Climate shocks could disrupt services that millions of vulnerable people rely on, but care is largely absent from adaptation plans and national funding estimates. Investing in climate-resilient care can prevent ongoing health and economic crises while creating jobs and reducing pressure on public budgets.
WASHINGTON, DC—It is increasingly difficult to justify the slow pace of adaptation to climate change. Last year was one of the hottest on record, with economies and communities around the world disrupted by extreme heat, heavy rains, and tropical cyclones. As November’s United Nations Climate Change Conference (COP31) in Turkey approaches, governments must go beyond their climate commitments and focus on implementation.
Funding for adaptation activities remains largely unneeded. The UN Environment Program estimates that developing countries will need $310–365 billion annually until 2035, leaving the current funding gap at $280 billion. Getting money where it can do the most good can be a bigger challenge, as institutions struggle to identify adaptation investments that are ready to be implemented and risks can be properly assessed and priced.
In a new working paper, we argue that funding needs estimates and the proposed investment pipeline ignore critical infrastructure: the ecosystem of climate-adapted care services that help families prepare for, cope with, and recover from climate-induced hazards. Properly designed, these services can improve household and community resilience. The same principle supports investment in early warning systems and adaptive social protection designed to help countries respond to climate shocks.
Provisional estimates suggest that there could be at least 35,000 excess deaths across Europe as heatwaves return to the end of a severe summer. Despite a well-developed welfare system, lack of climate-adapted physical infrastructure and coordinated services contribute to this excess mortality.
But national climate adaptation plans rarely address what happens when care breaks down. Floods and wildfires have uprooted families and separated caregivers from those who depend on them. When household-based care is no longer possible, formal care can be a lifeline for elderly and disabled people who cannot evacuate or manage on their own. Without reliable care services, health problems can lead to preventable hospital admissions, and put even more pressure on already strained services.
As matters stand, family caregivers are left to bear the brunt, dealing with injuries and burnout during prolonged emergencies. Some, mostly women, are forced to leave paid work only when their families cannot afford to lose their income. When care systems fail, climate shocks can quickly turn into health and economic crises. A robust treatment system can prevent these cascading failures, making treatment an essential part of climate resilience.
Leaving treatment out of national adaptation plans means underestimating what is needed for climate resilience. Admittedly, anticipating these needs is difficult, as there is no standard definition of what qualifies as adaptation, and national estimates are often based on individual projects, most of which are in the conventional sector.
That sector-by-sector approach allows care to fall through the cracks. Agriculture, forestry, fisheries, water supply, and sanitation account for nearly 40% of global adaptation funding, while health gets about 4-6% and education about 2%. Long-term care and early childhood care and education are lacking, especially in low- and middle-income countries, where most care is provided informally.
Although very low, the figure of $310–365 billion has been included in national plans and multilateral development bank targets. But as climate shocks intensify, people need more care, not less. And when formal services fall short, unpaid caregivers—many women and girls—will fill the gap.
Our paper proposes a way to begin correcting this omission. For example, we estimate that building climate-resilient care infrastructure in Bangladesh would require an investment equivalent to approximately 3-5% of GDP, similar to what is needed for health and education. This is a substantial investment, but only a fraction of the estimated value of unpaid care work.
Building that treatment infrastructure will require millions of workers. We estimate that early childhood care and education and long-term care can directly employ 3.6–7 million people in Bangladesh. More jobs will come from providing food and other supplies, as well as from building or renovating childcare facilities and housing for people receiving long-term care.
Care services also give financiers a concrete way to make money adapting. For starters, these investments come with an established evidence base—data on unit costs, staffing models, utilization, and outcomes—facilitating risk assessment. Some of these investments partially pay for themselves through tax revenue from higher employment and lower costs for health and social protection. And the demand is guaranteed demographically, because the need for care can only grow as the population ages.
As adaptation funding tightens, every dollar must work harder. That makes it all the more important to invest in care systems that help communities withstand climate shocks while reducing pressure on public budgets.