Building National Capacity on Climate Change Adaptation for Health in Canada

Context

Canada is a geographically diverse country, with provinces and territories experiencing different climate change risks and impacts. In some provinces, wildfires have become more frequent and intense due to warmer and drier conditions, leading to poorer air quality, and increased respiratory problems among residents. In the Prairies- in the middle of the country- droughts and heatwaves are threatening agriculture and livestock, affecting the livelihood of farmers and ranchers. In the North, above 60 degrees latitude, melting permafrost and changing weather patterns are causing infrastructure damage and loss of traditional foods, which can lead to food insecurity and impact the physical and mental health of Indigenous communities. Changing weather patterns and warmer temperatures associated with climate change are creating conditions that are more favorable to the transmission of vector-borne diseases, including the spread of ticks that carry Lyme disease. These conditions are also fueling the occurrence of deadly heat waves which put immense strain on local healthcare systems. The escalating impacts of climate change on public health underscore the critical need for adaptive measures to reduce vulnerability to climate hazards. The 2022 Health of Canadians in a Changing Climate: Advancing our Knowledge for Action report, provides a comprehensive assessment of current and projected risks from climate change to the health of Canadians.

With climate change, implementing targeted capacity building and support programs is crucial: such programs can ensure that building resilience to climate change will adequately consider the unique challenges faced by different regions. Using this approach, the HealthADAPT program in Canada aimed to increase the capacity of the health sector to anticipate, prepare for, and respond to the impacts of climate change on human health.

Implementation process

HealthADAPT is a multi-year capacity-building program developed by Health Canada. The pilot program was launched in 2018. In its initial phase, it supported 10 health authorities across Canada at local, regional, provincial and territorial scales of the Canadian health sector. Health services are a shared responsibility across different levels of government, with sub-national authorities (provinces and territories) having primary responsibility for the delivery of public health and healthcare services. These projects represented diversity across the country, including Indigenous peoples, urban, rural and coastal communities, and both of Canada’s official languages (English and French). Over three years, the HealthADAPT program supported health authorities in building their capacity for addressing climate change and health risks.

The goals of the HealthADAPT program are to:

Increase the understanding of climate change impacts on health systems and the health of Canadians;
Identify communities or people who are more at risk of experiencing negative health effects of climate change;
Support the developing, testing, and carrying out of local and regional climate change and health adaptation plans with partners;
Monitor and evaluate the effectiveness of climate change health adaptation plans.

The overall approach to implement such a program includes:

Developing a tailored approach to address regional and local needs
Engaging stakeholders and local communities
Networking to facilitate shared learning
Integrating health equity considerations
Securing foundational resources and data for informed decision-making at regional and local levels across the country

Health Canada developed and provided a suite of guidance documents that offered practical direction on integrating climate change considerations into health planning, conducting vulnerability assessments, and designing effective adaptation strategies. This included the Knowledge to action resource guide, which presents tools and information to help inform the development of rigorous and participatory V&As from local to national levels in Canada, as well as the Workbook for the Canadian health sector, which provides a series of steps as part of an approach to climate change and health vulnerability and adaptation assessment that is based on the latest knowledge of climate change and health and has been tailored to the Canadian health sector.

In addition to providing guidance to funding recipients, Health Canada promoted the HealthADAPT pilot funding recipients through two communications products to facilitate the sharing of learnings across the broader health sector:

The Digital Case Stories, launched in November 2022, allowed funding recipients to showcase their projects and facilitate knowledge exchange through a visual platform. Each project lead provided an overview of their project work, the process in developing their project, and the impact in their jurisdiction. The goal of the digital case story videos was to highlight various climate change impacts and action taken at the community level for each HealthADAPT project. Videos are available in English and French, with described video in both languages.
The Map of Adaptation Actions is the product of a co-led initiative by Environment and Climate Change Canada, and Natural Resources Canada. The website houses a collection of climate change adaptation case studies across Canada on an interactive and searchable map. It is intended for use by decision and policy makers, practitioners in the climate adaptation space, and Canadians who are looking for examples of what is already being done to adapt to climate change across Canada.

Map of HealthADAPT implementation.
Credit: Health Canada

Lessons learned

The pilot HealthADAPT program provided an opportunity to explore how health systems across Canada can build resilience to climate change. The lessons that emerged can guide future efforts to make health systems more climate-resilient:

1. Climate Change Needs to Be Framed as a Health Issue

One of the most important lessons that emerged from the pilot program is the need to frame climate change as a direct and pressing health concern. This framing helps generate internal support, align climate action with public health mandates, and makes the case for investing in adaptation.

2. Capacity Building is a Long-Term Commitment

Developing the skills, knowledge, and infrastructure needed to address climate-health risks takes time. Health authorities must invest in continuous learning, staff development, and institutional readiness to maintain their momentum.

3. Local Context Matters

Adaptation strategies need to be tailored to the particular needs, vulnerabilities, and capacities of local communities. Training staff, supporting local assessments, and investing in community-based planning ensures that adaptation efforts are grounded in local needs.

