We address an ethical challenge in climate change adaptation and global health research. The challenge stems from two pairs of intuitions about justice and responsibility in climate change and health. One pair assigns responsibility for adaptation research to high-income countries given their historical emissions, disproportionate share of resources and capacity to intervene. The other pair assigns responsibility to low- and middle-income countries given their agency, right to self-determination, local authority and legitimacy, and disproportionate burden of climate and health risks. The intuitions create conflicting views: obligation and assistance pull in one direction, and agency and authority pull in another. To resolve the tension, we distinguish two forms of responsibility: (i) adaptation-enabling responsibilities; and (ii) adaptation-enacting responsibilities. The resulting division of labour reflects different forms of justice and aligns with the principle of subsidiarity's core elements, namely: non-abandonment, non-absorption, and cooperation and coordination. We thus propose a framework that ascribes adaptation-enabling responsibilities to high-income countries, including adaptation financing, capacity-building and other forms of support; and adaptation-enacting responsibilities to low- and middle-income countries, including priority-setting in local adaptation research, and creation and implementation of their adaptation plans and policies. Our framework also suggests a third form of responsibility: shared adaptation responsibilities, which are jointly assigned to high-income countries, low- and middle-income countries and agents at multiple levels within them. We conclude that genuine collaboration in adaptation research, where high-income countries enable without dominating and low- and middle-income countries act without being abandoned, will be essential for just and effective adaptation to climate change.
Ferguson et al. (Sun,) studied this question.