Just made my first edits on National Library of Norway's local history wiki.

Let's see if they last longer than my first edits on Wikipedia.

https://lokalhistoriewiki.no

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Climate change and health: what the Lancet Countdown says about the value and significance of local knowledge and action

Here is everything that the new Lancet Countdown says about the value and significance of indigenous and other forms of local knowledge, as well as their value for community-led action to respond to the impacts of climate change on health.

Why does this matter? Read our article: How the Lancet Countdown illuminates a new path to climate-resilient health systems

On the value of community-led action and the significance of local knowledge

Defining community-led action by its local context and empowerment

“Community-led actions are those spearheaded by self-organised individuals within a community, working together for a common goal. Rooted in local societal, cultural, and economic contexts, they can promote equity, empower local actors, and strengthen climate resilience.”

Community-led action as a driver of meaningful progress

“Individual, community-led, and civil society actions can drive meaningful progress with substantial health benefits.”

Grassroots activities growing into formal organizations

“These grassroots activities can grow into formal organisations with national or international influence.”

The dependence of community-led initiatives on local actors

“Despite their capacity to enact change, community-led initiatives depend on the willingness and possibilities of local actors.”

The advantages of community-led actions over top-down interventions

“Tailored to local needs, community-led actions are more likely than top-down interventions to maximise health benefits, bypass the limitations of implementing top-down solutions, and can help avoid unintended harms such as gentrification or increased inequalities.”

The co-benefits of community-led action on mental health and awareness

“Community-led actions can also foster agency, increase attachment to the local environment, and promote social interactions, all of which help reduce the mental health impacts of climate change and increase awareness.”

Recommendation for individuals and civil society: Engage in community-led action

“Engaging in community-led action on health and climate change, supporting equitable inclusion of marginalised communities.”

Recommendation for individuals and civil society: Create community platforms for collective resilience

“Creating community platforms on climate change and health, including citizen groups, to safely exchange ideas and concerns, build collective resilience and adaptive capacity, and enable engagement with decision makers.”

Value of local knowledge: We need more examples of community-led action

Example of local community and indigenous peoples’ forest management

“In Nepal, community forests user groups have grown into a state-sponsored and legally mandated initiative, under which local communities, including Indigenous Peoples, manage 37-7% of national forests—augmenting carbon sinks, enhancing food access, and improving livelihoods.”

Example of farmer-led interventions improving health outcomes

“Across the Sahel, farmers have implemented Farmer Managed Natural Regeneration… These farmer-led interventions resulted in increased tree coverage, crop yields, drought resistance, and access to traditional medicines, contributing to improved health outcome and poverty reduction.”

Environmental defenders need protection

The disproportionate killing of indigenous and minoritized environmental defenders

“A Global Witness report found that 196 activists were killed in 2023 (57% in Latin America), with minoritised and Indigenous groups disproportionately affected.”

Protecting environmental defenders to enable community-led interventions

“Protecting environmental defenders in line with international conventions is critical to enabling community-led interventions, and providing a fertile ground for grassroots initiatives to deliver life-saving progress on health and climate change.”

On the need for community-led action amid waning political engagement

The role of health framing in driving community-led action

“This [health framings of climate change] can be a crucial driver for individual-led and community-led action, especially amid waning engagement from political leaders.”

Community and individual action as essential when national engagement wanes

“When national government engagement wanes (indicator 5.4.1), action by subnational governments, corporations, civil society organisations, communities, and individuals can contribute to keeping the planet within inhabitable limits.”

Recommendation for funders on the significance of local knowledge:

Recommendation for funders: Support community initiatives to scale action

“…supporting governmental bodies, civil society organisations, and community initiatives to scale-up health-promoting and inclusive climate change action.”

On the value of indigenous knowledge

Respecting indigenous knowledge in global health action

“To support global health, these actions need to be delivered in ways that are gender-responsive, reduce health inequities, respect and promote the rights and knowledge of Indigenous People, and account for the protection of vulnerable and underserved communities.”

Recommendation for national governments: Integrate community and indigenous perspectives in policy design

“Including community perspectives in the design of climate and health policies, with particular focus on the most vulnerable communities and Indigenous people.”

