Transcript Framing

Environmental Health Implications and
Adaptation to Climate Change in Africa
Dele Ogunseitan
Program in Public Health
University of California, Irvine
Chicago
2009
Outline
 Framing Climate Change Impacts and Health
 Stalking the Environmental Burden of Disease
 Translating Vulnerability Assessment Data into
Resources for No-cost Adaptation
“Framing”

A frame represents the schema of interpretation that we
depend on to understand and respond to events – both
local and global scales.

Framing is used to contain elements of rhetoric that
encourage certain interpretations while discouraging
others.

Frame Analysis: An Essay on the Organization of Experience.
London, Harper & Row. (1974)
By Ervin Goffman, 1922 – 1982.
Framing vulnerability and
climate assessments:
 In many countries, attempts to reconcile national
development priorities with international plans to mitigate
climate change represents an intractable policy controversy.
 The resolution requires conviction of vulnerability to new
conditions that will exacerbate preexisting environmental
stresses on society.
 Ogunseitan, O.A. 2003. Framing environmental change in Africa:
Cross-scale institutional constraints on progressing from rhetoric to
action against vulnerability. Global Environmental Change 13:101-111.
Emergence of Regional Frames of
Vulnerability to Climate Change
The Perspective of Developing Countries: The New Delhi Conference in 1989
(The equity argument).
African Perspectives: Nairobi Conference in 2-4 May 1990; Sponsored by the
Woods Hole Research Center at the UNEP headquarters.
Arrogation of International Support: Framing, funding, and the question of
intellectual hegemony.
Prioritizing GHG Inventories, Mitigation, and Vulnerability (Sensitivity
+ Capacity for Adaptation).
The benefits of national GHG inventories and mitigation are shared
globally. Whereas the burden of adaptation to the impacts are
expected to be borne nationally.
Policy Recommendations from the 1990
Gathering of “African Perspectives”
Focus on deforestation, carbon sinks, and food security
Futuristic scenarios
Enhancing research and training
Strengthening the technological base
Promoting public awareness and participation
Reforming the institutional environment
Vigilance of industrialized country actions
Promotion of private sector initiatives
Adjusting UN agency framework
UNEP, 2002
The Emergence of Public Health as a Dominant
Frame of Climate Change Impacts
 Argumentum in terrorem (Fear Appeal)
 Health is a common concern for many developing, and the ultimate impact of
climate on crop production and water resources is population health.
 Development of “Early Warning Systems” for local environmental changes
that currently accounts for most impact on human health and social welfare.
 *Pre-epidemiologic transition. Therefore, burden of disease is attributable to
environmental factors that are sensitive to climate change.
 *WMO-day 1999: Weather, Climate, and Health
The U.S. Country Studies Program provides financial and technical assistance to developing and transition
countries for climate change studies. The program was announced by the President prior to the United Nations
Conference on Environment and Development (UNCED) in Brazil in 1992. The first round of two-year studies
began in October 1993, and a second round followed in October 1994. Fifty-six countries on five continents
currently participate in the program. Regional and sectoral oversight for this program is provided by the U.S.
Country Studies Management Team (CSMT). Each participating country has both a U.S. Project Officer and its
own Country Study Coordinator.
Objectives of the Country Studies Program
Country Study
National Action Plans



The objectives of the program are
to assist countries as they:
 Establish a process for developing
and implementing national
policies and measures, including
formulation of National
Communications
 Develop information to further
national and international
discussions
 Support principles and objectives
of the U.N. Framework
Convention on Climate Change



The objectives of the SNAP phase are:
To assist countries in preparing
climate change action plans that may
form the basis for their national
communications
To promote diffusion of mitigation
and adaptation technologies by
assisting countries with assessments
of needs and opportunities for
technology exchange and diffusion
To enhance support for the objectives
and principles of the Framework
Convention on Climate Change
Framing Malaria and Climate
MIASMA – Modeling framework for the health Impact
ASsessment of Man-induced Atmospheric changes
Danny Dorling of the University of Sheffield: Worldmapper Project – PLOS-Medicine 2007
~ 500 million cases per year; 2 – 3 million deaths, most
under 5 years old children in Africa
http://www.rollbackmalaria.org/
Mapping Malaria Risk in Africa (MARA/ARMA)
Highland Malaria
1995
2005
“From Shakespeare to Defoe: Malaria in
England in the Little Ice Age.”
- Paul Reiter
Centers for Disease Control and Prevention, USA. [email protected]
 “Present global temperatures are in a warming phase that
began 200 to 300 years ago. Some climate models suggest
that human activities may have exacerbated this phase by
raising the atmospheric concentration of carbon dioxide and
other greenhouse gases. Discussions of the potential effects
of the weather include predictions that malaria will emerge
from the tropics and become established in Europe and North
America. The complex ecology and transmission dynamics of
the disease, as well as accounts of its early history, refute such
predictions.”
Scientific Controversy: Climate and
vector-borne diseases (Malaria)
Vol. 6, No. 4, Jul–Aug 2000
Pro-
Con-



