viii Executive Summary $200 million per year in East Asia and the Pacific, and $500 million per year in South Asia). A recent study by the United Nations Framework Convention on Climate Change (UNFCCC) estimated an adaptation cost in the health sector ranging between $2 billion and $14 billion over the period 2010–2030. If climate change is the biggest global health threat of the 21st century (Chan 2009), existing knowledge on the relationship between climate change and health, and how the nature of this relationship may change with the socioeconomic characteristics of populations, is mostly anecdotal and remains insufficient to guide policy making. Furthermore, the failure to fully and explicitly account for the health impacts of investment projects, including adaptation and mitigation investment projects, may exacerbate the health impacts of climate change, lead to underinvestment in climate change adaptation and mitigation, or elicit the wrong ranking and selection of options. Health Benefits of Adaptation in the Agriculture Sector, Water-financing Programs, and Disaster Risk Reduction In addition to raising awareness about the projected impacts of climate change on health among policy makers and the civil society of the developing member countries (DMCs) of the Asian Development Bank (ADB), this study presents a framework showing the relationship between climate change and health issues in agriculture, water projects, and disaster risk reduction projects. This framework recognizes that climate change will affect all sectors, and most importantly, integrates climate-related health risk into adaptation strategies. As an integrated framework of assessing impacts, this framework can be used to provide guidance to decision makers to deal with climate change impacts and could serve as basis for climate change adaptation policy for each sector. It also explains how investments in climate change adaptation in agriculture, water financing, and disaster risk reduction generate health benefits in the affected population, apart from the direct benefits that will be realized. As a result, the framework provides the mechanisms that show how health benefits of climate change adaptation strategies in these sectors become important determinants of investment decision. Unless DMCs systematically anticipate, plan, and prepare adequate and cost-effective responses to the health effects of climate change at geographic and sector levels, on short-term and long-term bases, the health impacts and costs of climate change are likely to overwhelm the capacity of the public sector to offer appropriate health care services in times of need. As such, the Commission on Climate Change and Development and the World Health Organization clearly point out that the health sector needs to be involved in strategic planning in sectors such as agriculture, water financing, and disaster management. This includes ensuring the integration of health concerns into national adaptation programs of action. The analysis presented in this study shows that accounting for the health impacts of climate change demands better use of existing information and systems, and new accessible tools and frameworks to help the decision-making process. The study also suggests ways to identify and quantify impacts of climate change, and how to monetize those impacts into costs and benefits in water, agriculture, and disaster risk reduction. The countries involved in the study (Nepal, the Philippines, and Tajikistan) are currently building climate resilient health sectors, by strengthening health systems and ensuring adequate water and sanitation for the population. Nepal and the Philippines have identified the health sector as a priority sector within their national adaptation plans, though in a manner that does not yet fully recognize and account for the role of adaptation options in agriculture, water, and disaster risk reduction to reduce the incidence of climate-induced health impacts. This process has just commenced, providing both country and regional opportunities for governments and their development partners. This study contributes to the development of a methodological approach aimed at ensuring that the health impacts of projected climate change be accounted for not only by the health sector itself, but by sectors through which these impacts may emerge, in particular agriculture, water, and disaster risk reduction.