The report is the first output of Resilient Cities, Reimagining Health - a partnership between the Sustainable Markets Initiative (SMI) and the Resilient Cities Network, led by Reckitt and Bupa, with support from the Yale School of Public Health, Mode Economics, and Sanofi - that brings together 29 cities, including Greater Manchester, Lagos, Mexico City and Rio de Janeiro.

Called The Case for Action: The power of prevention to support health in a changing climate, the report was developed with a first-of-its-kind Community of Practice and reveals how practical, city-led interventions can ease pressure on health systems while delivering major health and climate benefits.

The report warns that rising chronic disease, aging populations, skyrocketing healthcare costs and health inequalities are pushing health systems to breaking point. Indeed by 2030, urban mortality from heat is projected to rise 45%, and from air pollution 18% - a combined burden more than double that of transport accidents by 2030.

Yet the report provides hope: low-cost, high-impact measures could transform outcomes. The modelling shows that four bundles of city-led interventions could save more than 725,000 lives per year, cut $70bn in healthcare costs, and avoid 15.6 MtCO₂e (amounting to more than the annual emissions of Prague or Accra), when applied across 11,000 cities globally. The solutions include:

• Simple heat and air quality interventions such as urban greening, cool roofs, active transport, could cut related deaths by 15%.

• Short term measures to improve water, sanitation and hygiene (WASH), such as point-of-use water filtration devices, could prevent 57,000 deaths a year, while water infrastructure upgrades could prevent a further 109,000 deaths a year by 2030.

• Everyday healthy lifestyle promotion through urban design and social prescribing could prevent 131,000 deaths per year by 2030.

• Practical community resilience measures, like early warning systems and awareness campaigns could cut mortality by up to 13% in some cities and often rely on simple, affordable materials.

The coalition is now building a blueprint for climate-resilient health and co-developing a practical guide to embedding health equity and prevention directly into climate plans, as well as bespoke assessment tools to identify and prioritise local interventions, strengthening investment cases.

Katrin Bruebach, Global Director of Programs, Resilient Cities Network, said: “The Case for Action: The power of prevention to support health in a changing climate report is only the beginning of a suite of resources that our cities have asked for to help them understand better the intersection of climate, health and equity. This collective work between 29 pioneering cities, healthcare companies, academia and the private sector, will continue to evolve giving cities both the evidence to advocate for the resources they need and the guidance to take decisive action.”

The initiative reflects the growing recognition that reactive models of healthcare are no longer sustainable. Instead, place-based, cross-sector solutions, from infrastructure to preventative care, must form the foundation of a new approach.

Kris Licht, CEO of Reckitt said: “As pressures on global health systems grow, reaching people before they become patients, including through prevention, self-care, and climate adaptation, is more critical than ever. This project is part of our work to advance access to health and hygiene around the world, offering cities practical tools to deliver lifesaving interventions –that ease pressures on health systems, and benefit people and planet”.

Iñaki Ereño, CEO, Bupa, said: "Good health starts long before medical care is needed - in the air we breathe, the food we eat, and the cities we live in. But these foundations are increasingly under threat from a changing climate, which is making it harder to stay well and harder for healthcare systems to keep pace. At Bupa, we believe the answer lies in prevention: strengthening the environments, systems, and models that sustain health. By reimagining cities with wellbeing at their core, and working with partners, we can help people stay healthier for longer, reduce health inequalities, and build healthcare systems that are both resilient and sustainable."

Jennifer Jordan-Saifi, M.V.O., CEO, Sustainable Markets Initiative, said: “Cities are the heartbeat of our societies, shaping the lives, livelihoods and aspirations of billions of people around the world. At SMI, we see clean and healthy cities as essential to achieving a sustainable future. This demands practical action—deploying advanced technologies, green infrastructure, renewable energy, clean public transport, walkable cities, and inclusive human-centred green spaces. By investing in resilient cities, we empower communities, enhance well-being, drive global progress and accelerate prosperity for generations to come.”

Jeannette Ickovics, Samuel and Liselotte Herman Professor of the Social and Behavioral Sciences, Yale School of Public Health, said: “We made a strategic decision to focus on prevention, emphasizing the importance of leadership in cities to promote climate and health resilience for all. We demonstrate that these evidence-based solutions are feasible and cost effective. Acting now is essential to protect health in the face of climate change.”

