Gender, Determinants and Climate: Why Mitigation and Adaptation Must Address the Social and Commercial Drivers of Health

Climate change is a public health crisis with deeply gendered determinants and consequences. As it multiplies existing inequities, the same social, economic and commercial factors that shape health also determine who is most exposed, and who is least able to adapt.

From extreme heat exposure during pregnancy and unprotected outdoor work to loss of livelihood due to prolonged drought, the climate crisis can compound existing inequalities and create new risks to health, livelihoods, gender equality, and well-being. Across the Western Pacific Region, these impacts are increasingly evident. Yet climate mitigation and adaptation policies, financing and programmes too often overlook the social and commercial determinants that make climate impacts gendered.

With COP31 widely framed as the "Implementation COP", governments are increasingly being urged to translate commitments under the Belém Gender Action Plan and Belém Health Action Plan that emerged from COP30 into practical action. Yet many countries still lack the evidence, financing and policy integration needed to address the gendered impacts of climate change on health. To address this gap, the World Health Organization (WHO) has launched a new policy brief, Gender, climate change and health: Pathways to action in the Western Pacific Region.

The brief was developed by the WHO Regional Office for the Western Pacific, through its Social Determinants and Healthy Settings Unit and the WHO Asia-Pacific Centre for Environment and Health, based in Seoul, in collaboration with the Australian National University's Global Institute for Women's Leadership.

Launched during the Pacific Pre-COP31 in Fiji in October 2026, the brief supports countries in advancing these commitments ahead of COP31 in Antalya, Türkiye.  

Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific, launches the policy brief during the Pacific Pre-COP31 in Fiji, October 2026. © WHO / Vincent Chen

Different risks, unequal consequences

Climate change affects everyone, but not equitably. Gender intersects with age, disability, income, occupation, as well as access to resources such as land, energy, housing, finance and decision-making.

Exposure is shaped by living and working conditions. People engaged in outdoor, informal and subsistence work, those who cook with solid fuels and those living in inadequate housing face different climate-related risks. These risks often fall hardest on people who are poor, Indigenous, displaced or living with disability.

Protection depends on access to health services, early warnings and safe shelters. In disasters, women often get warnings late, lose access to sexual and reproductive health care and face greater exposure to gender-based violence, while gender-diverse people can be excluded from shelters. For rural men, losing a livelihood to drought can carry a severe mental health toll.

Capacity to adapt depends on land, income, finance and voice. Women often carry heavier unpaid care and have insecure land tenure, yet remain under-represented in climate decisions, and climate finance rarely reaches women-led organizations.  

The evidence is increasingly concerning.

In China, for example, a study of more than 6.2 million births revealed that heat stress during pregnancy increased the risk of preterm birth.

From evidence to experiences across the Region

Behind the statistics are the experiences of individuals and communities already adapting to a changing climate.

In Cambodia, a national Gender and Environment Survey found that 77% of respondents reported worsening mental health associated with slow-onset climate hazards, with women more likely to experience stress and anxiety.

In Solomon Islands, the SAFENET initiative is strengthening access to medical, legal and psychosocial services for women experiencing gender-based violence, including during emergencies.

And in Fiji, national climate policy explicitly incorporates gender considerations into adaptation, mitigation, decision-making and climate finance.

Ensuring safe conditions during pregnancy in extreme heat

At the Pacific Pre-COP31, Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific, supported the launch of Birthright, Wellcome's global call to action addressing the health risks of rising temperatures during pregnancy.

He emphasized that protecting health during pregnancy, birth and the postpartum period must become a central part of climate adaptation. This includes addressing the risks of preterm birth, stillbirth, low birthweight and maternal complications through heat-health early warning systems, clinical guidance, resilient health facilities and community-level action.

Turning commitments into action

The new WHO brief outlines ways to integrate gender and health into national climate plans, strengthen data and protect essential services. It also highlights the need to address the social and commercial determinants of health, including access to basic resources, working conditions, gender norms and the practices of high-emitting industries.

Building on the Belém Gender Action Plan, it calls for action to address the links between climate change, gender equality, health and care. This requires regulating harmful commercial practices, ensuring just transitions and protecting workers from occupational heat and enabling women, Indigenous Peoples, people with disabilities and gender-diverse communities to participate in climate-related decision-making.

As countries gather at COP31 in Türkiye, the priority is to turn commitments into action. Climate action that responds to people's different needs is not only fairer. It is more effective at protecting health and building resilient communities.

Read the full WHO policy brief: Gender, climate change and health: Pathways to action in the Western Pacific Region.