Climate-smart public health for global health resilience.

Climate change poses urgent public health risks from rising global temperatures and extreme weather events, including heatwaves, droughts, and floods, which disproportionately affect vulnerable populations. To address the current silos embedded in climate, environmental, and public health monitoring and surveillance systems, climate-smart public health (CSPH) creates an integrated platform for action across these sectors, enabling more rapid and efficient responses to climate-related public health challenges. In this Personal View, we introduce the concept of CSPH, a data-driven framework designed to monitor, assess, and adapt to climate-related health impacts. CSPH incorporates surveillance, risk assessment, early warning systems, and resilient health-care infrastructure to address the evolving challenges of climate change. The framework adopts an iterative, community-centred model that responds to local needs and incorporates feedback from health-care providers and policy makers. CSPH also leverages data science and artificial intelligence to address a wide range of health concerns, including infectious diseases, non-communicable diseases, nutrition, and mental health. We applied this framework in Madagascar, a region highly vulnerable to climate impacts, where poverty, malnutrition, and frequent extreme weather events make climate adaptation particularly urgent. Early data analysis has shown strong climate sensitivity in important diseases such as malaria and diarrhoea, which could enable preparedness efforts to target some regions more efficiently. CSPH provides a pathway to enhance resilience in such settings by improving the capacity of public health systems to withstand and respond to climate-related stressors.