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An Adaptive and Sustainable Health System for a Changing Climate in Grenada

Categories: VAA, Climate Change & Health Vulnerability & Adaptation Assessments, Health National Adaptation Plans, Action Plans for sustainable low carbon health systems, Country experience, Americas (Pan American Health Organization), Climate Resilient Health Systems, Low Carbon Sustainable Health Systems

Country: Grenada

Princess Alice Smart Hospital, GrenadaPrincess Alice Smart Hospital, Grenada. Credit: Mr. Leon Williams, Ministry of Agriculture, Land Use Division.

Context

Grenada, like many Caribbean small island developing states (SIDS), faces intensifying climate impacts with limited resources yet enduring resilience. Rising temperatures—projected to reach 2.9°C by 2100 under high-emission scenarios—are exacerbating vulnerabilities and threatening health infrastructure and disease patterns. Sea level rise poses a major risk to coastal zones and tourism (73% of structures are coastline-based), with a 0.5-meter rise expected to erase up to 60% of beaches.

The nation has endured major climate shocks: Hurricanes Ivan (2004), Emily (2005), and most recently, Hurricane Beryl – 2024 causing over $950 million in damages (Ivan & Emily) and impairing 69% of health facilities. Grenada also grapples with alternating droughts, heat waves and floods, affecting sanitation, agriculture, solid waste and water systems. Health repercussions include:

Direct impacts: trauma, heat stress, post-disaster mental health strain.

Indirect effects:

  • Vector-borne diseases (e.g. dengue, Zika, chikungunya);
  • Waterborne illnesses (e.g. leptospirosis, gastroenteritis);
  • Respiratory ailments (e.g. from Saharan dust);
  • Food insecurity;
  • Stress-related cardiovascular disease.
Climate Change Impacts on Health. Credit: CDC, 2022

From the figure above, Grenada’s climate and health focus areas are: extreme heat, severe weather, air pollution, changes in vector ecology, water quality impacts, water and food supply impacts. These were prioritized from the Vulnerability and Adaptation study.

In response, Grenada aligns its climate-health actions with the Belem Health Action Plan launched at COP30. This regional blueprint provides three action pillars:

1. Surveillance and Monitoring

Grenada integrates climate variables (temperature, rainfall) into disease surveillance to anticipate dengue, heat-related conditions, and gastroenteritis outbreaks. Investments in lab upgrades followed a CARPHA-led needs assessment, while epidemiology training (FETP, CR-FELTP) expands district-level detection.

2. Evidence-Based Policy and Capacity Building

The Health Sector Strategic Plan (HSSP 2016–2025) and Health National Adaptation Plan (HNAP 2025–2035) formalize climate-health resilience through cross-sector collaboration and disaster risk reduction. Training initiatives enhance surveillance and rapid response readiness.

3. Innovation and Production

Grenada scales up climate-smart health infrastructure via the PAHO SMART Hospitals initiative and G-CREWS project. Interventions include renewable energy, structural retrofitting, and wastewater upgrades boosting emission reductions and disaster preparedness.

Lived experience and national commitment

Grenada's commitment is shaped by personal and community-level climate-health experiences:

  • Mount Craven: Helen sheltered from Hurricane Beryl with grandchildren in a cellar, echoing trauma from past hurricanes—underscoring mental health vulnerabilities and the erosion of peace of mind.
  • Gouyave (2011): Urban floods overwhelmed clinics, prompting reforms under G-CREWS and showcasing the power of localized adaptation.
  • St. George’s University: Kwami, a biochemist, suffered chikungunya and chronic respiratory issues—highlighting disease shifts due to climate variability and air pollution.

These lived realities catalyzed national alignment with the Belém Plan, with Grenada embedding climate resilience into early warning systems, strategic health frameworks, and infrastructure upgrades.

 

Implementation process

Grenada evolved from reactive climate-health responses to coordinated national planning, anchored in:

Strategic policy alignment

Climate-resilient health is prioritized under Grenada’s Sustainable Development Plan 2035 and National Adaptation Plan. The Cabinet-approved HNAP reinforces these linkages and aligns with regional instruments (PAHO, CEDEMA, CARPHA) and global agreements (Sendai Framework, Paris Agreement).

