Transcript Global public health and climate change

Fourth Ministerial Conference on Environment and Health, Budapest, 23-25 June 2004
Global public health and climate change
Roberto Bertollini, MD MPH
Senior Adviser
Public Health
and the Environment
WHO – Geneva
Fourth Ministerial Conference on Environment and Health, Budapest, 23-25 June 2004
Climate change
UN High level meeting on climate change,
September 2007
72 Heads of State
67 Senior Ministers
6|
Global public health and climate change
Global Climate Change and Human Health
 How are climate change and human health linked?
 What health effects have been observed already, and
what can we expect in the future?
 How do we need to respond?
7|
Global public health and climate change
The Intergovernmental Panel of Climate Change
Fourth Assessment Report
70000 new studies
>2500 scientists involved
6 years -1 report
4 governmental approval sessions
8|
Global public health and climate change
Warming is
Unequivocal
Rising
atmospheric
temperature
Rising sea level
Reductions in
North
Hemisphere
snow cover
9|
Global public health and climate change
CO2 has not been this high in more than half a million years.
Carbon Dioxide Amount (ppmv)
350
Last interglacial
Last Ice Age
300
250
200
600
500
400
300
200
Thousands of Years Before Present
10 |
Global public health and climate change
100
0
[Adapted from Figure 6.3, ©IPCC 2007: WG1-AR4]
Extreme events are more frequent
Adapted from IPCC (2007) Summary for Policymakers. Contribution of Working Group I.
11 |
Global public health and climate change
Climate change made the European heatwave of 2003 more
likely…
2003 Heatwave
Stott et al, nature, 2004
12 |
Global public health and climate change
The relationship between health and climate
change
Social conditions
Environmental
conditions
(‘upstream’ determinants
of health)
Direct
exposures
Health
system
conditions
*
(temperature,
precipitation, sea
level rise, extreme
events)
Climate
change
Indirect
exposures
Health
impacts
(changes in water,
air, food quality;
vector ecology;
ecosystems,
agriculture, industry
and settlements)
Social &
economic
disruption
*
Modifying influence
Confalonieri, Menne et al, 2007
The health effects of climate change
Some expected impacts will be beneficial but most
will be adverse. Expectations are mainly for changes
in frequency or severity of familiar health risks
Health effects
CLIMATE
CHANGE
•Temperature-related illness and death
•Extreme weather- related health effects
•Air pollution-related health effects
•Water and food-borne diseases
•Vector-borne and rodent- borne diseases
•Effects of food and water shortages
•Effects of population displacement
Based on Patz et al, 2000
14 |
Global public health and climate change
Global Climate Change and Human Health
 How are climate change and human health linked?
 What health effects have been observed already, and
what can we expect in the future?
 How do we need to respond?
15 |
Global public health and climate change
Cronology of an epidemic
21 june
First imported case
to Castiglione di
Cervia from India
23 june
4 july
First case
develops
symptoms of
Chikungunya
First case of
Chikungunya in a
locally resident
person
29 august
18 august
Established surveillance
system. Serological
analysis confirms
Chikungunya
Start of disinfection of
public areas and
information to people
on how to protect
themselves
13 september
254 cases. 79
laboratory confirmed
Age between 1-95
anni. 52% females.
3° week in
August
Epidemic peak
…is exposing additional populations to infection with
Schistosoma japonicum…
Freezing zone 1970-2000
Freezing zone 1960-90
(Yang, Vounatsou, et al. 2005).
17 |
Global public health and climate change
What will happen, and what could happen?
3.4oC = 6.1oF
2.8oC = 5.0oF
1.8oC = 3.2oF
0.6oC = 1.0oF
ppm
850 CO Eq
2
600
Even if we
stop
emitting
today
IPCC, WG 1
18 |
Global public health and climate change
Many of the major killers are climate sensitive
-
Each year:
- Undernutrition kills 3.7 million
- Diarrhoea kills 1.8 million
- Malaria kills 1.1 million
Each of these is highly sensitive to temperature and precipitation:
19 |
Global public health and climate change
How sensitive is health to climate?
Diarrhoea
Temperature
Diarrhoea
admissions
Incidence of
diarrhoeal disease is
strongly related to
climate variables. In
Lima, Peru, diarrhoea
increased 8% for
every 10C
temperature increase.
