Rwanda has established climate health governance Rwanda through its Technical Working Group 1 to operationalize climate‑health coordination within the health sector. This group brings together government ministries, health agencies, climate authorities, and development partners to establish structured governance for adaptation planning. It develops guidelines, integrates climate considerations into national health strategies, and aligns vertical coordination across sectors. Through capacity building and stakeholder engagement, it supports systematic mainstreaming of climate risks into health policy, infrastructure standards, and emergency preparedness. The TWG fosters multisector collaboration, evidence generation, and adaptive decision-making, ensuring scalable governance models. Rwanda’s example illustrates how formal technical governance mechanisms can accelerate climate-resilient, equitable, and sustainable health system adaptation at national level.