When Communities Lead, Heat–Health Solutions Save Lives

When dangerous heat hits Rio de Janeiro, text alerts ripple across the city. When it strikes rural North Carolina, the Coharie Tribe gathers at their community gym, which stays powered when the grid goes dark. In northern Bangladesh, farmers carry manuals that help them spot and respond to heat stress.

Different tools, same principle: start where people are, listen first, and build with them. This local listening is a hallmark of work we support at The Rockefeller Foundation.

At the same time, the climate crisis is a global health crisis, and it demands that we connect and strengthen approaches across borders. So alongside our investment in locally built solutions, we’ve launched Build the Shared Future, a $50 million initiative to break down silos in the global development and humanitarian sectors and identify and test new solutions. That includes efforts to help reimagine and reinforce global health infrastructure, supporting climate and health leaders in strengthening systems that protect the most vulnerable.

Start Where People Are

Climate change is the greatest public health threat of our time, yet climate plans too often sit apart from health systems. In Rio de Janeiro, that changed after a tragic heat-related death following a Taylor Swift concert when the heat index reached nearly 140°F. Climate scientists and health practitioners co-designed a citywide heat-warning and response protocol.

At the Clínica da Família Maria do Socorro Silva e Souza in Rocinha, physicians stock oral rehydration solutions to protect residents during heatwaves. (Photo Credit: Felipe Wilhelm de Vasconcellos Lang/Pineapple Studio)

Now, when forecasts flag dangerous heat, alerts trigger a citywide response: outdoor work guidance, hydration stations, expanded clinic hours, cooling centers, and proactive outreach to older adults, people who are bed-bound, and families with small children. By treating heat as a risk that touches every part of city life, Rio is protecting residents’ health — on the street, at work, and at home.

Read more about how Rio de Janeiro is protecting health in extreme heat. →

Leadership Belongs Locally

For too long, global health priorities were set far from the communities most affected. That is shifting. In North Carolina, the Coharie Tribe turned lived experience into lasting readiness. After Hurricane Matthew cut power and trapped people in stifling homes in 2016, tribal leaders began organizing their local gymnasium as an emergency hub, serving residents across the county.

Settled in North Carolina since the 1700s, the Coharie now run a thriving community center serving 3,000 tribal members and neighbors across Sampson County. (Photo Credit: Katherine Mount/Global Health Strategies)

With support from Duke University’s Heat Policy Innovation Hub, the Coharie will be working to expand emergency services toward the goal of becoming a Community Lighthouse — an approach pioneered in New Orleans that equips trusted places like churches, clinics, and community centers with solar power, battery storage, and other practical tools. That means they can keep medicines cold, phones charged, information flowing, and doors open to neighbors who need a cool, safe place when a heatwave hits.

As Hub director Dr. Ashley Ward notes, the goal is to put resources and decision-making in the hands of local organizations the community already trusts and turns to.

Read more about efforts to build a Community Lighthouse in North Carolina. →

Finance the Shift, Not Just the Project

Seismic changes in global health financing have opened space to rethink how we fund climate and health. The Climate Vulnerable Forum — a partnership of 74 nations facing outsized climate risks — is supporting countries to develop Climate Prosperity Plans that mobilize investment for health and climate goals together.

Historically, Climate Prosperity Plans rarely included health systems. Today, all 74 Forum members have endorsed climate and health as a 2025 priority, and health investments are now being embedded in plans across 16 countries — to strengthen adaptation, safeguard livelihoods, and keep clinics and communities operating during heat waves, floods, and storms. This is how we move from aid to sustainable investment: by resourcing the systems communities rely on.

Rebuilding Cooperation for a Warming World

The last year has tested the global health architecture. Programs built over decades have been dismantled, exposing millions to avoidable risk. Even so, the public appetite for cooperation endures: in a recent survey of over 36,000 people across 34 countries, most agreed their nation should work with others on shared threats — even when it requires compromise.

That’s the impulse behind the Build the Shared Future initiative. As world leaders gather for the UN General Assembly, our charge is clear: act together, and act with communities, to protect health on a hotter planet.

The heat will keep coming; our response can keep getting smarter. Early warnings tied to real services, reliable services where people already gather, and coordinated emergency response rooted in trust — this is how health is protected in a hotter world.