Recommendation for city governments: Prioritize indigenous knowledge and community-led initiatives

“Reducing inequities and avoiding unintended harms by integrating community perspectives in all climate change actions and supporting community-led initiatives, with particular focus on vulnerable communities and the priorities and knowledge of Indigenous people.”

On the need to refocus the apparatus of science on the most vulnerable people and communities

Scientific evidence generation is concentrated in high-HDI countries, not where impacts are highest

“Scientific evidence generation is still concentrated in higher HDI countries rather than those most exposed to the health impacts of climate change.”

Data gaps obscuring the impacts on indigenous people

“This lack of disaggregated data makes it difficult to capture the disproportionate impacts of climate change on Indigenous people, such as those living in the circumpolar region, which is heating nearly four times faster than the global average.”

Conflict analysis must be shaped by local dynamics

“This relationship [between climate change and conflict] is now widely recognised as a complex, multicausal phenomenon shaped by local social and cultural dynamics, economic fluctuations, and geopolitical forces at both the domestic and international levels.”

On ensuring the relevance of science to support local action

Harnessing local knowledge for regional stakeholders

“…harnessing local knowledge and translating findings to meet the needs of local stakeholders.”

Advancing the local generation of evidence

“…to advance the local generation of evidence to inform action in one of the world’s most vulnerable regions.”

Informing action at the local level

“…make their findings available to inform action at the national and local levels.”

References

Image: The Geneva Learning Foundation Collection © 2025

#communityResilience #communityLedAction #IndigenousKnowledge #LancetCountdown #localKnowledge #MarinaRomanello #The2025ReportOfTheLancetCountdownOnHealthAndClimateChange

Please read this thread: https://m.ai6yr.org/@ai6yr/114802747128327905

It carries both intelligent commentary and deep local knowledge of the Guadalupe River flood, and it shows nicely how past understanding of severe weather extremes in a landscape where people have learned to adapt ... just is not much help now. Sobering and terrifying.

Scientists contributing to the IPCC talk about integrated physical/social models for long-term forecasting. The worst ones are those where environmental degradation goes along with political fragmentation and a collapse in regulation, driving further breakdown in climate/pollution/biodiversity... in a vicious spiral. This is what that looks like at a local level.

h/t to @ai6yr @johntimaeus @michael_w_busch

#globalHeating
#Polycrisis
#localKnowledge

Why guidelines fail: on consequences of the false dichotomy between global and local knowledge in health systems

Global health continues to grapple with a persistent tension between standardized, evidence-based interventions developed by international experts and the contextual, experiential local knowledge held by local health workers. This dichotomy – between global expertise and local knowledge – has become increasingly problematic as health systems face unprecedented complexity in addressing challenges from climate change to emerging diseases.

The limitations of current approaches

The dominant approach privileges global technical expertise, viewing local knowledge primarily through the lens of “implementation barriers” to be overcome. This framework assumes that if only local practitioners would correctly apply global guidance, health outcomes would improve.

This assumption falls short in several critical ways:

The hidden costs of privileging global expertise

When we examine actual practice, we find that privileging global over local knowledge can actively harm health system performance:

• It creates a “capability trap” where local health workers become dependent on external expertise rather than developing their own problem-solving capabilities.
• It leads to the implementation of standardized solutions that may not address the real needs of communities.
• It demoralizes community-based staff who see their expertise and experience consistently undervalued.
• It slows the spread of innovative local solutions that could benefit other contexts.

Evidence from practice

Recent experiences from the COVID-19 pandemic provide compelling evidence for the importance of local knowledge. While global guidance struggled to keep pace with evolving challenges, local health workers had to figure out how to keep health services going:

• Community health workers in rural areas adapted strategies.
• District health teams created new approaches to maintain essential services during lockdowns.
• Facility staff developed creative solutions to manage PPE shortages.

These innovations emerged not from global technical assistance, but from local practitioners applying their deep understanding of community needs and system constraints, and by exploring new ways to connect with each other and contribute to global knowledge.

Towards a new synthesis

Rather than choosing between global and local knowledge, we need a new synthesis that recognizes their complementary strengths. This requires three fundamental shifts:

1. Reframing local knowledge

• Moving from viewing local knowledge as merely contextual to seeing it as a source of innovation.
• Recognizing frontline health workers as knowledge creators, not just knowledge recipients.
• Valuing experiential learning alongside formal evidence.

