Introduction Climate change is an environmental challenge and health threat. In Indonesia—one of the countries most vulnerable to the climate crisis—its thousands of islands and long coastlines put communities at risk from rising seas, floods, and other climate-related disasters, placing health systems under pressure. Rising temperatures, shifting rainfall patterns, and extreme weather events are increasing the spread of infectious diseases such as dengue and malaria and worsening respiratory illnesses linked to air pollution and forest fires. Climate change also contributes to food insecurity, displacement, and poor living conditions. These impacts strain an already overburdened health system and threaten progress toward the Sustainable Development Goals and universal health coverage. Low-income families, women, children, older people, and people living in informal or coastal settlements are particularly vulnerable, showing how climate change can deepen existing inequalities. Addressing these risks requires more than action within the health sector. Climate-related health risks cut across government ministries, making policy alignment and inter-ministerial coordination essential. Building a Coordinated Climate-Health Approach Indonesia has been strengthening this coordination through national policies and strategies that bring together climate change and health. The country ratified the Paris Agreement through Law No. 16 in 2016, and its National Action Plan for Climate Change Adaptation identifies health as one of four priority sectors. To help translate these commitments into action, the Asian Development Bank (ADB) provided technical assistance to the Indonesian government on climate and health. This technical assistance project helped the Ministry of Health develop a guide for implementing health adaptation actions at the national, district, and city levels. It also mapped climate change policies and programs, their intersections with health, and the potential stakeholders and development partners that could support adaptation. Through these activities, the technical assistance project brings together policy alignment, implementation guidance and institutional coordination for climate adaptation. Bringing health into climate planningIndonesia’s climate and health policies increasingly recognize that the two agendas need to be addressed. The National Medium-Term Development Plan for 2020–2024 called for stronger primary health care and referral systems and expanded digital health, while embedding environmental sustainability and climate resilience across food systems, industrial policy, and ecological resilience. The Long-term Strategy on Low Carbon and Climate Resilience 2050 recognizes potential economic losses from climate change impacts on the health sector. It identifies water, food, energy, environmental health, ecosystem, and disasters as priority areas for climate action. The Climate Resilience Development Policy 2.0 places health among four priority sectors. It recognizes that changes in temperature, rainfall, humidity, and environmental conditions can increase climate-sensitive diseases. The policy defines climate-resilient development as a whole-of-system approach that integrates adaptation into development planning and uses climate projections, risk mapping, and economic loss estimates to guide action. Turning policy into actionIndonesia’s Health National Adaptation Plan was developed based on the country’s Nationally Determined Contribution, climate adaptation plans, and national disaster management plan. These identify the health risks associated with climate change and provide a basis for implementing adaptation strategies in the health sector. The Ministry of Health also established a technical team on Adaptation to the Impacts of Climate Change in the Health Sector. The Ministry of Health's Strategic Plan calls for regulatory frameworks on climate change adaptation in the health sector and requires coordination among units and agencies. However, a national policy framework is only one part of implementation. Policies must fit together and adaptation actions need to be carried out at different levels. Coordinating across agenciesClimate-related health risks do not fall within the responsibility of one ministry. In Indonesia, various ministries and agencies contribute to the climate change agenda and, thus to the climate–health response. The Ministry of Environment, through its Directorate General of Climate Change, serves as the focal point for climate policy planning. It also leads the Climate Village Program, whose community focus aligns with the Ministry of Health’s Desa Sehat Iklim, or Climate-Resilient Healthy Village, initiative. The Ministry of Health contributes health facility and epidemiological data. The Meteorology, Climatology and Geophysics Agency and the National Disaster Management Agency generate climate and disaster data to model risks and inform responses to climate-sensitive diseases. Meanwhile, the Ministry of Energy and Mineral Resources collaborates with the Ministry of Environment to align national energy planning with climate commitments. This illustrates why climate-related health risks require coordination across government. Different agencies have different responsibilities, information, and areas of expertise. Connecting these roles aligns climate priorities with health action. Indonesia’s experience with COVID-19 illustrates the challenges of coordinating information across institutions and levels of government. Its One Data system enabled the cross-sectoral review of government guidelines and their implementation. However, integrating information from subnational governments into a national system remained challenging because of interoperability, data-quality, and human-resource constraints. Engaging stakeholders and partnersClimate–health action also requires collaboration beyond government agencies. Development partners—such as United Nations agencies, development partners, and multilateral development banks—support national efforts through financial support, technical assistance, and capacity building. The broader health-security experience documented in this report demonstrates the role of partnerships in responding to complex health challenges. During the COVID-19 response, Indonesia worked with private companies and nongovernment organizations to establish vaccination centers and provide logistics support. Indonesia’s approach shows that responding to climate-related health risks requires action beyond the health sector. Aligning climate and health policies, translating them into implementation frameworks, and coordinating the roles of government agencies and partners strengthens the foundation for climate-health action. Ask the Experts Alexo Esperato Senior Health Specialist, Human and Social Development Sector, Sectors Department 3, Asian Development Bank Alexo Esperato works across the Southeast Asia and Pacific region. Previously, he worked on health systems in Latin America, the Middle East and India with the Gates Foundation, World Bank, and World Health Organization. He holds a PhD in health services from Johns Hopkins University, a master's degree in public policy and a bachelor's degree in economics. He has also co-authored several studies on health systems, including a Lancet report on primary health care. Randolph Dacanay Regional Coordinator, Sectors Department 3, Asian Development Bank Randy Dacanay is a health security and social development specialist with extensive experience in technical assistance coordination, health cooperation, and community-driven development. He has served in various roles with ADB, including senior technical coordinator, program manager, Greater Mekong Subregion health security coordinator, and knowledge management specialist. He worked as an outreach officer for an Asia-Pacific network facilitating Aid Effectiveness Multistakeholder Consultation Workshops across Asia, Latin America, the Middle East, and Africa. He also worked on USAID- and World Bank-supported development projects. Asian Development Bank (ADB) The Asian Development Bank is a leading multilateral development bank supporting sustainable, inclusive, and resilient growth across Asia and the Pacific. Working with its members and partners to solve complex challenges together, ADB harnesses innovative financial tools and strategic partnerships to transform lives, build quality infrastructure, and safeguard our planet. Founded in 1966, ADB is owned by 69 members—49 from the region. Follow Asian Development Bank (ADB) on Leave your question or comment in the section below: View the discussion thread.