The report considers insights from city leaders around the world, who have expressed the need of support to formulate, implement and finance city interventions to address the increasing threats that climate change poses to the health of their citizens.

Thiago Curvello, Chief Executive of the Centre for Operations and Resilience, City of Rio de Janeiro, said: "In Rio de Janeiro, data is essential to build the responses to the health impacts of climate change. We've made good progress, but there's still much more to be done. That's why we welcome this new report, as it provides insights and strategies that could help Rio de Janeiro become even safer and more resilient for all residents."

Dr Kathy Oldham OBE, Chief Resilience Officer, Greater Manchester Combined Authority, expressed: “In Greater Manchester, we know that some of our residents face greater health risks from the effects of climate change. It’s critical to have data that underscores the need to focus on the most vulnerable and that makes the case for building resilience at the community level.”

Roberto Castillo Cruz, Director General for Environmental Policy and Culture Coordination, Mexico City, said: “Cities like Mexico City face countless competing priorities. Reliable data, advanced modelling, and community insights are vital in demonstrating how climate and social factors shape public health, building the case for targeted investments that make the city safer, healthier, and more just. Community-led heat mapping and early warning systems already in place showcase Mexico City’s pioneering work at the climate and heat nexus, and this report underscores the urgency of scaling such efforts and reinforcing our commitment to protect all residents.”

See the full Report PDF here

Media Contacts:

• Steve Marinker, Sodali & Co - SMI Communications Partner: sodali@sustainable-markets.org

• Fabiola Guillen, Communications Manager, Resilient Cities Network: Fguillen@resilientcitiesnetwork.org

• Martinne Geller, Global Media Relations Director at Reckitt: +44(0) 7408801216

• Hattie Underwood, Sustainability & People Culture Communications Manager, Bupa: hattie.underwood@bupa.com

• Fred Mamoun, Media Relations, Yale School of Public Health, fred.mamoun@yale.edu

About Resilient Cities, Reimagining Health

The Resilient Cities, Reimagining Health initiative is a two-year partnership between the Sustainable Markets Initiative Health Systems Taskforce, led by Reckitt and Bupa, and the Resilient Cities Network, with support from the Yale School of Public Health, Mode Economics, and Sanofi. This first-of-its-kind global coalition of 29 cities across 19 countries, alongside healthcare companies, academics and the private sector, is working to understand cities’ priorities and the barriers they face, and to develop the tools and resources required to help overcome the increasing threats that climate changes pose to health of the population and health systems. These will include:

• Health assessment tools to understand the magnitude and drivers of current and future health risks, tailored to individual city contexts.

• Decision-making tools to develop the economic case for adopting packages of interventions. Economic appraisal tools can help identify and shape best-value approaches, accounting for co-benefits, and inform approaches to financing that combine public and private sources.

• Playbooks to drive implementation including step-by-step guides to designing and implementing strategies, with archetypal partnership and financing models.

Participating cities

Greater Manchester (United Kingdom); Lagos (Nigeria); Mexico City (Mexico); Rio de Janeiro (Brazil); Berkeley (United States); Broward County (United States); Buenos Aires (Argentina); Cape Town (South Africa); Christchurch (New Zealand); Ciudad Juárez (Mexico); Colima (Mexico); Glasgow (United Kingdom); Guadalajara Metropolitan Region (Mexico); London (United Kingdom); Medellín (Colombia); Melbourne (Australia); Monterrey (Mexico); Montevideo (Uruguay); Nairobi (Kenya); Panama City (Panama); Penang (Malaysia); Porto Alegre (Brazil); Quezon City (Philippines); Ramallah (Palestine); Salvador (Brazil); Santa Fe (Argentina); Santiago (Chile); Semarang (Indonesia); Surat (India); Sydney (Australia).

About the Sustainable Markets Initiative

The Sustainable Markets Initiative (SMI) is the world’s go-to private sector organisation for sustainable transition; characterised by our unique brand of 'private sector diplomacy'. With the vision of our founder, His Majesty King Charles III, and our unique convening power, the SMI facilitates action between world leaders and CEOs to position sustainability at the heart of global value creation.

Together, we seek to mobilise the trillions of dollars required to achieve a sustainable future. Investment at this scale requires global systems-level change with a default sustainable orientation across markets, industries, and supply chains. Here, our mandates, the Terra Carta and Astra Carta, provide practical private sector trajectories.