4. Build on What Works

The pilot HealthADAPT program was built on existing frameworks like the Building Resilience Against Climate Effects (BRACE) model and WHO guidance. Adapting proven tools to local contexts supports health authorities to act with greater confidence and clarity, bridging the gap between broader guidance and localized action.

5. Equity is Foundational, Not Optional

Effective adaptation means addressing the needs of those most at risk. Engaging with Indigenous communities, low-income populations, and other at-risk groups ensures that no one is left behind.

6. Collaboration Multiplies Impact

Working together and sharing knowledge across sectors and networks can make climate-health initiatives more impactful. Collaboration sparks new ideas, prevents duplication, and helps everyone build skills and solutions more effectively.

7. Adaptation is an Ongoing Process

Climate resilience is not a one-time goal but a continuous process. Regular monitoring, evaluation, and adjustment are essential for responding to evolving risks and emerging data and evidence.

Challenges

The pilot HealthADAPT program highlighted several important challenges that health authorities may face while working to build climate-resilient and low-carbon health systems. Many organizations were just starting to explore the links between climate change and health, which meant they needed time to build internal understanding and secure leadership support. This learning curve was further complicated by competing priorities, such as the COVID-19 pandemic, which stretched staff capacity and delayed progress. Funding was another common barrier, especially in rural and remote areas, where resources to hire skilled staff, conduct training, and develop tailored adaptation plans were often limited.

Accessing reliable and localized data was also challenging for many health authorities. Health authorities struggled to find the information they needed to assess climate risks, particularly for Indigenous communities and future climate projections. The technical complexity of climate change, combined with its cross-sectoral nature, made it challenging to design effective interventions. In some cases, existing guidance documents were outdated, hard to access, or not relevant to local needs.

Human resource limitations further impeded progress. High staff turnover, limited awareness of climate-health connections, and a focus on immediate health concerns, rather than longer-term impacts, reduced the ability to sustain long-term adaptation efforts. Time and resource constraints also made it difficult to build partnerships and share knowledge across regions.

Finally, advancing health equity required thoughtful engagement, trust-building, and culturally appropriate approaches. While many health authorities made meaningful efforts, in some cases, additional tools and stronger community relationships were needed to fully support at-risk populations.

Success factors

Despite the challenges, the HealthADAPT program highlighted several strategies that helped health authorities across Canada make meaningful progress in preparing for the health impacts of climate change. A key success factor was strong leadership. Support from senior management and internal champions helped secure resources, prioritize climate action, and integrate it into broader health planning. This leadership created the foundation for sustained momentum.

Building multidisciplinary teams was another important strategy. By bringing together professionals from climate science, public health, epidemiology, and communications, health authorities were better equipped to understand complex risks and design effective, locally relevant responses. Training and education also played a vital role. Staff who received targeted training were better able to understand the connections between climate and health, assess vulnerabilities, and contribute to adaptation planning.

Community engagement was also central to many successful projects. Health authorities worked closely with local leaders and used participatory research methods to build trust and ensure that equity was embedded in their planning. These efforts helped ensure that the voices of at-risk populations were heard and that solutions reflected local realities.

Collaboration across regions and sectors also proved valuable. Through Communities of Practice and support from external facilitators, health authorities were able to share lessons learned, avoid duplication, and strengthen their approaches. Developing locally tailored tools and guidance made it easier for teams to apply best practices in their own contexts, while technical support from Health Canada helped improve data collection and analysis.

Finally, having dedicated staff focused specifically on climate-health work was a major asset. These roles helped maintain continuity, deepen expertise, and ensure that climate adaptation remained a consistent priority. Together, these strategies demonstrate that with the right support, health systems of all sizes can take meaningful steps toward climate resilience.

Recommendations

Many lessons learned from the HealthADAPT pilot program can help guide other countries as they work in this area of the Belem Health Action Plan:

1. Invest in Long-Term Capacity Building

Building climate-resilient health systems requires time and sustained effort. Countries should prioritize ongoing training for health professionals, integrate climate change into health education, and support leadership development across all levels of the health system. This ensures that institutions are ready to respond to both current and future climate-health challenges (aligned with Action Line 2.2 of the Belém Plan).

2. Tailor Actions to Local Contexts

Adaptation strategies are most effective when they reflect the needs of local communities. This includes using local data, engaging community leaders, and incorporating Indigenous and traditional knowledge into planning and decision-making (Action Line 2.3).

4. Embed Equity and Inclusion

Climate change doesn't affect everyone equally. Adaptation efforts need to priorities the needs of those most at-risk, such as Indigenous people, low-income communities, and people with disabilities. Equity should be a guiding principle in planning, implementation, and evaluation (cross-cutting priority i and Action Line 2.8).

5. Foster Cross-Sectoral Collaboration

Climate-health solutions require collaboration and teamwork. Building partnerships across sectors and creating spaces for shared learning, such as communities of practice, promote intersectoral communication, and leverage partnerships, which can enhance the impact of initiatives and avoid duplication (Action Line 2.5).

Key resources

Further information about the HealthADAPT program and projects can be found on the following webpages:

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