Dr SanYuMay Tun outlined the need for sustainable healthcare, drawing attention to one of the General Medical Council’s (GMC) outcomes for newly qualified doctors as being able to apply sustainable healthcare to medical practice. Dr Tun guided participants through her work  forming and leading a national working group of the Medical Schools Council, to publish a guidance document that is freely available on the Medical Schools Council website. The framework, Education for Sustainable Healthcare - a Curriculum for the UK (MSC ESH curriculum) is designed to be adaptable to differing contexts, and covers: the sustainability of health systems; the need for mitigation and adaptation actions to reduce harm to health; sustainable clinical practice in the medical specialties; and the need in Higher Education to train learners in professionalism, leadership and achieving structural change. The MSC ESH document also includes the provision of guidance on professional competencies in planetary health, communicating sustainability values, and promoting organisational change. 

The timeliness of the MSC ESH framework is pertinent given the GMC’s publication of a new duty of sustainable healthcare as part of the 2024 Good Medical Practice document, which mandates the need for practicing doctors in the UK to choose sustainable solutions when able, and to reduce the environmental impact of healthcare. Similarly, the International Association for Health Professions Education (AMEE) has recognised the need for including sustainability in medical training and practice, exemplified by a symposium in 2024 under the cross-cutting theme of ‘Sustainability and Global Health’, which included reflections from those who have applied the MSC ESH framework to their own settings internationally. A further session based on the MSC ESH framework was a workshop on how to find resources and support. As part of the ongoing work with the Medical Schools Council, Dr Tun has recently established and chairs the Education for Sustainable Healthcare Alliance (MSC – ESHA). 

The influence that universities can have was explored by Dr Nikolaus Mezger. Dr Mezger introduced KI’s Climate Strategy, which sets goals for 2030 to increase education and research efforts relating to climate change and health, as well as decreasing emissions by 50%, and which translates a Climate Framework endorsed by 38 Higher Education Institutions across Sweden into local practice at KI in Stockholm. The Climate Strategy is operationalised through 3-year Environment and Climate Action Plans, catalysing work being undertaken within the institution. The next Environment and Climate Action Plan will outline a clear distribution of responsibilities and indicators for monitoring and evaluation, and is ambitious in embedding sustainability into graduate and postgraduate research programs, as well as in education offerings through learning outcomes.  

To demonstrate further ways in which KI is recognising the need to be a role model in climate and health, Dr Mezger outlined KI’s engagement with the international, student-driven Planetary Health Report Card (PHRC), encouraging students and staff to collaborate to evaluate the institution’s performance across 5 domains and 51 items, thus identifying areas of improvement. Dr Mezger outlined another example of institutional collaboration through KI’s upcoming Sustainability Day. In 2025, Sustainability Day will be centred on the theme of ‘Planetary Boundaries and Health’ and provides an opportunity to celebrate climate action on campus. A promising example of cooperation on climate change and health between higher education institutions is KI’s partnership with Makerere University in Uganda via the Centre of Excellence in Sustainable Health. 

Professor Xiaoqi Feng highlighted the positive influence universities can have by serving as role models through their own practices. Professor Feng outlined various ways that UNSW Sydney is working to include and promote environmental sustainability on campus, as well as within curricula. Professor Feng shared an example of work demonstrating how targeted interventions—such as 'greening' hospital spaces—can enhance the health of local communities while helping to reduce the effects of rising urban temperatures. By ‘greening’ hospital terraces at the Royal Hospital for Women (Sydney, Australia), the aim is to improve wellbeing, as well as to reduce the heat impact from the hospital building. Professor Feng advocated for preventable healthcare, describing it as being essential in reducing the environmental impact of the healthcare sector, which currently accounts for approximately 7% of Australia’s total carbon footprint. 

The importance of collaboration and breaking down discipline silos was a central theme across both sessions of the dialogue, and was exemplified by work undertaken by Dr Jirair Ratevosain. Dr Ratevosain described how he is seeking to advance collaborative practices, and how in November 2024 he convened a distinguished group of climate scientists and public health practitioners from around the globe to advance a research agenda at the intersection of climate, health, and equity. The goal of the discussion was to chart and prioritise a research agenda for universities that sit at the nexus of climate change and global health. 

Dr Ratevosain reminded participants of the unique position universities have in being able to sustain long-term initiatives that have the potential to outlive funding cycles and government programs, through inclusive collaboration with communities that foster equitable partnerships. Dr Ratevosain highlighted ‘academic freedom’ as a cornerstone of universities that allows for work that is aligned with real-world climate and health challenges.  

The motivations behind the 2024 global discussion were to foster interdisciplinary collaboration to address pressing challenges, and to align research priorities with the needs of vulnerable communities. Four insights arose including: fostering cross-country and cross-sectoral collaboration; universities bridging science and policy; universities promoting equity in research; and universities as models for climate resilience. The discussion aimed to produce actionable recommendations for fostering equitable, innovative, and sustainable solutions to the health impacts of climate change. The outcomes of the discussion will be published in a forthcoming report. 

