Foreword from the WHO Director-General xvi

Acknowledgements xvii

Abbreviations xix

Executive summary xxi

1. Introduction 1

  1.1 Climate change and health 1

  1.2 Definition of a climate–health action 3

  1.3 Quantitative assessments across health topics 4

  1.4 How the report is structured 5

2. Data sources and methods 7

  2.1 Choice of economic analysis 7

  2.2 Prioritization of climate–health actions for quantitative assessment 7

  2.3 Analytical standards applied 10

  2.4 Standpoint (or perspective) 11

  2.5 Time horizon 11

  2.6 Health impacts 11

  2.7 Environmental impacts 11

  2.8 Economic impacts 11

  2.9 Benefits 12

  2.10 Costs 13

  2.11 Net benefit and BCR 13

  2.12 Primary analysis conducted 14

  2.13 Scenario and sensitivity analyses conducted 16

3. Quantitative assessment of heat–health warning systems 21

  3.1 Background 21

  3.2 Description of the action 21

  3.3 How the action might work 21

  3.4 Evidence synthesis of valuation of benefits in prior BCAs 22

  3.5 Evidence synthesis of costing in prior BCAs 27

  3.6 Evidence synthesis of impacts, benefits, costs, net benefit, and BCR in prior BCAs 30

  3.7 Methods 41

  3.8 Results 68

  3.9 Discussion 76

  3.10 Conclusions 82

4. Quantitative assessment of climate-resilient safely managed drinking-water 85

  4.1 Background 85

  4.2 Description of the action 85

  4.3 How the action might work 85

  4.4 Evidence synthesis of valuation of benefits in prior BCAs 86

  4.5 Evidence synthesis of costing in prior BCAs 109

  4.6 Evidence synthesis of impacts, benefits, costs, net benefit, and BCR in prior BCAs 120

  4.7 Methods 149

  4.8 Results 165

  4.9 Discussion 173

  4.10 Conclusions 180

5. Quantitative assessment of climate-resilient basic sanitation 183

  5.1 Background 183

  5.2 Description of the action 183

  5.3 How the action might work 183

  5.4 Evidence synthesis of valuation of benefits in prior BCAs 184

  5.5 Evidence synthesis of costing in prior BCAs 207

  5.6 Evidence synthesis of impacts, benefits, costs, net benefit, and BCR in prior BCAs 218

  5.7 Methods 241

  5.8 Results 248

  5.9 Discussion 256

  5.10 Conclusions 262

6. Quantitative assessment of climate-resilient hand hygiene 265

  6.1 Background 265

  6.2 Description of the action 265

  6.3 How the action might work 265

  6.4 Evidence synthesis of valuation of benefits in prior BCAs 266

  6.5 Evidence synthesis of costing in prior BCAs 271

  6.6 Evidence synthesis of impacts, benefits, costs, net benefit, and BCR in prior BCAs 272

  6.7 Methods 275

  6.8 Results 285

  6.9 Discussion 293

  6.10 Conclusions 299

7. Quantitative assessment of cleaner household energy sources 301

  7.1 Background 301

  7.2 Description of the action 301

  7.3 How the action might work 302

   7.4 Evidence synthesis of valuation of benefits in prior BCAs 304

  7.5 Evidence synthesis of costing in prior BCAs 321

  7.6 Evidence synthesis of impacts, benefits, costs, net benefit, and BCR in prior BCAs 325

  7.7 Methods 334

  7.8 Results 340

  7.9 Discussion 351

  7.10 Conclusions 355

8. Quantitative assessment of fiscal policies to efficiently price fossil fuels 357

  8.1 Background 357

  8.2 Description of the action 357

  8.3 How the action might work 357

  8.4 Evidence synthesis of valuation of benefits in prior BCAs and benefit analyses 359

  8.5 Evidence synthesis of costing in prior BCAs 379

  8.6 Evidence synthesis of impacts, benefits, costs, net benefit, and BCR in prior BCAs and benefit analyses 379

  8.7 Methods 400

  8.8 Results 408

  8.9 Discussion 416

  8.10 Conclusions 421

9. Quantitative assessment for all six assessed climate–health actions combined 423

  9.1 Health impacts 424

  9.2 Environmental impacts 424

  9.3 Economic impacts 424

  9.4 Benefits 424

  9.5 Costs 425

  9.6 Net benefit and BCR 425

  9.7 Distributional analysis 430

10. Discussion 435