The SMI believes that with bold ambition and courageous leadership, we can seize a new era of global prosperity that will last for generations to come. We call this ‘The Growth Story of Our Time.’

Read more: www.sustainable-markets.org/

About the Sustainable Markets Initiative Health Systems Task Force and Lighthouse Projects

The Sustainable Markets Initiative‘s Health Systems Task Force is a public-private partnership launched at COP26, comprising of healthcare companies (AstraZeneca, Bupa, GSK, Novartis, Novo Nordisk, Merck Group, Reckitt, Roche, Samsung Biologics, Sanofi), the World Health Organization and key public sector partners (NHS England, Sustainable Healthcare Coalition, the University of Pavia and the University of Glasgow).

The Task Force is taking action at scale, focusing on four priority areas:

• Supply Chain Decarbonisation

• Patient Care Pathways Decarbonisation

• Digital Innovation

• Consumer Health & Wellbeing

SMI Lighthouse Projects are created to demonstrate the ways in which stakeholders are making concrete progress to address the pressing health, societal, economic, environmental, technology, regional, and industry challenges of our time.

About Resilient Cities Network (R-Cities)

Resilient Cities Network is the world’s leading urban resilience network. It brings together global knowledge, practice, partnerships, and funding to empower its members to build safe and equitable cities for all. Its unique city-led approach ensures cities drive the agenda to benefit the communities they serve. At work in over 100 cities worldwide, the Resilient Cities Network supports on-the-ground projects and solutions to build climate resilient, circular and equitable cities while also facilitating connections and information-sharing between communities and local leaders.

For more information, please visit https://resilientcitiesnetwork.org/

About Bupa

Established in 1947, Bupa's purpose is helping people live longer, healthier, happier lives and making a better world. We are an international healthcare company serving over 60 million customers worldwide. With no shareholders, we reinvest profits into providing more and better healthcare for the benefit of current and future customers. Bupa has businesses around the world, principally in Australia, the UK, Spain, Poland, Chile, Hong Kong SAR, India, Türkiye, Brazil, Mexico and New Zealand. We also have associate businesses in Saudi Arabia.

At Bupa, we see first-hand how climate change impacts health and we recognise that healthcare must adapt to a changing world. We are working to create healthier societies by focusing on keeping people healthy, enhancing access to healthcare through innovation, and working to decarbonize healthcare delivery, supporting both human and planetary health but without compromising health outcomes. Find out more at Bupa.com .

About Reckitt

Reckitt makes the products people trust to care for the ones they love. We are home to some of the world’s best-loved consumer health and hygiene brands, including Dettol, Durex, Finish, Gaviscon, Harpic, Lysol, Mucinex, Nurofen, Strepsils, Vanish and Veet. Consumers are at the heart of everything Reckitt does. By creating innovative, science-backed solutions, Reckitt support people every day to live healthier lives.

Reckitt exists to protect, heal and nurture in the pursuit of a cleaner, healthier world. This commitment goes beyond the products it makes. Through its actions, Reckitt expands access to healthcare, education and economic opportunities. The company supports the planet by reducing waste, conserving resources and driving sustainable innovation.

Reckitt believes good health starts at home. With every action it takes, Reckitt strives to make consumers’ lives easier, cleaner and healthier, to strengthen communities and to create a more sustainable future.

Find out more, or get in touch with us at: Reckitt.com .

About Yale School of Public Health

Founded in 1915, Yale School of Public Health is one of the oldest public health programs in the United States. We are at the forefront of transforming public health by linking science and society to tackle the most pressing health challenges of our time. As a fully independent school within Yale University, we harness interdisciplinary collaboration, cutting-edge research, and community-driven solutions to create systems-level innovations. Our bold vision—making public health foundational to thriving communities everywhere—drives us to educate the next generation of leaders who are equipped to address global and local health disparities. Through this work, we are advancing public health science, shaping policy, and fostering trust in the health systems of tomorrow. Together, we are not just imagining a healthier future—we are building it.

About Mode Economics

Mode Economics is a strategic consultancy whose mission is to support clients in better adapting to climate risks. We help our clients to understand what climate change will mean for them, the adaptive strategies they may take, and the financial, policy and operational models required for implementation. Much of our work focuses on the intersection of climate and health – and we are honoured to provide technical support to the SMI and R-Cities in this initiative.