Health professionals and organizations saw COP28 as a pivotal moment to integrate health issues into the global climate agenda and to advocate for stronger links between health and climate policy. The event provided an opportunity to highlight the growing impacts of climate change on public health, including the rise in heat-related illnesses, respiratory conditions linked to air pollution, and the spread of infectious diseases.

To build on this momentum, the Wellcome Trust commissioned Dalberg to evaluate the engagement, contributions, and influence of the “Climate x Health” (CxH) community, a coalition convened by the Wellcome Trust, Rockefeller Foundation, Global Climate and Health Alliance, and Amref, and chaired by Global Health Strategies. The evaluation aimed to measure outcomes of COP28, identify enabling and limiting factors, and generate strategic recommendations for future COPs, with the ultimate objective of mobilizing stronger action on climate and health interventions.

Dalberg developed a high-level Theory of Change for the health community’s COP28 strategy, centered on three direct impacts: securing political commitments, fostering a shared understanding, and increasing access to funding. The strategy sought to achieve two outcomes: positioning the health community as a valuable voice in climate negotiations and elevating health issues in order to drive stronger commitments to public health.

To inform the evaluation, Dalberg carried out extensive data collection, including interviews with members of the health, climate, and scientific communities; national negotiators; COP28 Presidency officials; UNFCCC insiders; and representatives of thematic groups such as food and agriculture, energy, and youth. This resulted in a robust framework of indicators and metrics to assess the community’s strategy. Internal reflections were shared with the Wellcome Trust, while an external version of the evaluation was disseminated to the wider climate and health community.

The evaluation found that health concerns were successfully embedded in the COP process, with the community building momentum by mobilizing diverse actors, advancing arguments such as phasing out fossil fuels, and gaining visibility for the climate–health nexus. While health was not widely reflected in the formal outcome texts, the community did secure significant funding commitments and endorsements on health-specific documents. Its presence at COP28 was markedly stronger than in previous years: the number of health delegates grew nearly sevenfold between COP27 and COP28, while health-related events nearly doubled since COP26. For the first time, health was included in COP’s high-level event schedule, and media coverage mentioning health increased 135-fold compared with COP27.

Our experience with global health stakeholders at COP28 revealed that a unified and strategically aligned community can significantly amplify its influence on climate action, emphasizing the importance of collaboration to drive systemic change. That said, we also found that effective policy advocacy at the global level requires sustained work over multiple cycles or years, and that support for the advocacy organizations themselves needs to reflect this long-term commitment.”

Laura Amaya

Partner, Dalberg Advisors