructure, contaminate water sources, disrupt medical supply chains and restrict access to essential services. Drought and food insecurity can worsen malnutrition, particularly among children and vulnerable households. Changes in temperature and rainfall can also influence the transmission patterns of malaria and other climate-sensitive diseases. Nigeria must therefore make a stronger case for climate finance that supports solar-powered healthcare facilities, flood-resistant infrastructure, reliable water and sanitation systems, climate-informed disease surveillance, resilient medical supply chains, emergency preparedness and the training of healthcare professionals. Such investments should not be treated as peripheral components of climate action. They are fundamental to protecting lives.
The debate on climate finance must also address the nature of the financing being offered to developing countries. Nigeria and other African countries require substantial resources to adapt to climate change. However, financing adaptation through excessive borrowing creates another development challenge. difficult.
There is an important distinction between financing a renewable energy project that can generate revenue and borrowing to reconstruct a health facility destroyed by flooding or protect a vulnerable community from disease outbreaks. The latter may be essential for public welfare without necessarily generating direct financial returns. Consequently, international climate finance must prioritise grants and highly concessional financing for adaptation, particularly for vulnerable health systems and communities with limited fiscal capacity. Nigeria should also strengthen domestic resource mobilisation through appropriate budgetary allocations, the Climate Change Fund established under the Climate Change Act 2021, innovative financing arrangements and partnerships with development institutions and the private sector. The objective should not be to replace domestic responsibility with external assistance. Rather, international support should complement national investments and enable Nigeria to achieve adaptation targets that would otherwise be difficult to finance.
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Perhaps the most important implementation challenge is translating national commitments into action at the subnational level. Climate risks are not experienced uniformly across Nigeria. Communities in the North-East may face different combinations of drought, displacement, food insecurity and heat exposure from coastal communities in Lagos, Bayelsa and Rivers, where flooding, coastal erosion and water contamination present significant concerns. Similarly, the health adaptation priorities of communities in the Sahelian region may differ from those of communities in the rainforest and coastal ecological zones. A national framework must therefore be supported by state-specific climate and health vulnerability assessments, costed implementation plans and clearly defined institutional responsibilities. The HNAP provides a basis for this approach by identifying the need for state-level implementation structures and measurable plans. State Ministries of Health, Ministries of Environment, Primary Healthcare Development Agencies, emergency management institutions and local government authorities must work together to translate the framework into practical interventions. Primary healthcare should occupy a central position in this process. As the first point of contact for many Nigerians, PHC facilities are critical to disease surveillance, immunisation, maternal and child healthcare, health education and emergency response. A climate-resilient PHC system should have reliable electricity, safe water, adequate sanitation, appropriate waste management, functional referral arrangements and the capacity to maintain essential services during extreme weather events. Importantly, the proposed 2,000 climate-resilient PHC facilities under NDC 3.0 should be implemented transparently, with attention to geographical equity and communities facing the greatest climate and health vulnerabilities. Infrastructure and financing alone will not deliver climate-resilient healthcare. The health workforce must also be adequately prepared. Nurses, doctors, community health workers, environmental health officers, epidemiologists and public health professionals are often at the frontline of climate-related emergencies. They must be equipped with the knowledge and skills to recognise climate-sensitive health risks, interpret early warning information, support vulnerable populations and maintain essential healthcare services during emergencies. Climate and health education should therefore become part of continuing professional development, pre-service training and public health preparedness programmes. Nigeria should also strengthen research and health information systems to generate evidence on the relationship between climate exposure and disease patterns. Integrating climate-informed indicators into routine health information systems would support more effective planning, resource allocation and early intervention. This is particularly important because climate-related health risks do not affect everyone equally. Children, older persons, pregnant women, people living with disabilities, displaced populations and people with pre-existing health conditions may experience disproportionate consequences. An effective climate and health response must identify these vulnerabilities and ensure that adaptation resources reach the populations most at risk.
As Nigeria engages in COP31 and subsequent climate negotiations, its position should extend beyond the general demand for increased climate finance. It should articulate a clear case for financing the implementation of its national climate and health priorities. Five areas deserve particular attention. First, Nigeria should pursue dedicated grant-based and concessional climate finance for health adaptation, including the implementation of the HNAP. Second, the Federal Government should establish clear mechanisms for tracking climate-related health expenditure, including allocations, disbursements, project implementation and measurable health outcomes. Third, states should be supported to develop costed climate and health adaptation plans that reflect their unique geographical, environmental and epidemiological vulnerabilities. Fourth, climate finance should support the delivery of NDC 3.0 health targets, particularly renewable energy for public hospitals, climate-resilient PHC facilities, integrated early warning systems and sustainable healthcare waste management. Finally, government institutions, development partners, researchers, civil society organisations and the private sector should establish stronger accountability and coordination mechanisms to ensure that climate investments translate into measurable improvements in health system resilience. Beyond COP31, the real test will be whether Nigeria can translate its commitments into functional institutions, resilient healthcare facilities, adequately prepared health workers and healthier communities. The country has an important opportunity to connect its climate ambitions with its broader health sector transformation agenda. This requires treating climate resilience not as an additional project competing for limited health resources, but as an essential consideration in how healthcare is financed, designed, delivered and evaluated. We must begin to see reliable electricity in hospitals as both an energy transition priority and a patient safety intervention. We must recognise flood-resistant health facilities as both infrastructure investments and public health protection. We must understand disease early warning systems as both climate adaptation tools and essential components of national health security. Ultimately, the success of Nigeria’s climate commitments should not be measured only by emissions reductions, international pledges or the number of policies adopted. It should also be measured by whether a pregnant woman can access emergency obstetric care during a flood, whether a rural health centre can continue providing services during extreme heat, whether an outbreak can be detected early enough to prevent avoidable deaths, and whether vulnerable communities can withstand climate shocks without losing access to essential healthcare. Nigeria does not need another declaration that climate change threatens public health. It needs the financing, institutional coordination and political commitment to protect the health of its people. At COP31, Nigeria must make the case that climate finance is also healthcare finance. And when the negotiations are over, that commitment must be visible not merely in policy documents, but in the hospitals, primary healthcare centres and communities where the consequences of climate change are already being felt.
•Fawole is a public health entrepreneur, research consultant and climate-health advocate
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