As climate change impacts intensify, health systems have the double responsibility of building resilience while reducing their carbon footprint. This rapid review assessed case studies of interventions implemented towards climate resilient and low carbon health systems in six Western-Pacific countries (Australia, Fiji, South Korea, Laos, Mongolia, and Viet Nam).

We conducted a rapid review of academic and grey literature. Framework analysis was applied to map case study interventions against the World Health Organization's Operational Framework for Climate Resilient (CR) and Low Carbon (LC) Health Systems.

We identified 43 case studies from a yield of 605 documents. The majority of interventions were classified as LC (n = 25), followed by those integrating CR and LC (n = 10), and CR only (n = 8). Geographically, the majority of case studies were from Australia (n = 28), followed by Viet Nam (n = 5), Fiji (n = 4), Laos (n = 3), South Korea (n = 2) and Mongolia (n = 1). Additional implementation characteristics included co-benefits (n = 30), evaluation criteria (n = 23), barriers (n = 23) and enablers (n = 20). No studies reported implementation costs.

This review highlights a significant gap in published evidence on the practical application of the WHO Operational Framework for Climate-Resilient and Low-Carbon (CR and LC) Health Systems, underscoring the urgent need for further research, documentation, and dissemination of real-world implementation experiences. While we identified numerous co-benefits and emerging considerations for community engagement, the scarcity of cost-benefit analyses limits the ability to determine the most cost-effective investments. A rapid transition from fragmented mitigation efforts to comprehensive, system-wide strategies for resilience and decarbonization is essential to drive transformative change in the health sector.