Transcript Partnerships for Climate Change and Public Health

David Rogers
Health and Climate Foundation
Climate Change has profound implications for human health
and well-being
Partnerships between the public and private sector, between
climate scientists and health practitioners and between climate
and health policy makers are needed to ensure a balance
between social and economic development, health equity and
the urgency of dealing with climate change
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Creating affordable medicines and technologies for developing and least developed countries
Creating new cross-sectoral and institutional arrangements to quantify the determinants of
health and to cope with climate-sensitive diseases
Conducting collaborative cross-disciplinary research to produce good evidence on the links
between climate change and health
Empowering individuals, groups and communities to take action
Developing equitable climate-informed health policies and health-informed climate change
policies
Innovative funding
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Determinants of health and health equity
Why health should be central to climate change
and development policies
What are we doing about it?
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Climate change puts the basic determinants
of health at risk
" Climate change is one of the greatest
challenges of our time. Climate change will
affect, in profoundly adverse ways,
some of the most fundamental
determinants of health: food, air, water.
In the face of this challenge, WHO is
committed to do everything it can to
ensure all is done to protect human health
from climate change”
Margaret Chan, WHO – Director-General
(07/04/2008)
The poor health of the poor, the social gradient within countries
and the marked inequities between countries are caused by the
unequal distribution of power, income, goods and services –
access to health care, schools and education, conditions of work
and leisure, homes, communities, towns or cities
Health and health equity should be a fundamental result of
climate change and development policies
*WHO Commission on the Social Determinants of Health
http://www.who.int/social_determinants
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Two policy objectives
•More health-informed decisions about mitigating
climate change
•Knowledge base for choosing and developing adaptive
strategies to lessen otherwise already-unavoidable
health risks
Climate change acts, mostly, as a multiplier
of existing health risks and health inequities
Photo: Matthew Marek/American Red Cross
Climate change impacts on the natural
environment and socio-economic conditions
may increase or decrease the cost and
effectiveness of current interventions
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Despite “free health care” for anyone affected with
meningitis
Families must pay for medicines, provide and cook the
food, wash laundry and otherwise take care of their kin
Most families pay on average $25 in direct medical costs
and another $15 in non medical direct costs
Indirect costs – loss of income (cattle, crops) is about
$50 per episode
Adds up to almost half of a family’s annual income of
$220
= downward spiral of poverty
Photo: Science
Upwards of100
million people
are pushed into
poverty each
year through
catastrophic
household
health costs
Meningitis is an important contributor to poverty
*Anaïs Colombini – Agence de Médicine Préventive
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Extreme air temperature and air pollution
contribute to deaths from cardiovascular and
respiratory disease
Floods, drought and contaminated water
compromise hygiene, increase diarrheal disease,
increase vector-borne diseases
Decreasing crop yields stress food supply and
contribute to malnutrition and under-nutrition
increasing severity of infectious diseases
Photo: Jacob Dall/Danish Red Cross
Increased frequency and severity of storms
destroys homes, communities and lives
New challenges for control of infectious diseases
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Overall negative effects
of Climate Change on
Health outweigh the
positive (WHO and IPCC
4th Assessment)
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Energy and transport
•Major determinants of greenhouse gas emissions. Also associated with greater
environmentally mediated premature morbidity and mortality than any other sector,
primarily through air pollutants
•Disease burdens affected by energy and transport sectors are very large –
•~ 800,000 annual deaths from outdoor air pollution
•1.5 million from indoor air pollution
•1.2 million from traffic accidents
•1.9 million from physical inactivity
Water resources, land use
•Decisions in response to climate change in these sectors has the capacity to increase or
decrease risks from infectious diseases, under-nutrition, and other health risks
•Adaptation in the water sector including infrastructure development, irrigation and use
of wastewater, are likely to change the pattern of water related health risks
•Agricultural policy and practice (e.g., biofuels) influences food security and hence
under-nutrition – currently the largest single contributor to the global disease burden
•~3.5 million annual deaths, mostly children
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Benefits and costs
•A full accounting of the public health risks and benefits of adaptation and
mitigation choices is necessary at all level
•Should tip the balance strongly in favor of more sustainable policy choices
•Protecting public health in the short-term from negative externalities of
energy and other decisions
•Long term protection from climate change impacts
Requires more baseline scenarios and vulnerability assessments,
and facilitation of inter-disciplinary collaboration
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More people live in disaster prone areas – coastal
areas, flood plains, arid regions, megacities
Floods and drought are the most deadly forms of
natural disasters. E.g., Very wet summers in South
Asian monsoon region are 5 times more likely in 2050
and beyond. Drought will have a more severe impact
on places already water stressed
Mudslide, Ukraine Photo: Joe Lowry/IFRC
Tropical storms – estimated 300% increase in largest
(Category 5) storms
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Diseases
include:
Inter-annual Sensitivity
variability:
to climate:
Climate
variables:
Influenza
*****
**
(<T)
Meningitis
****
***
>T,<H (>R)
**
***
(>T,>R)
Loa loa
*
***
>R (<T)
Cholera
*****
*****
(>T)
Malaria
*****
*****
(>R,T,H)
Dengue
****
***
(>R,T,H)
Leishmaniasis
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1990
•Distribution
of Dengue
1990
2085
•Projected
distribution,
assuming no
change in non
climate
determinates
Hales et al. 2002
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Project Risk 2020 compared with the average risk for
years 1961-1990 (Pim Martens, Maastricht Univ.)
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.
Meningitis
Cuevas, L.E., Jeanne, J.,
Molesworth, M., Bell, M., Savory,
E.C., Connor, S.J., and Thomson
M.C. (in press).Risk mapping and
early warning systems for the
control of meningitis in Africa
Vaccine
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Present
2030: +0.9°C
Successfully controlled in China
since 1950s
90% reduction in cases by 2000
Now re-emerging
2050: +1.6°C
Zhou et al. 2008 Am J. Trop. Med. Hyg. 78(2), 2008,
pp. 188-194
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Creating stronger partnerships to deliver climate-informed public health
policies and health-informed climate change policies
Making health equity a central theme of climate change and development
policies
Changing health community focus: Health is not currently central to climate
change policies in part because of emphasis within the health community on
technological and curative solutions rather than population health
Supporting cross-sectoral collaboration to understand and properly assess the
health consequences of climate change mitigation and adaptation strategies
at the community level
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Strengthening current public health strategies (immunizations, treatment of
diarhoea, better nutrition, etc) will reduce the “baseline” disease rates will
constrain the multiplier effect of climate change
Acquiring more evidence-based determination of health risks from climate
change
Better evaluation of the effectiveness of health protection interventions
Using health outcomes to inform climate change mitigation and adaptation
policies
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Strengthening collaboration between public health and climate communities
Strengthening Health sector preparedness for natural disasters
Providing Health sector education and training about the sensitivity of diseases to climate and
climate change
Providing Public education about health risks associated with climate and climate change
Extending existing surveillance systems and develop early warning and response systems
including public health decision support
Improving vector control programs
Continuing engagement of all sectors for coordinated planning, development and response
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David Rogers
Health and Climate Foundation
1425 K St. NW Suite 350, Washington DC 20005, USA
Tel. +1 (202) 587 5658, Fax +1 (202) 587 5601
Champ Courtet, Marchissy 1261, Switzerland
Tel. +41 22 368 21 03, Fax +41 22 368 21 04
http://www.hc-foundation.org/
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