Advancing Health Solutions

Health Overview

In 2023, the world largely moved on from Covid-19, even if the virus still affected many. For the Foundation’s health team, this transition played out in our daily work as we shifted our focus more to the health threats of climate change. We wound down our Covid-19 projects while seeking to apply many of the tools and lessons learned to this new body of work.

Lessons Learned

As we seek to achieve our health goals in 2024 and beyond, we’ll benefit from insights and lessons learned over the course of our engagement and work in 2023, including: local context matters, sustainability requires planning from day one, and go where there is government excitement.

Epidemic Intelligence

Building on the learnings from The Pandemic Prevention Initiative identified in last year’s report, a deep collaboration was established with the WHO’s Hub for Pandemic and Epidemic Intelligence to launch the International Pathogen Surveillance network (IPSN) to scale up pathogen genomic surveillance as a critical tool for early detection and response to pandemic threats. The IPSN now includes 108 partner organizations across 45 countries.

Our partners also strengthened disease surveillance through wastewater surveillance—a tool to detect and monitor a broad spectrum of established, nascent, and overlooked pathogens especially in low resource settings. The Alliance for Pathogen Surveillance Innovations—India, a group of leading scientific institutions, are collaborating in India to institutionalize multi-pathogen wastewater surveillance. Today, the surveillance is active in four major cities, reaching over 25.5 million people.

Dr. Petros Chigwechokha of the Malawi University of Science and Technology with Dr. Rochelle Holm of the University of Louisville working on multi-pathogen wastewater surveillance.

Indigenous nursing technicians go house-to-house in Puerto Nariño, two hours downriver from Puerto Leguizamo, to do sample testing for malaria. (Photo Courtesy of ACT)

Climate x Health Financing Principles

Countries convened for the first-ever “Health Day” at the 2023 United Nations Climate Change Conference (COP28)—a milestone for the climate and health community. The deliberations issued the COP28 UAE Declaration on Climate and Health signed by 150 countries, including the United States and China, which acknowledged for the first time the growing health impacts of climate change and the protective health benefits of stronger climate action.

As a member of the Health Day Steering Committee, the Foundation worked with the COP28 Presidency to advance substantive climate-health political commitments at COP. Working with a coalition of global partners, including the World Health Organization, the Global Fund, and the Green Climate Fund, The Rockefeller Foundation also developed the COP28 Guiding Principles for Financing Climate and Health Solutions and secured endorsements from over 40 climate and health funders, multilateral development banks, philanthropies, governments, private sector, and civil society. The Guiding Principles anchored over $1 billion USD in climate-health commitments.

Precision Public Health

The Precision Public Health Initiative, launched in 2019 alongside UNICEF, the Global Fund, Gavi, and the World Bank’s Global Financing Facility, helped community health workers across 13 countries in East Africa, Southern Africa, and India use data to deliver the right care at the right time. This five-year body of work, which continued amidst the global pandemic, resulted in national community health policies and national data visualization tools supporting more than 518,000 community health workers.

The work led to the creation of the Community Health Roadmap, now housed within UNICEF, to continue mobilizing resources for community work. The global partnership created dedicated financing mechanisms, including the Africa Frontline First Catalytic Fund at the Global Fund, and a new $100m fund for the Community Health Delivery Partnership being established at USAID and UNICEF.

Our partners also helped develop high-impact data visualization tools across three states in India—Rajasthan, Tamil Nadu, and Chhattisgarh—including a real-time tracking system (THAIMAI) for high-risk pregnancies and sick newborns that uses chatbot technology to track and record services delivered to antenatal women and children up to one year of age.

$100Million
leveraged for community health systems on top of RF's $15M funding from bilateral and multilateral donors
95
health institutions—serving 27 million people—with stronger data-informed immunization practices

FEATURED IMPACT STORIES

Intelligent Community Health Systems Initiative

We partnered with UNICEF to support countries in implementing scalable data-driven community health systems to improve maternal and child health outcomes.

