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I. Strategic Positioning

BVI approaches the climate crisis as, first and foremost, a crisis of governance. Public health and human rights are not adjacent concerns to climate action — they are the terrain on which climate action succeeds or fails. Consistent with its institutional mission, BVI works at the intersection of three inseparable axes:

• Public health as a fundamental right and a site of structural inequality. The right to health obligates states to protect, respect, and fulfill it — an obligation that extends to the basic necessities, food, water, and shelter, without which no health system can function.
• Climate justice as a struggle over territory, resources, and survival. Rural and marginalized communities absorb the first and worst effects of climate change. Indigenous peoples in the Amazon and other remote territories act as de facto custodians of the land and biodiversity they protect, even as deforestation, territorial dispossession, and internal displacement strip away their water, homes, and livelihoods.
• Democracy as the mechanism through which climate and health responses earn public trust. Structured opportunities for public participation strengthen political equality and ensure that government action reflects the interests of the people it is meant to serve. Decolonized capacity-building and the elevation of youth and civil-society voices are not symbolic gestures — they are what makes participation mechanisms real rather than performative.

1.1 — What This Looks Like on the Ground in the LAC Region

Across Latin America and the Caribbean, communities facing floods, droughts, extractive industries, and forced displacement do not experience climate change as a single disaster. They experience its compounding effects across every part of daily life:

• Disruption of health services. Clinics lose water, electricity, and supply chains; disasters destroy the facilities themselves and cut off the roads that would otherwise bring in food and medicine.
• Heightened exposure to gender-based violence. Climate stress intensifies the conditions that put women at risk — scarce resources, disaster displacement, and the collapse of rural livelihoods. When displacement forces women into temporary shelters or homelessness, it places them within reach of traffickers and exploiters; when water or food insecurity forces them to travel farther, the same risk follows them.
• Reduced access to sexual and reproductive health services, through the loss of contraception supply, unsafe conditions for surgical procedures and births, and broken supply chains for essential care.
• Systematic exclusion from decision-making. Marginalized communities are the last to receive relief and the last considered in disaster preparedness and response planning — not incidentally, but structurally.

II. Evidence from LAC: Climate Change and Adolescent SRHR

BVI's position is grounded in regional evidence, including research led by the Pan American Health Organization (PAHO) and New York University on the intersection of climate change and adolescent sexual and reproductive health (ASRH) in Latin America and the Caribbean.

2.1 — Climate Change as a Risk Multiplier

Climate change does not create new inequities so much as it exacerbates the ones that already exist. The documented pathways include:

• Food and water insecurity, driven by contaminated water, weak water infrastructure, and climate-linked damage such as erosion, chronic flooding, and hurricanes.
• Deepening economic vulnerability and dependency.
• Displacement that heightens the risk of gender-based violence and exploitation.
• Climate-driven disruption of health systems, limiting access to contraception and maternal care.

Adolescents bear a disproportionate share of these impacts — girls, Indigenous youth, Afro-descendant populations, and LGBTQ+ individuals most of all. The consequences include higher rates of adolescent pregnancy alongside reduced access to contraception and SRHR services, heightened exposure to gender-based violence, and the long-term educational and economic costs of climate-related school disruption. A growing body of global and regional research confirms the pattern: climate stressors intensify pre-existing gender and health inequities rather than operating apart from them.

2.2 — Regional Practice and Policy Gaps

Where PAHO and its partners have supported integrated, multisectoral approaches connecting health, education, and social protection, adolescent health outcomes improve — proof that workable models already exist and can be adapted at scale. But critical gaps persist:

• Climate policy remains largely disconnected from health-system planning.
• Youth participation is too often reduced to tokenism and consultation rather than decision-making authority. Multilateral organizations can change this by establishing structured, meaningful engagement mechanisms — youth advisory councils, participatory policy forums — that actually shape outcomes.
• Data systems lack the disaggregation needed to identify intersectional vulnerabilities.
• These gaps are not a capacity problem. They are a governance failure — one that clear metrics and accountability mechanisms could correct, if the political will existed to track them.

III. The Core Challenge: A Governance Deficit

Current health and climate responses fall short not primarily because of limited capacity, but because of a governance deficit. Closing it requires practical, rights-based strategies that treat these challenges as interconnected rather than sector by sector.

BVI identifies five systemic failures — all sharing a common root: treating affected populations as policy beneficiaries rather than political actors.

BVI rejects the beneficiary model. In its place, BVI promotes a rights-based approach in which communities and governing institutions work as partners — driving concrete policy change and institutional reform together, rather than one acting upon the other.

IV. BVI Framework: Health–Climate–Democracy Integration

BVI proposes an integrated, rights-based framework built on three operating principles.

V. Policy Recommendations for Multilateral Institutions

BVI calls on multilateral actors — including PAHO, UNFPA, the World Bank, and global climate funds — to work with civil society to integrate the following strategies into their programs and policies.

VI. BVI's Role: A Bridge Actor for Systemic Change

BVI works to connect what too often stays disconnected: territorial realities and multilateral policy spaces, scientific evidence and political advocacy, youth leadership and institutional decision-making. Its role is to translate lived experience into actionable policy frameworks — not to speak for communities, but to make sure the systems that govern them can hear what they are already saying.

VII. Conclusion

BVI advocates for health to be built into the foundation of climate policy — not added to it after the fact — so that climate action can be redefined as a matter of public health, territorial justice, and democratic power, shaped through genuine community consultation and buy-in.

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Health, Climate, Democracy: An Indivisible Agenda

Catherine Martinez, MPH · Bastion Vert International · September 16 2026 · 7 pages · English

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