Lao PDR: Integration of Health in NDCs

Flooding in Lao PDR. Credit: WHO Country Office Lao PDR.

With coordination and technical support from the NDC Partnership, Lao PDR is updating its NDC 3.0 Mitigation and Adaptation Commitment which includes priority sector-specific strategies and action plans covering the 2021-2025 period. This comprehensive plan is pivotal, encompassing critical sectors such as agriculture, forestry, land use change, energy, transportation and urban development, waste management, water resources, and public health (ndcpartnership.org/country/lao). These interconnected sectors are vital for the country’s development and resilience against climate-related threats.

Context

The National Health Adaptation in the Context of Climate Change

The Ministry of Health (MoH) and WHO are co-leading the assessment, consultation, and development process of the health component of the NDC 3.0.

The Lao PDR government prioritizes building a resilient health system in response to changing climate conditions, while also promoting a low-carbon, sustainable health system approach as part of NDC 3.0. In response to climate-related health challenges, the MoH has taken proactive and deliberate steps to integrate climate resilience into national health planning. The Climate Change and Health Adaptation Strategy (2018–2025) was established based on comprehensive vulnerability assessments conducted in 2010, 2019, and 2023.

This strategy establishes a strong framework for the Health National Adaptation Plan (H-NAP), which explicitly addresses the various climate-sensitive health risks that threaten the population. These include the provision of safe water in healthcare facilities and to the rural community, waterborne and vector-borne diseases, heat-related illnesses, the adverse effects on nutrition, as well as water, sanitation, and hygiene (WASH) systems.

Key Achievements under NDC 2.0

As part of its second Nationally Determined Contribution (NDC 2.0), Lao PDR has uniquely positioned health as the only sector with a results-based adaptation framework (NDC Lao PDR, 2021). This innovative approach has led to several key milestones, which include:

Development of the H-NAP through national consultations (2022–2023)^{^[1]}
Training of over one hundred health professionals in climate-health risk assessment and management
Creation of nine training modules and information, education, and communications materials on climate-health topics
Implementation of the “Safe, Clean, Green, Climate-Resilient Healthcare Facilities” initiative, including non-combustion waste management in 110 facilities
Development and pilot of the “Safe, Clean, Green Climate Resilient Healthcare” Initiative and its integrated interventional packages developed in 2020-22, with scale-up in 2022-2024. The implementation of this initiative comprises safe water, sanitation, cleaning and disinfection services, environmentally sustainable green technology, and climate resilient healthcare facility training and practice to minimize environmental impacts across 110 healthcare facilities
Expansion of climate-resilient WASH services in rural areas; These efforts were supported by annual operational planning and prioritization exercises across all regions

Health Policy Alignment and Long-Term Objectives of the Health Component of NDC 3.0

The health component of NDC 3.0 has been developed from April to Sept 2025. The following long and short-term priority adaptation actions and six strategic directions were identified:

Strengthening Leadership: Elevate leadership support for both climate and health sectors to ensure cohesive policy implementation.
Developing the Health Workforce: Invest in the development of a skilled health workforce, capable of addressing climate-related health challenges effectively.
Enhancing Surveillance Systems: Establish robust climate-sensitive disease surveillance, early warning, and response systems to mitigate health risks proactively.
Building Resilient Infrastructure: Foster the development of resilient healthcare infrastructure that can withstand climate impacts and continue to deliver essential services.
Implementing Financial Strategies: Create sound financial strategies to ensure sustainable funding for health adaptation initiatives.

The integration of health into the NDC 3.0 is aligned with the World Health Organization’s guidance on the quality criteria for integrating health into NDCs as well as the MoH’s Climate Change and Health Adaptation Strategy.

[1] https://www.atachcommunity.com/fileadmin/uploads/atach/Documents/Country_documents/LAO_HNAP_2024.pdf

Implementation process

The H-NAP will be operationalized and serves as the implementation vehicle for NDC 3.0, which will advance efforts to address the health impacts of climate change, support climate-resilient and low-carbon sustainable health systems and maximize the health-related co-benefits of climate policies and plans.

Lessons learned

Key challenges:

Limited climate-health data integrated and limited applicability for practice
Lack of sustainable funding support and climate and health partnerships
Lack of integrated climate and health data for the design of adaptation measures, institutionalisation of the climate change and health vulnerability and adaptation assessment, as well as the implementation and monitoring of the HNAP to incrementally improve the adaptation capacity
Evaluating the effectiveness of the HNAP

Success factors:

Systematic, long-term technical support in increasing staff and institutional capacity, advocacy, and awareness raising
Safe water, sanitation and sustainable waste management as an entry point as well as an engaged health, water and environment sector
Intersectoral collaboration and coordination in mobilising resources
The MoH has made concerted efforts to mobilize resources, accessing funding from the Green Climate Fund (GCF Readiness) and Global Environment Facility to develop its H-NAP with support from the WHO. Now, GCF adaptation funds (2024-2029) are being employed through the project “Strengthening Climate Resilience of the Lao People’s Democratic Republic (PDR) Health System” to increase the climate resilience of the health system and strengthen community capacity to manage the current and anticipated health impacts of climate change. Specifically, through this project, the MoH, with support from Save the Children and WHO, will strengthen health sector leadership and governance, expand the use of climate information and WASH data, and enhance capacity in selected climate vulnerable districts to manage climate-sensitive diseases. Selected health facilities will receive infrastructure upgrades to increase their resilience and reduce emissions. These actions will also deliver co-benefits considering climate change mitigation (lower health facility emissions), improved service delivery, and gender.
While GCF’s current support marks a critical step forward, fully realizing the ambitions of the H-NAP and NDC 3.0 will require additional, sustained financing.
Monitoring and evaluation frameworks are being embedded in the H-NAP and NDC 3.0, with defined indicators for each strategic direction. These include integration of climate-health data into DHIS2, development of emergency response plans, and tracking of climate-resilient infrastructure.

Recommendations

Recommendations based on Lao PDR's experience include:

Building of health adaptation capacity at the national, sub-national, and healthcare facility levels as a key priority.
Ensure effective implementation and monitoring of long-term priority adaptation actions, guided by the Nationally Determined Contributions (NDCs) and health sector-specific adaptation strategies (H-NAP).
Embed monitoring and evaluation frameworks in the H-NAP and NDC 3.0, with defined indicators for each strategic direction, including the assessment of health co-benefits through mitigation actions in other sectors.
Climate finance is an essential enabling factor for the successful implementation and monitoring of the health component of the NDC and the H-NAP as well as for the sustainability of the results.
Consider cross-cutting issues such as loss and damage related to mortality directly caused by extreme weather events, as well as access to climate finance.
Continued prioritization of intersectoral collaboration and data sharing through governance mechanisms, to support evidence-based decision-making
Risk communication and community engagement is key to improving early warning response and care-seeking behavior

Key resources

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