MBDS conducting an exercise in Laos in 2019 for a joint investigation of a disease outbreak (Photo Courtesy of MBDS)

Mekong Basin Disease Surveillance conducting an exercise in Laos in 2019 for a joint investigation of a disease outbreak.

Disease Surveillance

Because climate data can help improve health care, we supported the creation of a disease surveillance dashboard in India that can provide a risk prediction for dengue infection outbreaks four weeks in advance with 70% accuracy. Dengue is a climate-affected disease and is likely to become more common as temperatures rise. In Karnataka, the AI & Robotics Technology Park (ARTPARK) is helping integrate climate data along with other data variables into the Government of Karnataka’s disease monitoring dashboard, which serves 31 districts—over 61 million people. City specific climate and disease management interventions are also introduced at Bengaluru’s Smart City integrated command and control center. This has enabled the district to mobilize resources at least one week in advance of a potential outbreak. The work in Karnataka is already generating interest in other states and is expected to expand partnerships between local collaborators and our Asia Regional Office.

Asia’s Visionary Early Warning System Enables Swift Public Health Responses

The Mekong Basin Disease Surveillance Network, comprising six countries, improves disease detection through collaboration and training. This model is globally relevant for managing disease spread amid climate change and urbanization.

On Reflection

Lessons Learned from our Health Work

2023 was a year of reflection and change. It is clear the world needs a transformation of health systems to better prevent, predict, detect, and respond to disease outbreaks caused or worsened by climate change. Taking time to understand the right role for RF to play in the climate and health intersection is challenging given the urgency our partners feel. But we know it would be irresponsible and unwise to run ahead without understanding what role we’re best placed to play.

Local context matters.In 2023, we tested several pilots to understand the role of technology in responding to climate-aggravated infections, such as the work with ARTPARK. One of the lessons we learned after the disappointment of our Pandemic Prevention Institute work is that we cannot underestimate the power of local context. The Foundation needs to practice deep listening to understand climate and health needs and priorities as they evolve. How we create matters as much as what we create.

Sustainability requires planning from day one. Some of the work the Foundation is concluding will continue because we stepped into it understanding we would be time-bound partners. As the strategy gains momentum, we must do so in coalition with leaders in the field who are well-placed to make sure the work that matters for people’s health continues beyond RF and philanthropy’s initial intervention.

Go where there is government excitement. For successful government engagement, it is critical to engage early and continuously, as well as understand the decision-making process and priorities. ARTPARK engaged closely with local government stakeholders to understand local needs, limitations and aspirations. This insight and close collaboration led to the development of a tool for dengue surveillance that went on to become a model for other states in India.

Prisma Alvarez takes a blood sample to check for malaria on Mocoron, Honduras

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Jump to Other Chapters

CH01

Energy

Speeding the Energy Transition

Electricity access is the most impactful catalyst for opportunity and development, with income and energy consumption tightly correlated on every continent. And yet, estimates suggest that more than three-quarters of all emissions globally come from the energy sector. For nearly 15 years, the Foundation has worked at the intersection of both challenges—bringing renewable energy to those who lack steady power while also pushing to reduce emissions. Since no one organization will solve this, we have worked alongside diverse partners to test new ideas, learn, and adapt together.

CH.02

Food

Scaling Good Food

In much of the world, the food we eat is increasing human health risks, while our methods for growing that food are harming the planet. Climate change is also making it harder for many to find the food they need to live and thrive. The Foundation is working on multiple fronts to ensure the world grows, produces, and eats “Good Food,” which benefits people and planet alike.

CH.04

Finance

Unlocking Finance

The world has many solutions to help transform the energy, food, and health systems—but only additional capital can provide the access and scale necessary. In 2023, the Foundation’s Finance team worked to close the global climate financing gap—which stands annually at $3.5 trillion—by working to tap private and public sources while also seeking to ensure that important legislative action helps families and communities adapt and prosper.

CH.OV

Overview

Impact Report 2023