To the Editor: I read with great interest the
article "From Shakespeare to Defoe: Malaria in
England in the Little Ice Age“ . Unfortunately,
the article is not as balanced as a presentation
last year by Paul Reiter, which clearly
illustrated that, although climate is important
in the transmission of malaria, the influence of
other factors (e.g., access to medical care and
improved housing) is likely to be of more
importance in Europe…. While Reiter's paper
offers an interesting perspective on the history
of malaria in Europe, it provides no
illuminating information on the influence of
climate change on human health.
- Pim Martens (Maastricht University,
Maastricht, The Netherlands)

To the Editor: The two reports from
the International Panel on Climate
Change (IPCC) cited in the letter by
Pim Martens are widely regarded as
"the standard scientific reference for
all concerned with climate change and
its consequences," yet the contents of
these reports are often
misleading…….. Repeated claims that
global warming may have already led
to increases in these diseases in the
tropics are equally indefensible…..
- Paul Reiter (Centers for
Disease Control and Prevention, USA)
Malaria Continues to Dominate Health Impacts of
Climate Vulnerability Assessments
Source: Vattenfal (2007); IPCC WG II (2007)
Malaria Eradication?
Genetically-Engineered
Mosquitoes
Pesticides/DDT
WHO – Studies on the Environmental Burden of Disease
 In 1990, the Commission on Health Research for
Development estimated that only about 5% of the
world's resources for health research (which totaled
~US$ 30 billion) were being applied to the health
problems of developing countries, where 93% of
the world's burden of ‘preventable mortality’
occurred.
 The term '10/90 gap' was coined to capture this
major imbalance between the magnitude of the
problem and the resources devoted to addressing
it.
2008 Update: The Bamako Call to Action on
Research for Health

Global expenditure on health research has more than quadrupled to over US$
125 billion;

There are many more actors engaged in funding or conducting health
research relevant to the needs of developing countries; But the epidemiology
of diseases has shifted substantially, so that many developing countries are
now experiencing high burdens of non-communicable diseases such as
cancer, diabetes, heart disease and stroke, as well as continuing high burdens
of infectious diseases and injuries: The End of Epidemiologic Transition.

Observations and Recommendations:


[6] “There is often misalignment between funders, government, and other
organizations in relation to research for health.”

[16] “To better align and harmonize their funding and programs to country research and
innovation for health plans and strategies, in line with the Paris Declaration of Aid
Effectiveness.”
http://www.oecd.org/document/18/0,2340,en_2649_3236398_35401554_1_1_1_1,00.html
How Useful are Composite Measures of Disease
Burden for Agenda Setting at the Local Level?
 A composite measure of the combined impact of death
and disability in a population is used to estimate
disease burden. The Disease-Adjusted Life Years
(DALY) model:
 DALYi[0,0] = YLLi + YLDi
 Where DALYi[0,0] = Undiscounted, unweighted for
disease i
 YLLi = Years of Life Lost due to disease i
 YLDi = Years of Life lived with Disability due to disease i
Estimating risks attributable to
environmental factors
Attributable Risk is assessed according to the following equation, using published
data on relative risks for each cause of death and disability related to the
exposure, levels of exposure (prevalence), and burden of disease due to each
cause of death and disability in the population:
AB = ∑ AFj Bj = ∑ {Pj (RRj – 1) ÷ Pj (RRj – 1) + 1}

Where

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
AB = Attributable Burden for a risk factor
AFj = Fraction of Burden from cause j
Bj = population level burden of cause j
P = Prevalence of exposure
RRj = Relative Risk of disease or injury for cause j in exposed versus unexposed group.
n = Maximum exposure level
Relative Contribution of Modifiable
Environmental Risk Factors to the Global
Burden of Disease
UNSAFE WATER, SANITATION AND
HYGIENE
50%
45%
40%
35%
30%
25%
20%
CLIMATE CHANGE
15%
INDOOR SMOKE FROM SOLID FUELS
10%
5%
0%
URBAN AIR POLLUTION
LEAD EXPOSURE
Studies on the Environmental Burden of
Disease
Deaths
DALYs

