Health In Harmony’s response to the Belém Health Action Plan For The Adaptation of the Health Sector to Climate Change (BHAP) adopted at COP30

Health In Harmony welcomes the adoption of the Belém Health Action Plan For The Adaptation of the Health Sector to Climate Change (BHAP). We endorse its ambition to place health at the center of climate action and applaud its call for stronger integration across sectors.

That said, we maintain three critical recommendations for its implementation:

1) We would like to see more ambition in BHAP measure 2.4.5, which strengthens adaptation by safeguarding "food security, water access, and territorial rights of Indigenous Peoples" as fundamental determinants of health. We would like BHAP implementation to reflect the fact that  Indigenous Peoples’ health is a fundamental determinant of ecosystem and planetary health...and therefore of humanity’s health.

The BHAP acknowledges the importance of vulnerable populations, yet the plan still falls short of fully recognizing that the people whose lives are most intertwined with critical ecosystems are not mere beneficiaries of climate and health reform. They are its architects. The knowledge systems, cultural practices, and rights to self-determination of Indigenous and traditional people are the foundation of health systems that strengthen both community well-being and forest protection. Earth’s ecosystem guardians—Indigenous Peoples, Afro-Descendant Peoples, and local communities—are the most effective defenders of Earth’s life-giving ecosystems, and therefore of humanity’s health.

Our work alongside rainforest communities globally has proven time and again that when they lead the design and management of health interventions, outcomes improve on every front: human health indicators improve, threats to forests sharply decrease, and climate benefits multiply. Their self-determination and holistic, nature-based solutions create health systems that work, while delivering greater climate and biodiversity results for less money than externally imposed initiatives. 

The BHAP nods to this reality, but it needs to embed community-led decision-making and Indigenous governance as core implementation principles.

2) Policy makers need to more forcefully break the artificial silos across and between conventions, across the COPs and the Health Assemblies. We have never lived in a world where the health of people, ecosystems, and the planet could be addressed in isolation. Yet, the COPs—and the BHAP—remain siloed, while humanity’s grand challenges are interdependent and linked.

BHAP missed a pivotal opportunity by not aligning explicitly with the Global Action Plan on Biodiversity and Health adopted under the UN Convention on Biological Diversity (CBD). This global plan recognizes that biodiversity, human health, and climate are deeply interconnected: it promotes cross-sectoral, One Health operational approaches, and recognizes Indigenous Peoples and local community expertise.

The disconnect is demonstrated when the BHAP makes little mention of the operational interdependence between human health and ecosystem health. Actioning this interdependence remains a vital step for the global health community to realize its goals.

3) We would like to see a more ambitious social justice orientation in the BHAP.

The BHAP rightly emphasises inclusive risk-monitoring and disaggregated data – including Indigenous and traditional community knowledge in measure 1.2.3. We believe the plan should go further by embedding community-designed and owned monitoring systems, where forest-dependent communities own and govern the data and use of the system. 

And in Action Line 3 (Innovation, Production & Digital Health), the emphasis on resilient infrastructure, digital access and remote communities is welcome—including telehealth and supply-chain resilience. But innovation must go beyond external technology, and include Indigenous and local community-led innovation. 

The Plan also mentions “equitable access” but falls short of embedding self-determination in local production of essential medicines and community-based innovation design.

We call on parties to be more ambitious in the implementation of the BHAP, to center Indigenous and local leadership, invest in their priorities, and treat their ways of knowing as indispensable to health system adaptation and planetary health. We must fund climate and health solutions at the source.