2. Rethinking technical assistance

• Shifting from knowledge transfer to knowledge co-creation.
• Building platforms for peer learning and exchange.
• Supporting local problem-solving capabilities.

3. Restructuring power relations

• Creating mechanisms for local knowledge to inform global guidance.
• Developing new metrics that value local innovation.
• Investing in local knowledge documentation and sharing.

Practical implications

This new synthesis has important practical implications for how we approach health system strengthening:

Investment priorities

• Funding mechanisms need to support local knowledge creation and sharing
• Technical assistance should focus on building local problem-solving capabilities
• Technology investments should enable peer learning and knowledge exchange

Capacity building

• Training should emphasize critical thinking and adaptation skills as constitutive of new forms of leadership
• Learning programmes should connect peers across contexts
• Evaluation should measure local innovation and problem-solving

Knowledge management (KM)

• Systems need to recognize that knowledge is found in the connections between humans (and increasingly machines), so that improving KM is about more ‘pipes’ (connections) and better quality-ones
• Platforms should therefore enable peer learning and exchange
• Evidence must include practitioner experience and insights

New paths forward

Moving beyond the false dichotomy between global and local knowledge opens new possibilities for strengthening health systems. By recognizing and valuing both forms of knowledge, we can create more effective, resilient, and equitable health systems.

The challenges facing health systems are too complex for any single source of knowledge to address alone. Only by bringing together global expertise and local knowledge can we develop the solutions needed to improve health outcomes for all.

References

Braithwaite, J., Churruca, K., Long, J.C., Ellis, L.A., Herkes, J., 2018. When complexity science meets implementation science: a theoretical and empirical analysis of systems change. BMC Med 16, 63. https://doi.org/10.1186/s12916-018-1057-z

Farsalinos, K., Poulas, K., Kouretas, D., Vantarakis, A., Leotsinidis, M., Kouvelas, D., Docea, A.O., Kostoff, R., Gerotziafas, G.T., Antoniou, M.N., Polosa, R., Barbouni, A., Yiakoumaki, V., Giannouchos, T.V., Bagos, P.G., Lazopoulos, G., Izotov, B.N., Tutelyan, V.A., Aschner, M., Hartung, T., Wallace, H.M., Carvalho, F., Domingo, J.L., Tsatsakis, A., 2021. Improved strategies to counter the COVID-19 pandemic: Lockdowns vs. primary and community healthcare. Toxicology Reports 8, 1–9. https://doi.org/10.1016/j.toxrep.2020.12.001

Jerneck, A., Olsson, L., 2011. Breaking out of sustainability impasses: How to apply frame analysis, reframing and transition theory to global health challenges. Environmental Innovation and Societal Transitions 1, 255–271. https://doi.org/10.1016/j.eist.2011.10.005

Salve, S., Raven, J., Das, P., Srinivasan, S., Khaled, A., Hayee, M., Olisenekwu, G., Gooding, K., 2023. Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies. PLOS Glob Public Health 3, e0001447. https://doi.org/10.1371/journal.pgph.0001447

Yamey, G., 2012. What are the barriers to scaling up health interventions in low and middle income countries? A qualitative study of academic leaders in implementation science. Global Health 8, 11. https://doi.org/10.1186/1744-8603-8-11

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Critical evidence gaps in the Lancet Countdown on health and climate change

The 2024 report of the Lancet Countdown on health and climate change “reveals the health threats of climate change have reached record-breaking levels” and provides “the most up-to-date assessment of the links between health and climate change”.

Yet its treatment of experiential knowledge – particularly the direct observations and understanding developed by frontline health workers and communities – reveals both progress and persistent gaps in how major global health assessments value different forms of knowing.

The fundamental tension appears right at the start.

The report notes a significant challenge: “A global scarcity of internationally standardised data hinders the capacity to optimally monitor the observed health impacts of climate change and evaluate the health-protective effect of implemented interventions.”

This framing privileges standardized, quantifiable data over other forms of knowledge.

