At the 20th Community-Based Adaptation (CBA) conference, held in Manila in May 2026, Itad collaborated with the Wellcome Trust to explore this question. Drawing on experience and learning from two of the Wellcome Trust’s Climate Impacts Awards projects, we examined how evidence can translate into real policy change:
- The health impacts of climate change on precarious outdoor workers in urban megacities in Vietnam (National Centre for Social Research)
- If cities could speak: Health impacts in vulnerable settlements in megacities of the Global South (Indian Institute for Human Settlements)
We know that while the evidence base on climate-related health impacts across local and indigenous communities continues to grow, it is not driving change at the scale required. Our session brought together insights from Wellcome’s Climate Impacts Awards grantees and the wider CBA community to discuss what it takes to translate evidence into meaningful, sustained policy action.
Below, we reflect on four key insights from these discussions.
1. Impact comes from aligning with existing priorities – and health can provide an entry point.
We heard that meaningful policy traction rarely comes from introducing entirely new agendas. Instead, progress is more likely when efforts build on what already exists – such as National Adaptation Plans, development strategies, and sectoral policies – identifying where climate and health policy goals can add value to one another.
Health can be a powerful entry point, helping frame climate impacts in ways that are immediate, relatable and politically relevant. However, influencing policy is not just about strong technical evidence and solutions – it is also deeply relational. Success often depends on identifying champions within policy systems, framing messages in ways that resonate with decision-makers, and building trust over time through credible, actionable insights.
2. Cross-sector working delivers results when it is anchored in ownership, incentives and accountability.
Climate and health challenges require collaboration across diverse expertise – and this is stipulated within the Climate Impacts Awards through the requirement for mature, transdisciplinary teams, who are able to hit the ground running to achieve impact in a short time frame. To deliver impact, teams need to engage across sectors, stakeholders and government departments. However, driving coordinated action can be an uphill struggle.
The biggest barriers are not technical but systemic. Misaligned incentives and fragmented governance approaches between siloed government ministries is frequently flagged as a core challenge when working across the climate and health sectors. Even where coordination exists, inadequate financing to respond to health issues continues to stall progress. Success depends on aligning incentives – across sectors, funding streams, and political priorities – so that collaboration becomes not just possible, but essential.
Grantees and practitioners identified that defining responsibilities, shared metrics for success, and mechanisms for collaboration across government, are key to successful cross sector working.
3. Scaling requires investment in proven approaches, through validating, sustaining and strengthening what works.
Across different contexts, there is no shortage of promising approaches already delivering impact at the local level – from community-based health worker programmes to provincial adaptation planning. What drives their success is strong local ownership and effective engagement with communities through trusted partners.
However, scaling these approaches remains a significant challenge. Many initiatives struggle to move beyond pilot stages due to limited funding and capacity constraints among the community-based organisations that lead and drive them. Support from regional and local government is crucial – not only for resourcing efforts, but also for legitimising and sustaining them.
Participants emphasised the need for long-term investment in capacity building and policy frameworks that mandate integrated approaches. We heard an example of this from Australia, where government legislation requiring cross-sector collaboration around subnational adaptation plans has helped drive more effective policy action and wider uptake of effective health interventions.
4. Better outcomes require redistributing power in policy processes.
Policy processes don’t always give a seat at the table for those groups suffering the deepest realities of climate change; those most impacted by climate-related health risks are often the least represented in decision-making. We heard countless examples of the impacts of climate change on underrepresented groups who have limited protection or voice in traditional policy processes, including informal outdoor workers in Vietnam, and informal settlement communities in India. Alongside this, we heard that the data being used by decision-makers in some contexts fails to capture the link between climate change and health impacts on local communities, even when it is available.
When the lived experience of vulnerable communities is absent from policy dialogues, critical risks and barriers affecting those populations remain invisible and unaddressed. Resulting policy and interventions then fail to reach those who are most impacted.
Addressing this requires intentional, human-centred processes. This includes investing in data systems that capture local realities, embedding participatory approaches into policy processes from the outset, and ensuring budget priorities reflect the needs of marginalised groups. Participants discussed that inclusion in policy processes needs to move from principle to practice – through mechanisms that enable communities to not just inform decisions, but to shape them.
Closing the gap between evidence and action
Closing the gap between evidence and action in climate and health is not primarily a knowledge challenge – it is a systems challenge, with direct implications for funders, practitioners, and decision-makers.
Progress will depend on aligning with existing policy priorities, enabling genuine cross-sector collaboration, scaling proven solutions, and – critically – broadening who has a voice in shaping decisions.
With growing evidence, rising political attention, and practical examples of what works, the foundations for change are already in place. The task now is to act with intent – aligning incentives, resources, and power to ensure that climate and health policies deliver not just in theory, but in practice, for those most at risk.
Itad’s ongoing evaluation of the Wellcome Trusts Climate Impacts Awards aims to elevate insight and learning on how meaningful and lasting policy change can be achieved.
Clare Stott and Jennie Thomas are consultants at Itad. Georgia Glasman James is Research Manager, Climate Impacts and Adaptation at the Wellcome Trust.
If you’re working to translate climate and health evidence into policy or practice, we’d love to connect. Get in touch to share your experiences, explore collaboration opportunities, or learn more about our work in this space.
