One fifth of the population of southern Malawi will be better equipped to safeguard against climate-aggravated health risks due to a US$37 million initiative announced today by the Green Climate Fund, the Government of Malawi, and Save the Children and its partners.

The project, Climate resilient health and well-being for rural communities in Southern Malawi, aims to directly benefit an estimated 1.7 million people - 22% of the population - across six districts in southern Malawi over the next five years.

It will focus on women, children and other vulnerable groups who are most affected by climate shocks such as cyclones, floods and droughts. These climate events are becoming more frequent and severe due to the climate crisis, leading to spiralling cases of water- and vector-borne diseases like malaria, cholera and diarrhoea.

With a recent study [1] in resilience to shocks, including the impacts of climate change, ranking Malawi as 117 in a list of 142 countries, this programme aims to better prepare healthcare staff and communities to manage these risks and to support children to thrive.

Malaria is the fifth biggest cause of death in Malawi [2], with transmission driven by high temperatures, rainfall and humidity. With these weather patterns becoming more extreme, the disease is already now being reported in high-altitude areas that were previously “malaria-free zones”, and the growth cycle of the parasite in lower altitudes is developing more quickly, increasing transmission and burden of the disease.

Increased flooding is also likely to spread malaria and other vector-borne diseases, as well as diarrhoeal diseases like cholera – the seventh biggest cause of death in Malawi. [3]

The new project will support the establishment of an Early Warning and Response System (EWARS) – an integrated climate and health surveillance to predict outbreaks and surges of climate-sensitive diseases and conditions. This will go one step ahead of traditional health surveillance systems, providing advance warnings based on climate and weather events to allow the health sector and vulnerable groups in society to take action to mitigate and respond to the impacts of impending health risks.

The project will also strengthen the resilience of health centres, hospitals and water, sanitation and hygiene infrastructure; support and train healthcare staff to improve the monitoring, treatment, prevention and public health messaging around disease; and support communities to manage a range of impacts of climate change on health, particularly focusing on marginalised groups, including pregnant women and households with children under two.

This project has been made possible due to a Green Climate Fund grant of US$33 million and co-financing of £1 million from pharmaceutical company GSK and 1 million euros from Foundation S - The Sanofi Collective (Sanofi's philanthropic organisation). Further financial support comes from Moondance Foundation and the UK’s Foreign, Commonwealth and Development Office, along with an in-kind contribution from the Government of Malawi’s Ministry of Health.

Ashebir Debebe, Country Director at Save the Children Malawi, said:

"With more than 25 severe storms and floods in the last decade, climate change is pushing Malawi’s health systems to the brink. Tropical Cyclone Freddy in 2023 damaged over 300 health facilities, displaced 92 health workers, and left entire communities—especially children, pregnant women, and people living with HIV—without access to critical care. Cyclone Freddy caused an estimated $4.14 million damage to the health and nutrition sector, and disrupted services to nearly 340,000 children under five, 175,000 people living with HIV, and 90,000 pregnant and breastfeeding women.

“This project will ensure that our healthcare infrastructure is more resilient to climatic shocks, so we can better protect vulnerable communities and save lives. By introducing the Health Early Warning and Response System, we will better equip healthcare staff to predict and respond to climate-sensitive diseases like cholera and malaria, which are rising due to extreme weather. We look forward to implementing this project alongside the Ministry of Health as co-executing entities and starting to realize the Ministry’s climate and health ambitions articulated in Health Sector Strategy III.”

Mr Henry Gonzalez, Chief Investment Officer of the Green Climate Fund (GCF), said:

“The project represents an important step toward reducing the adverse effects of climate change on the health and well-being of the Malawian population. The project adopts a holistic climate-informed approach to strengthening Malawi’s health system. This comprehensive programmatic strategy is one that GCF is increasingly adopting in its investments in health and other sectors in several countries.”

Thomas Breuer, Chief Global Health Officer at GSK, said:

“We are proud of our contribution to this important climate-health project to strengthen Malawi’s climate resilience. Changing climate conditions are shifting the patterns of infectious disease transmission, making disease outbreaks more likely and intensifying health impacts from extreme weather events. At GSK, we are committed to getting ahead of the health impacts of climate change, and together through partnership, we hope to positively impact the health of women, children and other vulnerable groups in Malawi disproportionately affected by climate shocks.”

Vanina Laurent-Ledru, Director General at Foundation S – The Sanofi Collective, said:

“The climate crisis is a health crisis and it’s devastating to see the impact this is already having on rural populations in Malawi. There is a staggering $366 billion finance gap between current annual funding for climate adaptation and the need. At Foundation S, we are deeply committed to fast-tracking flexible financing, fostering resilience and improving health outcomes in vulnerable communities. Our contribution to this initiative underscores our support for innovative solutions to address the urgent health challenges posed by climate change. We believe that by working together, we can create a safer, healthier future for the people of Southern Malawi.”

This is Save the Children’s sixth project with the Green Climate Fund, following the approval of major climate resilience and adaptation programmes in Vanuatu in May 2022, Lao PDR in November 2023,  Solomon Islands in July 2023, Sierra Leone in March 2024 and Mozambique in July 2024.

The Board of the Green Climate Fund approved financing for the project at their Board meeting today in Songdo, South Korea, with representatives from the Green Climate Fund and Save the Children signing the project agreement.