The importance of collaborative working practices, particularly the unique ability of those working in universities to bridge gaps between agencies and communities, was also explored from an Australian perspective. Professor Nicky Morrison’s presentation considered that while local governments are widely recognised as the key level of government responsible for climate change adaptation, they have faced challenges in effectively addressing this critical issue. Professor Morrison’s research focuses on Western Sydney, a rapidly growing urban region in Australia that is frequently affected by extreme weather events. Professor Morrison described how she had conducted stakeholder interviews and document analysis, using an adaptive capacity framework to identify the barriers and enablers to implementing climate and health related strategies across the region. A range of barriers were identified, both spatially proximate and contemporary, as well as remote and legacy-related.  

The central finding from Professor Morrison’s study was the critical need for increased collaboration within and between agencies, and with the communities they serve, in order to overcome adaptation barriers and implement solutions. This collaboration is seen as essential to address numerous proximate and contemporary challenges, including the inconsistent framing of climate and health issues in local strategies, limited knowledge-sharing, and siloed working practices. Collaboration can also help address legacy and remote barriers, particularly the prioritisation of economic development over climate resilience and the insufficient allocation of federal and state resources to local governments. Ultimately, fostering collaboration among professionals, communities, and political stakeholders is crucial for building adaptive capacity and implementing effective climate adaptation strategies. These strategies can mitigate climate-related health impacts throughout the region and ensure that communities are better prepared for future challenges. 

Professor Morrison’s consideration of the need to implement climate adaptation strategies was presented within the context of increasing frequency of extreme weather events (such as increased episodes of extreme heat) in Western Sydney, Australia.  

The consequences for people who feel the effects of extreme heat, and the need for climate adaptation strategies, was also explored by Andrea Lobato-Cordero, who considered the impact of temperature from a different geographical and methodological lens. 

Andrea Lobato-Cordero is an architect who researches habitability, well-being, healthy indoors, and energy efficiency in homes. Andrea spoke about the vulnerability of indoor spaces to climate conditions. The effects of climate change on human health present potential risks linked to exposure to inadequate temperatures. Indoor environments create microclimates influenced by several factors, with outdoor environmental conditions being a primary contributor. A case study conducted on homes in Campinas, Brazil, revealed that in residences lacking climate adaptation strategies, indoor and outdoor temperatures are often similar. Due to the prevailing heat in the region, residents may report discomfort, even when temperatures fall within the ranges deemed acceptable by standards. Andrea Lobato-Cordero’s takeaway message for participants was that addressing temperature variations and extremes is essential, not only for comfort but also for mitigating health impacts. 

Research that demonstrates the importance of aligning and responding to the needs of local communities was presented by Dr Kirk Douglas. Complementing the presentations by Professor Morrison and Andrea Lobato-Cordero, Dr Douglas considered the implications of increased temperatures from another part of the world, and with a different focus.  

Dr Douglas explained how climate change is impacting the Caribbean with an increased intensity of temperatures, resulting in a larger mosquito population, and in turn increasing the transmission of vector borne diseases. Dr Douglas described his project to develop renewable energy powered mosquito traps, and explained how the University of the West Indies Barbados campus will be used in a pilot study to document the effectiveness of the traps. Such an intervention will not only mitigate the health impacts of an increased numbers of mosquitos in the local area but will reduce the use of chemicals that harm the local ecosystem. 

Dr Douglas’ work is an example of how universities can serve as role models through adapting their own campus environments to respond to climate change, as well as engaging with local communities, particularly those who may be vulnerable to the effects of climate change. This was a common theme across the Global Dialogue, and also highlighted the importance of documenting consequences of climate change, through fieldwork. 

The role of universities as centres for research that document the impact of climate change was exemplified by work undertaken by Isabella Lenihan-Ikin, who is engaging directly with outdoor workers in Aotearoa New Zealand. Isabella’s research aims to reveal, through qualitative methodologies that include interviews and reflexive photography, how climate change is having an impact on the health of outdoor workers. This work engages research participants from across Aotearoa New Zealand working in occupations such as farming, construction, forestry, park management, horticulture, and conservation. Isabella described three themes that have emerged through recent fieldwork: the embodied attachment to land for those working outdoors, including questions around power and agency; outdoor labour and the ethic of care; and ideology around climate change, and how the term is used. 

Considering the lived experiences of those impacted by climate change has been central to the work of Professor Lara Dugas. Robust evaluation of the environmental, health and socio-economic outcomes of heat adaptations are limited for Africa, especially in real-world settings, despite high vulnerability to heat-related health risk. The Heat Adaptation Benefits for Vulnerable groups In Africa (HABVIA) study aims to address these evidence gaps by gathering high-quality cohort data on physiological and mental health, alongside climate, environmental and socio-economic information.  This work is undertaken in four heat-vulnerable study sites in Ghana and South Africa where heat adaptations are underway or can easily be implemented because of pre-existing community-health research partnerships. The project is focusing on a housing adaptation intervention (cool reflective roof paint) for vulnerable populations, in both the urban and rural settings (one rural and one urban research community). HABVIA uses mixed methodologies including quantitative climate data/models, human physiology (core body temperature, measured physical activity and sleep behaviour, dehydration, mental health and clinical non-communicable disease risk) as well qualitative in-depth focus group discussions, to understand the lived experience of climate change in these vulnerable communities.