Climate change as a health crisis: Mental health, non-communicable diseases, and health system resilience as neglected dimensions of national adaptation plans

Recent assessments including the World Health Organization COP29 special report on climate change and health (2024) the Sixth Assessment Report (AR6) by the Intergovernmental Panel on Climate Change (IPCC) 2023, and the 2025 Lancet Countdown on health and climate change confirm that climate change is a present and accelerating threat to human health with wide-ranging consequences for populations and health systems worldwide. Yet, while global mitigation efforts have gained momentum including through World Health Assembly Resolution WHA75.8 (2022) and the WHO Alliance for Transformative Action on Climate and Health (ATACH), the dominant adaptation response remains narrowly focused on infectious disease and acute disaster impacts. This commentary argues that the true health toll extends far beyond these immediate threats, encompassing three dimensions that remain systematically underrepresented in general National Adaptation Plans (NAPs): the mental health consequences of climate-driven displacement; the exacerbation of non-communicable diseases through food insecurity, air pollution, and disrupted care; and the fragility of health systems under repeated climate shocks. Critically, these dimensions remain underrepresented in general NAPs, the whole-of-government instruments through which cross-sectoral climate investments are directed, even as Health National Adaptation Plans (H-NAPs) have made greater progress in addressing them. Fewer than half of countries have developed H-NAPs, and their implementation and financing remain uneven, particularly in low- and middle-income countries (LMICs) where climate vulnerability is greatest. This commentary calls for urgent integration of these overlooked burdens into climate policy through a multisectoral, whole-of-society approach coupling ambitious mitigation, which delivers immediate health co-benefits through cleaner air, active transport, and sustainable diets, with adaptation strategies that explicitly address mental health, chronic disease, and health system resilience. Only by expanding climate-health policy to explicitly address mental health, chronic disease burden, and health system resilience alongside the more visible acute impacts can we build adaptation responses that are both just and effective.