From Heatwaves to Health Costs: Tunisia Confronts the Growing Price of Climate Change

Tunisia faces escalating health and economic risks from extreme heat, floods, water scarcity and climate-sensitive diseases, threatening healthcare access, food security and productivity. The report calls for urgent investment in resilient health facilities, early-warning systems, digital healthcare, renewable energy and stronger supply chains to protect people and long-term development.

Tunisia's climate crisis is increasingly becoming a public-health and economic challenge, with rising temperatures, floods, drought, water scarcity and air pollution threatening communities while putting additional pressure on healthcare infrastructure. The World Bank's Climate and Health Vulnerability Assessment – Tunisia shows that climate adaptation can no longer be treated only as an environmental issue. It needs to become part of health policy, infrastructure investment, public finance, emergency preparedness and long-term development planning.

Extreme Heat Is Turning Into a Public-Health Emergency

Extreme heat is emerging as one of Tunisia's most serious climate-related health threats. The number of days with temperatures above 35°C could increase from around 57 a year to 84 by mid-century. More than 65 percent of the population could eventually experience over 30 extremely hot days annually.

The health consequences are already significant. Heat-attributable mortality increased from 1.69 deaths per 100,000 people in 1992 to 8.25 in 2021, a rise of about 388 percent. This is particularly concerning because non-communicable diseases already account for around 86 percent of deaths in Tunisia. Hypertension affects approximately 29 percent of the population and diabetes about 16 percent, making large numbers of people particularly vulnerable to extreme temperatures.

Flooding poses another threat. By 2050, a severe 1-in-100-year flood could expose 16 emergency facilities and 112 primary healthcare centres to at least 15 centimetres of floodwater. Flooded roads could leave as many as 1.4 million people without access to emergency healthcare within 30 minutes and more than 2.4 million without access within an hour.

For policymakers, this means hospitals, clinics, electricity, water supplies, transport networks and emergency services must be planned as one interconnected resilience system.

Climate Damage Could Become a Major Economic Burden

Climate-related health impacts will increasingly translate into financial losses. The assessment estimates that stunting, diarrhoea and heat-related illness linked to climate change could generate annual economic costs exceeding US$61 million by 2030 and potentially US$378 million by 2100.

The wider development consequences could be considerably greater. Climate pressures, particularly water scarcity and associated productivity losses, could contribute to GDP contraction of around 3.4 percent by 2030 and 6.4 percent by 2050.

Agriculture and food security are also vulnerable. By 2050, wheat and barley yields could decline by around 35 percent, while olive production could fall by as much as 69 percent. By 2100, climate change could contribute to approximately 10,000 additional cases of childhood stunting and 113,000 additional diarrhoeal cases every year.

For government, these figures strengthen the economic case for investing before disasters occur. Spending on resilient healthcare facilities, disease surveillance, water security and early-warning systems should be compared with the potentially much higher future costs of healthcare, lost productivity, food insecurity and reconstruction.

Development Partners Can Turn Climate Finance Into Health Resilience

For the World Bank, WHO, development agencies and other international partners, Tunisia presents an opportunity to connect climate finance more closely with health-system investment.

Priority areas identified in the assessment include climate-resilient primary healthcare, stronger disease surveillance, digital health systems, emergency preparedness, reliable water and sanitation, renewable energy for healthcare facilities, workforce training and resilient pharmaceutical supply chains.

Development partners can combine concessional finance, grants and technical assistance rather than funding isolated interventions. A solar-powered healthcare facility, for example, can simultaneously strengthen energy security, reduce vulnerability to electricity disruption and maintain critical medical services during extreme weather.

Financing should also target regional inequalities. Tunisia has more than 2,200 primary healthcare centres, but only around 419 provide daily outpatient consultations. Strengthening these facilities, particularly in underserved areas, could improve routine healthcare while simultaneously building climate resilience.

A New Investment Market Is Emerging for the Private Sector

Climate-resilient healthcare also creates opportunities for businesses. Demand could increase for solar power, energy-efficient cooling, backup electricity, resilient construction, water-storage systems, digital health platforms, telemedicine, diagnostics and temperature-controlled pharmaceutical logistics.

Digitalisation is particularly important. Climate forecasts, satellite information and historical disease data could be combined to predict outbreaks and help authorities pre-position medicines and equipment before emergencies occur. Technology companies, logistics providers and healthcare businesses could therefore play a larger role in building climate-responsive health systems.

However, investors must also manage growing physical risks. Flooding, extreme heat, water shortages and electricity disruptions can damage facilities, interrupt supply chains and increase operating and insurance costs. Climate-risk assessments should therefore become part of healthcare investment and infrastructure design.

The assessment ultimately points towards a shift from reacting to disasters to anticipating them. Tunisia needs stronger early-warning systems, trained frontline health workers, climate-informed disease surveillance, reliable water and sanitation, resilient healthcare buildings, renewable backup energy and more responsive medical supply chains.

For policymakers, the priority is coordination across health, finance, water, agriculture, energy and disaster-management institutions. For development partners, it is financing integrated systems rather than fragmented projects. For private investors, climate-resilient healthcare represents both a growing market and a risk-management necessity. Acting early could help Tunisia protect human capital, reduce future economic losses and make its health system better prepared for a hotter and more uncertain climate.