Supporting people needing care in Japan through all disaster phases under climate change

Abstract Issue Climate change has increased the frequency of disasters. Europe experienced the 2021 floods and the 2024 Spanish floods; Japan faced Typhoon Hagibis (2019) and the 2020 Kyushu floods. Problem In ageing societies like Japan and many European countries, supporting people requiring care across all disaster phases-pre-disaster, response, and recovery-is crucial. Many victims have died not only from direct impacts of storms and floods, but also due to hardships during evacuation. Results In Japan, health and medical responses were previously uncoordinated. Since 2017, prefectures began establishing a Health and Medical Coordination Headquarters for large-scale disasters. To support these, the Disaster Health Emergency Assistance Team (DHEAT) was launched in 2018. The Disaster Welfare Assistance Team (DWAT) was also created to provide welfare support for vulnerable populations. In 2022, based partly on our team's recommendations, the government replaced the Health and Medical Coordination Headquarters with a Health, Medical, and Welfare Coordination Headquarters. Our 2023-2024 national survey showed that 72% of prefectures planned to adopt this new structure. Since 2021, municipalities have been responsible for developing individualized evacuation plans for vulnerable populations. Additionally, disaster case management-assessing and delivering individualized support during recovery-is being promoted. Lessons Despite progress in system development, major challenges persist during actual disasters. To improve effectiveness, regular training and post-disaster reviews are essential. Key messages • Due to global warming, disasters are becoming more frequent, and it is necessary to strengthen support systems for vulnerable populations at every phase of disaster management. • Even with systems in place, major challenges arise during actual disasters. Sharing experiences and information nationally and internationally is essential to improve disaster response.