(Checkley et al,
Lancet, 2000)
Daily measurements Jan 1993 – Dec 1998
20 |
Global public health and climate change
Future climate change and dengue
Climate change is
expected to increase
the proportion of the
global population
exposed to dengue
from about 35% (upper
figure), to 50-60%
(lower figure), by 2085.
Hales et al, Lancet 2002
21 |
Global public health and climate change
Cumulative emissions of greenhouse gases
Countries scaled according to cumulative emission in carbon equivalent to 2002.
Patz et al, Ecohealth, December 2007
22 |
Global public health and climate change
Health impacts of climate change
WHO regions scaled according to WHO estimates of mortality per million people in the year 2000, attributable to the
climate change that occurred from 1970s to 2000. Patz et al, Ecohealth, December 2007
23 |
Global public health and climate change
Global Climate Change and Human Health
 How are climate change and human health linked?
 What health effects have been observed already, and
what can we expect in the future?
 How do we need to respond?
24 |
Global public health and climate change
Six focus areas for WHO, public health, and climate
change
1. Health security
2. Strengthening health
systems
3. Health development
4. Evidence and information
5. Delivery
6. Partnerships
25 |
Global public health and climate change
1. Health Security
26 |
Global public health and climate change
2. Strengthening health systems
27 |
Global public health and climate change
Health sector actions as climate change adaptations
Infectious disease
surveillance
Health action
in emergencies
Safe drinking
water
28 |
Global public health and climate change
Integrated vector
management
Diseases
affected by
climate
Environmental
health capacity
building
Healthy
development
29 |
Global public health and climate change
3. Health Development
30 |
Global public health and climate change
Protecting health while reducing Emissions
Buildings
Indoor air pollution
Heat and cold
protection
Transport
Air pollution
Traffic injuries
Physical inactivity
Industry
Occupational risks,
mining and transport
Greenhouse Gas
Emissions
Energy supply
& conversion
Occupational risks;
Construction and transport
Agriculture
Nutrition,
Water /
vector-borne disease
31 |
Global public health and climate change
Waste
Occupational,
chemical
The opportunity for improving health determinants
Can we reduce:
The 800,000 annual deaths from urban air
pollution
The loss of 1.9 million deaths, and 19 million
years of healthy life, from physical inactivity
The 1.2 million deaths and over 50 million
injuries from road traffic accidents
32 |
Global public health and climate change
Evidence, Delivery, Partnerships
33 |
Global public health and climate change
Research for Improved Tools
Can you accelerate development of tools
to control diseases which are
increasing rapidly, such as dengue?
Can you help us measure the
effectiveness of interventions to
address emerging health threats, such
as heatwaves?
34 |
Global public health and climate change
Research for Improved Health Systems
Can you help us adapt existing
surveillance systems, anticipate risks
and reduce human health impact?
Can you help us improve delivery
systems to meet the new challenges
of climate change?
35 |
Global public health and climate change
Research for Improved Policies
Can you help assess better the
health impacts of major policies
related to climate change?
Can you help assess the costs to
health of (in)action to mitigate and
adapt to climate change?
36 |
Global public health and climate change
37 |
Global public health and climate change
“The health sector has been much too
separatist in the past. It has been
thinking that all it has got to do is run a
healthcare system and traditional public
health. Climate change is telling us that
no, that’s not good enough. We’re going
to have to be more imaginative, more
collaborative, and be prepared to look to
a more distant future as well as deal with
the problems that press on us in the here
and now.”
“We’ve got to get more imaginative about working with other sectors,
other arms of government, making the argument that every ministry
is a health ministry.
British Medical Journal, 29 September 2007; 335:636
38 |
Global public health and climate change
La salute e l’ambiente
health and climate
change
39 | Global
Strumenti
di public
prevenzione
sanitaria
– R. Bertollini, OMS Europa
Director General’s
Speech at the 57
session of the WHO
Regional Committee
for Europe
Beograd,
18 September 2007
Just as we fought so long to secure a high profile for health on the
development agenda, we must now fight to place health issues at the
centre of the climate agenda.
I personally believe that the inevitability of climate change makes it all
the more imperative for us to reach the Millennium Development
Goals.
40 |
Global public health and climate change
The face of climate change ?
41 |
Global public health and climate change
World Health Day
April 7th 2008
Protecting Health from Climate Change
www.who.int/globalchange/climate
42 |
Global public health and climate change