The Triple Burden: Climate, Health and Financial Exclusion

2024 shattered climate records - not just in rising temperatures, but in the urgency it brought to every sector, including financial inclusion. As heat waves scorched cities and floods displaced communities, the conversation around climate risks moved from the margins to the mainstream. In the financial inclusion space, however, the response has remained relatively narrow - often focused on agriculture or housing finance, leaving significant gaps in how we understand and support the broader climate resilience needs of low-income clients and the financial service providers that serve them.

While agriculture and housing finance are undoubtedly critical, they represent just a slice of the resilience landscape. Climate change affects all aspects of life – environment, food systems and nutrition, business and livelihoods, education, housing and human health. As climate shocks grow more frequent with increased magnitude, our approach must grow as well - expanding beyond sector-specific solutions to include tools for recovery, migration, health shocks and the financial system’s own adaptive capacity. 

Bringing health into the climate resilience picture

Around the world, millions of people lack access to essential healthcare. Out-of-pocket health expenditures continue to rise and push people into poverty. Those affected most by the rising cost of healthcare tend to live in low- and middle-income countries that already have weak financial systems and strained healthcare systems. These are also the people who are most affected by climate change and, in parallel, by financial exclusion. This triple burden – of climate vulnerability, lack of access to healthcare and lack of financial services - weighs heavily on the shoulders of women living on low incomes, smallholder farmers and rural populations, migrants, youth, and low-income households more broadly.  

Financial inclusion can help to ease this burden, as these are the very same populations the sector seeks to serve. And while the problem goes far beyond the financial inclusion sector, there is a clear role for it to play in health financing solutions that enable climate vulnerable populations to access healthcare and reduce out-of-pocket medical expenses.

Innovations at the intersection of climate, health and financial inclusion

Earlier this year (2025) Swiss Capacity Building Facility (SCBF), with the support of UBS Optimus Foundation, published a pioneering report, Financial Inclusion Innovations for Healthcare in a Changing Climate. The report highlights promising innovations, identifies gaps and explores opportunities at the intersection of climate, health and financial inclusion. To further the conversation, SCBF and UBS Optimus Foundation co-hosted a virtual roundtable discussion featuring insights from the International Labour Organization’s Impact Insurance Facility and Atlantic Councils’ Climate Resilience Center.

While the report found that there are few financial inclusion solutions explicitly addressing climate-related health risks, there are innovations that already serve the most climate vulnerable populations. The most promising innovations highlighted in the report and the roundtable discussion focused on integrated solutions to address the problem, incorporating the following ways of working:

1. Design with clients, not just for them. Go beyond financial services. Listen to what clients truly need and co-create integrated solutions with the right partners.

• For example: Hospital cash insurance is a proven, simple entry point for health coverage in financial inclusion. It's easy to understand and affordable, especially when bundled with savings or credit products. After learning that health was a top concern for clients, VisionFund launched hospital cash insurance for savings group members - primarily women - in rural Malawi, Ghana and Rwanda, where floods, cyclones and droughts are common.
• Similar hospital cash products beyond the traditional microfinance delivery model are emerging, as well as different channels, such as digital delivery channels. For example, hospital cash insurance is bundled with seed or fertilizer purchases for smallholder farmers, or with insect repellent purchases for consumers in dengue- or malaria-prone areas.

2. Push the frontier: Innovate for climate-driven health risks. As climate change intensifies both chronic disease and sudden illness, financial solutions must evolve too. 

• For example: Parametric insurance for income protection is gaining ground in India, where heatwaves and monsoons affect livelihoods for months each year. In 2023, Blue Marble partnered with SEWA - India’s largest women’s trade union - to pilot a pioneering product for extreme heat. For 2025, based on feedback from SEWA members, the coverage was expanded to include both heatwaves and flooding, protecting health and income alike. 

3. Leverage technology to connect, protect and empower. Tech isn’t just a channel for financial services — it can deliver health protection and timely information, especially in emergencies.

• For example: Telemedicine and digital health platforms are emerging as critical tools. When paired with microfinance or insurance, they can offer borrowers and smallholder farmers virtual consultations, early warning alerts and actionable health content - helping vulnerable populations respond to climate-related health threats before they become crises.

The solutions we have shared are still in their infancy and need support to grow and scale. For this to happen, public agencies (both health- and climate-focused), donors, international organizations, insurance companies, pharmaceuticals and financial institutions need to work in parallel and in partnership. The goal should be to create an enabling environment where sufficient resources – in both technical assistance and financing - are deployed to solve the pressing global challenge of the triple burden.