Public Health and Environment Department (WHO). 2007. Country Profiles of Environmental Burden of Disease
http://www.who.int/quantifying_ehimpacts/countryprofilesafro.pdf
Environmental
Burden of Disease
Summaries
United States
Botswana
Angola
Infant mortality
= 260/1000
Nigeria
Africa’s Share of the Global Burden of Diseases
1990 D A L Y s
aDisability
2000 D A L Y s
2010 D A L Y s
2020 D A L Y s
% of
T o ta l
A fric a n
B u rd e n
A fr ic a ’s
Share of
G lo b a l
B urden
W ith in
C a te g o r y
(% )
% of
T o ta l
A fric a n
B u rd e n
A fr ic a ’s
Share of
G lo b a l
B urden
W ith in
C a te g o r y
(% )
% of
T o ta l
A fric a n
B u rd e n
A fr ic a ’s
Share of
G lo b a l
B urden
W ith in
C a te g o r y
(% )
% of
T o ta l
A fric a n
B u rd e n
A fr ic a ’s
Share of
G lo b a l
B urden
W ith in
C a te g o r y
(% )
9
85
32
3
52
18
13
19
75
8
9
< 0 .1
1
3
3
1
6
91
41
5
58
24
13
19
51
6
7
< 0 .1
1
2
4
1
6
93
46
6
64
28
14
19
42
4
5
< 0 .1
0 .5
2
5
1
4
94
49
6
73
30
15
20
33
Disease
Malaria
Diarrhea
Dengue
Tropical C.
Malnutrition
Respiratory
Eyes
HIV
a
11
< 0 .1
2
3
3
1
3
Adjusted Life Years Lost (Murray & Lopez, 1996). Data were extracted from Murray & Lopez 1996 (baseline scenarios)
vector-borne tropical-cluster diseases includes Trypanosomiasis, Schistosomiasis, Leishmaniasis, Lymphatic Filariasis, and Onchocerciasis.
cNutritional deficiencies include: Protein energy malnutrition, Iodine deficiency, Vitamin A deficiency, and Iron deficiency anemia.
dChronic Obstructive Pulmonary Disease (COPD) and Asthma
eCataracts and Glaucoma
fHIV is included primarily for comparison, but the impact of climate change-induced population destabilization on the HIV epidemic should be taken seriously.
In addition, the impact of ultraviolet light exposure on the immune system is a concern for the prognosis of AIDS.
bInsect
Energy Resources and Respiratory Health
Hugo Ahlenius, UNEP/GRID-Arendal
Climate, Water Stress and
Diseases
The 10/90 Gap on the Ground
Water quality
Disease vectors
Solid fuel
Broadening the Frame
Forest fires / meningitis belt
Annual Fires: 2002
Cases of Cerebrospinal Meningitis
120000
100000
80000
60000
40000
20000
0
1990
1991
1992
1993
1994
1995
1996
1997
1998
YEAR
Neisseria meningitidis (Nm) serogroup A
*1.2 Million Cases/year; *135,000 Fatalities
*8-12 year cycles in hyper-endemic regions
*Shorter and more irregular intervals since 1980s
1999
2000
1963
1973
25,000 km2
95% reduction
Population Migration and HIV
1,250 km2
1997
1987
Goal 5 Conference @ Harvey Mudd
30
Climate Change and Lead Poisoning



Blackwell Institute. 2006. The Worlds Worst Polluted Sites – The Top
Ten. http://www.blacksmithinstitute.org/ten.php
Kabwe, Zambia
Lead, cadmium
Source of Pollution: Lead mining and processing
Conclusions/Acknowledgments
 Public health impacts of climate change is one of the most compelling
strategies for frame alignment.
 Exacerbation of existing conditions rather than new/emerging conditions
is key to arrogating resources for mitigation.
 Co-benefits of climate change mitigation need to be better quantified to
support expenditure of meager resources at the local level for global
issues.

Thanks to:






Global Forum for Health Research
Centers for Disease Control and Prevention
National Science Foundation
Dr. Timothy Smith
Mr. Aaron Hipp
Several Undergraduate Students