Impact of Climate Change on Surgical Health Systems: Vulnerabilities and Resilience Strategies

Climate change is increasingly recognized as a major threat to health systems, yet its implications for surgical care remain underexplored. Surgical health systems are particularly vulnerable because they rely on uninterrupted infrastructure, stable supply chains, skilled personnel, and resource-intensive technologies. Climate-related hazards, including extreme heat, floods, storms, wildfires, and sea-level rise, can disrupt surgical service delivery by damaging healthcare facilities, interrupting electricity and water supplies, delaying the availability of essential medicines and equipment, and limiting workforce capacity. These disruptions compromise timely access to surgical care, increase perioperative risks, and exacerbate existing inequities, especially in low- and middle-income countries where surgical systems often operate under constrained resources. This review explains current evidence on the pathways through which climate change affects surgical health systems and critically examines strategies for enhancing system resilience. Key resilience approaches include climate-resilient healthcare infrastructure, sustainable procurement and supply chain management, workforce preparedness, disaster-informed surgical planning, supportive governance, and the integration of digital health technologies to strengthen service continuity. The review also highlights emerging innovations and identifies research priorities needed to improve adaptive capacity and inform evidence-based policy. Strengthening the resilience of surgical health systems is essential not only for maintaining safe and equitable surgical care during climate-related disruptions but also for advancing broader health system sustainability. The findings provide a comprehensive framework to guide policymakers, healthcare leaders, and researchers in developing climate-resilient surgical services capable of meeting current and future challenges.