Climate change is disproportionately impacting vulnerable communities through extreme heat, disease spread, and food/water insecurity. Over 3.3 billion people live in high-risk areas, with a 15-times higher death rate from extreme weather. Climate change could cause 21 million additional deaths by 2050 without intervention. Local actors, who deeply understand community needs, are key to driving climate adaptation. However, barriers like insufficient funding, incomplete data, and power imbalances limit their effectiveness. This report identifies three priorities to overcome these barriers and accelerate funding for locally led health adaptation strategies.