Stakeholder engagement

Implementation draws on multi-sector collaboration—including ministries of Climate Resilience, Finance, Social Development, Agriculture, and Security agencies (NDO, RGPF). A National Steering Committee oversees the rollout of National Health Insurance, bridging health equity and climate resilience.

Capacity building

Workforce training spans environmental epidemiology, climate-health integration, and emergency management. Infrastructure investments improve data systems, monitoring, and diagnostic capabilities.

Resilient infrastructure

PAHO’s SMART Hospitals and G-CREWS upgrades feature storm-resistant construction, solar energy, and water management systems. These ensure service continuity amid shocks.

Resource mobilization and monitoring

Grenada leverages:

  • $11.5M from the OECS Regional Health Project
  • $9.9M from the Caribbean Development Bank
  • $10M from a proposal to the Caribbean Community Climate Change Centre (5Cs)

These funds support surveillance, clean energy, EV ambulances, wastewater upgrades, and community awareness programs. Monitoring systems ensure accountability and data-driven decision-making.

 

Drone image of a health facility in Grenada
Drone image of a health facility in Grenada. Credit: Mr. Leon Williams, Ministry of Agriculture, Land Use Division.

Lessons learned

Several lessons and strategies for regional replication can be drawn from Grenada’s experience:

1. Integrated planning is essential

Climate-health resilience must be embedded across environment, health, and disaster sectors. Grenada’s alignment of HNAP, NAP, and SDP 2035 avoided policy fragmentation and supported shared goals.

2. Data systems are power tools

Digitized platforms like DHIS2 improves data capture and outbreak response and link disease patterns to climate variables. Integration of environmental indicators enhances predictive modeling, policy development, research, treatment regimen and public health decisions.

3. Community engagement drives impact

Inclusive planning, public awareness and education foster trust and uptake. Grenada centered community voices and tailored messaging especially on heat stress and mental health.

4. Infrastructure matters

Retrofitting clinics proved more cost-effective than rebuilding. SMART facilities can function at 90% post-disaster capacity, which strengthens health delivery and sustainability.

5. Partnerships multiply gains and progress

Grenada partnered with PAHO, CARPHA, DEFID, GIZ, 5Cs, and others to access resources and technical expertise. These alliances enabled scalable projects, innovations and stronger implementation.

6. Human resource capacity is critical

Shortages in climate-health expertise persisted. Grenada responded with regional exchanges and training in climate finance, emissions tracking, and disaster management. Surveillance and DRR are areas of strength.

7. Monitoring and evaluation must improve

Feedback loops remain weak. Strengthening M&E frameworks with real-time climate-health indicators is essential for adaptive management and tracking. The integration of loss and damage and just transition in this process are important pillars for sustainability.

 

Recommendations

Based on Grenada’s experience, the following recommendations may be useful to countries working to build climate resilience and sustainability in the health sector:

  • Embed climate-health in core national strategies to align goals across sectors and maintain momentum beyond leadership cycles.
  • Invest in infrastructure retrofitting - adopt renewable energy, water efficiency, and resilient construction for disaster continuity (DRR). It improves structural integrity, non-structural e.g. fire protection system, operational e.g. response plans and green checklist e.g renewable energy.
  • Digitize surveillance and integrate climate data to enhance early warnings and outbreak forecasting. ((DHIS2 &EMR)
  • Train health personnel in climate-health analytics and surveillance through regional programs (FETP &CR-FELTP) and capacity exchanges. This will foster better understanding by health professionals of the impacts of climate change and enhance data collection and capture.
  • Engage communities for campaign designs, monitoring, and resilience-building to drive behavioral change towards a resilient population.
  • Secure diversified financing through domestic allocations and strategic international partnerships (e.g. GIZ, PAHO, GCF, 5C’s, CDB, etc.).
  • Strengthen monitoring systems to track climate-health outcomes and adapt interventions in real time at national level.
  • Champion regional learning platforms to share successful models, lessons learnt and catalyze collaboration across SIDS and the wider global community.

 

Key resources

 

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