Yet paradoxically, the report recognizes that “health workers are already intimate witnesses to the impacts of climate change on the health of the communities they serve, possessing valuable knowledge that should inform both science and policy.”

This recognition of frontline experience as a valid source of knowledge is significant, even if not fully integrated into the report’s methodology.

Health workers’ experiences are not merely anecdotal but represent a crucial form of evidence gathering and early warning that conventional research methods cannot match.

When a nurse in Bangladesh notices changing patterns of heat-related illness in specific neighborhoods, or when a community health worker in Kenya observes shifts in disease transmission seasons, they are detecting signals that might take epidemiological studies decades to formally document.

Can we afford to wait?

As the report acknowledges that we face “record-breaking threats to their wellbeing, health, and survival from the rapidly changing climate,” why wait for traditional longitudinal studies to validate what health workers are already seeing?

Explore the value of health workers’ experiential knowledge: Jones, I., Mbuh, C., Sadki, R., Eller, K., Rhoda, D., 2023. On the frontline of climate change and health: A health worker eyewitness report. The Geneva Learning Foundation. https://doi.org/10.5281/zenodo.10204660

Their observations, if their significance and value were fully recognized, could provide vital early insights into emerging health threats and guide rapid, life-saving adaptations.

This is especially critical given the report’s call to alarm that climate change impacts are “increasingly claiming lives and livelihoods worldwide” and that “delays in climate change mitigation and adaptation have intensified these impacts.”

The humanitarian imperative to act quickly makes health workers’ experiential knowledge not just valuable but essential – they are the canaries in the coal mine of our climate crisis, and their insights could help bridge critical evidence gaps while more traditional research catches up.

The report’s most thoughtful engagement with alternative forms of knowledge comes in its treatment of Indigenous knowledge systems.

A panel titled “Indigenous knowledge for a healthy future” explicitly acknowledges that “Indigenous peoples maintain deep connections with the natural environment that are important for the social, livelihood, cultural, and spiritual practices that underpin their health and wellbeing.”

More importantly, it recognizes that “Indigenous knowledge has been shown to be the key to protect Indigenous health in times of health emergencies when official health systems and governments are unable to provide assistance to Indigenous communities.”

However, the report also acknowledges that “Indigenous medicine and worldviews are rarely considered within health care or health risk preparedness and response.”

This gap between recognizing the value of Indigenous knowledge and actually incorporating it into health systems and policies reflects a broader challenge.

A crucial observation comes in the report’s data discussion: available data are “rarely disaggregated by relevant groups (eg, gender, age, indigeneity, ethnicity, and socioeconomic level)” and “Indigenous knowledge is often overlooked, and Indigenous populations are seldom taken into consideration in the production and reporting of evidence and data.”

This gap in representation means that crucial experiential knowledge is systematically excluded from our understanding of climate change’s health impacts.

Perhaps most tellingly, while the report calls for “improved data” to evaluate progress on international commitments, it focuses primarily on standardized quantitative metrics rather than developing new frameworks that could better integrate experiential knowledge.

This reveals an underlying epistemological bias – while experiential knowledge is acknowledged as valuable, the report’s methodology remains firmly grounded in traditional scientific approaches.

Looking forward, truly leveraging experiential knowledge in understanding climate change’s health impacts will require more than just acknowledgment.

It will require developing new methodological frameworks that can systematically incorporate and validate different forms of knowing, while ensuring that frontline voices – whether from health workers, Indigenous communities, or other groups with direct experience – are centered rather than marginalized in our understanding of this global crisis.

For the Lancet Countdown to fully live up to its mission of tracking progress on health and climate change, future reports will need to more fundamentally rethink how they recognize, validate, and incorporate experiential knowledge.

The seeds of this transformation are present in the 2024 report.

Doing so is both necessary to improve science and consistent with The Lancet Countdown’s commitment to “operate an open and iterative process of indicator improvement, welcoming proposals for new indicators… from the world’s most vulnerable countries”.

References

Image: The Geneva Learning Foundation Collection © 2024

#climateAndHealth #COP29 #CriticalEvidenceGapsInTheLancetCountdownOnHealthAndClimateChange #epistemology #experientialKnowledge #IndigenousKnowledge #localKnowledge #quantitativeData