  10.1 Summary of results 435

  10.2 Limitations of the analyses 435

  10.3 Strengths of the analyses 438

  10.4 Next steps 439

11. Conclusions 441

References 442

Annex 1. World Bank GDP deflators for US$ 458

Annex 2. Expected deaths averted, benefits, costs, net benefit, and BCR for heat–health warning systems, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 57 countries, 2024–2075 459

Annex 3. Benefits, cost and net benefit for heat–health warning systems, sensitivity analysis with discount rate of 0%, 57 countries, 2024–2075 465

Annex 4. BCA reference case guidelines reporting checklist for the quantitative assessment of heat–health warning systems 467

Annex 5. Expected deaths averted, benefits, costs, net benefit, and BCR for climate-resilient safely managed drinking water, basic sanitation, and hand hygiene combined, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 132 countries, 2024–2075 470

Annex 6. Expected deaths averted, benefits, costs, net benefit, and BCR for climate-resilient safely managed drinking-water, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 132 countries, 2024–2075 473

Annex 7. Benefits, costs, and net benefit for climate-resilient safely managed drinking-water, sensitivity analysis with discount rate of 0%, 132 countries, 2024–2075 479

Annex 8. BCA reference case guidelines reporting checklist for the quantitative assessment of climate-resilient safely managed drinking-water 481

Annex 9. Percentage of the population and number of people covered by scale-up of climate-resilient basic sanitation, by sewered versus unsewered, 132 countries, 2024–2075 484

Annex 10. Costs for climate-resilient basic sanitation, primary analysis, by sewered versus unsewered, 132 countries, 2024–2075 486

Annex 11. Expected deaths averted, benefits, costs, net benefit, and BCR for climate-resilient basic sanitation, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 132 countries, 2024–2075 487

Annex 12. Benefits, costs, and net benefit for climate-resilient basic sanitation, sensitivity analysis with discount rate of 0%, 132 countries, 2024–2075 493

Annex 13. BCA reference case guidelines reporting checklist for the quantitative assessment of climate-resilient basic sanitation 495

Annex 14. Expected deaths averted, benefits, costs, net benefit, and BCR for climate-resilient hand hygiene, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 132 countries, 2024–2075 498

Annex 15. Benefits, costs, and net benefit for climate-resilient hand hygiene, sensitivity analysis with discount rate of 0%, 132 countries, 2024–2075 504

Annex 16. BCA reference case guidelines reporting checklist for the quantitative assessment of climate-resilient hand hygiene 506

Annex 17. Expected deaths averted, CO2e emissions averted, benefits, costs, net benefit, and BCR for cleaner household energy sources, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 130 countries, 2024–2054 509

Annex 18. Benefits and net benefit for cleaner household energy sources, sensitivity analysis with discount rate of 0% of mortality reduction and change in time use benefits only, 130 countries, 2024–2054 517

Annex 19. BCA reference case guidelines reporting checklist for the quantitative assessment of cleaner household energy sources 519

Annex 20. Expected deaths averted, CO2e emissions averted, and benefits for fiscal policies to efficiently price fossil fuels, for the primary, scenario, and sensitivity analyses, annual averages or annualized values and for the projection period, 168 countries, 2024–2043 522

Annex 21. Economic benefits for fiscal policies to efficiently price fossil fuels, sensitivity analysis with discount rate of 0% for air pollution mortality reductions benefits only, 168 countries, 2024–2043 528

Annex 22. BCA reference case guidelines reporting checklist for the quantitative assessment of fiscal policies to efficiently price fossil fuels 529