Interview with Estelle Willie, Director of Health Policy at The Rockefeller Foundation
To build resilient health systems, governments must plan through a climate lens, says Estelle Willie, Director of Health Policy at The Rockefeller Foundation. The Foundation works closely with the public sector and multilateral health organizations to integrate climate change into their agendas. In an interview with IFC, Willie explains how they are helping communities address extreme weather events, identifying and testing potential solutions, and bringing in private partners to scale them.
The Rockefeller Foundation recently committed $100 million to advance solutions at the nexus of climate and health. What are the focus areas of this investment?
Our five-year $100 million commitment to protecting health in a warming world focuses on three strategies. One is investing in community-driven approaches to respond to climate-exacerbated health risks that are happening right now. This includes our support to the Collective Service to strengthen anticipatory action to address devastating floods, hurricanes, and typhoons, which have worsened in recent years due to climate change.
Second, we are exploring how philanthropy can catalyze more sustainable financing for climate change adaptation. It’s easier to make an investment case for mitigation, but climate change is a material risk that will impact the bottom line of businesses, gross domestic product, and how countries move forward in the 21st century. We want to find pathways to scalable investments in adaptation, dealing with the impacts of climate change today.
Lastly, we’re bringing together experts, policymakers, and other partners to build consensus around a shared global health agenda to address these threats. For instance, with the G20 Joint Finance and Health Task Force, we co-hosted an event on the sidelines of the recent United Nations General Assembly on Debt for Health, which brought together Member States and private sector organizations who are not part of the G20 collective but have valuable insights on how to align business priorities with public goods.
What lessons from the COVID-19 pandemic guide your efforts to build more resilient health systems?
The pandemic was a health emergency, but it wasn’t limited to the healthcare industry. It was one of the first times we experienced how impactful a health emergency could be on areas like national security, the economy, and education in developed and developing countries alike. The same applies to climate change, which has far-reaching implications for health and economic prosperity at personal and country levels. We encourage businesses and organizations to ask themselves, “Even if climate change isn’t impacting my business now, how might that change in the future, and what steps can I take now to address it.”
Another takeaway from COVID was seeing philanthropy's influence on sparking action and creating systemic change. I was working on the COVID response here in the United States. Before vaccines became available, we struggled to get our hands on tests. Many test manufacturers were ready to sell, but individual states didn’t have the technical and logistics capabilities to buy them at scale. Through Rockefeller, we created a marketplace called Project ACT and served as a guarantor to kickstart the program. We negotiated the price for tests and worked with an online platform and logistics and delivery service. This initiative eventually became a national model for accessing and disseminating COVID-19 tests. Through the pandemic, we saw philanthropy as a connector between the private and public sectors, and we are applying that lesson to address climate change.
How does the Foundation ensure communities in low- and middle-income countries benefit from its global climate and health agenda? Can you share an example?
We look at countries where ministries of health, finance, and the environment are eager to work together to address climate change, and many of them are in developing countries. If government leadership does not commit to making an investment case in a climate health initiative, it won’t work. So, we work with countries with the greatest political will, inject capital, and bring together public and private experts.
A great example is our work in Dhaka, Bangladesh, through our partnership with the Red Crescent Society. They developed an early action protocol to minimize health risks during intense heat waves. We helped them build multisectoral teams—including climate, health, urban planning, transportation, and education experts—to assist with heat forecasting to pinpoint when specific communities would be at risk of a heat wave. Then, we created a system to alert communities of potential risks and deploy lifesaving resources like safe drinking water, shading areas, and umbrellas at central locations. The World Health Organization and World Meteorological Organization estimate that if scaled to 57 countries, this type of warning system could save around 100,000 lives per year.
Given the critical financing gap in the climate health space, what role does the Rockefeller Foundation play in shaping the market for climate health investments?
What's very clear is that when you look at development aid in general, a lot of money is going to health. We're not saying that the funds for essential health services or health system strengthening should go to climate change. The work to build more resilient healthcare systems should factor in the impact of climate change on health when developing programs, strategies, and infrastructure. That’s what we mean by embedding climate considerations into the health sector.
For instance, when looking at immunizations, one needs to focus on climate-impacted diseases and how they are spreading. When considering Universal Health Coverage (UHC), one can’t achieve UHC if climate impacts a country's health. We must evaluate health through the lens of climate.
We are also doing a lot of advocacy work around making climate change one of the critical priorities for multilateral health organizations and climate funders. We spent a lot of time collaborating with The Global Fund, GAVI, and the World Health Organization to integrate climate priorities into their strategies, and they have responded swiftly. I am proud that all three major multilaterals have made climate change a big focus of their work moving forward in the last year.
How is the Rockefeller Foundation working with private sector partners to develop scalable, technology-based solutions that address climate and health challenges?
The Foundation’s first step in collaborating more effectively with the private sector is to better understand where there is alignment between business strategy and public need. We are working closely with the World Economic Forum to map out what private sector players are doing in this emerging field.
We are also working with countries that have identified their climate-health vulnerabilities and have developed Health National Adaptation Plans to broker partnerships with the private sector to support country-led projects.
How can partnerships with global stakeholders and development banks contribute to sustainable financing models targeting the intersection of climate and health?
At the Rockefeller Foundation, we want to use philanthropic risk capital to test and understand market conditions. We start with data from organizations like the Wellcome Trust, which funds research on factors contributing to extreme weather and climate events and creates speculative models of what could happen in future scenarios. The next step is to apply and test these insights in the field.
Take an early weather warning system as an example. Practically speaking, what does this type of system look like? How does one integrate weather data into a health surveillance system? We have models based on predictive data that show that an early warning system could save X number of lives. We are looking at how that knowledge can be tested and applied in an actual city. Ultimately, we want to create solutions that people will use and then bring in the partners to scale them.
This interview has been edited for length and clarity.
Published in December 2024
Estelle Willie serves as the Director of Health Policy at The Rockefeller Foundation, where she oversees investment portfolios, program partnerships, and engagement strategies for the Foundation's $100 million Climate-Health program. Prior to joining the Foundation, Estelle served as Vice President of Social Impact at Weber Shandwick, where she brokered public-private partnerships for purpose-driven organizations focused on solving complex business and social issues. She started her career as a Health Fellow for U.S. Representative Jim McDermott (D-WA). Estelle earned a Master of Public Health in Health Policy and a Bachelor of Arts in Anthropology from The George Washington University in Washington, DC. She is a term member of the Council on Foreign Relations.