TACKLING THE PUBLIC HEALTH IMPACT OF CLIMATE CHANGE: THE ROLE OF DOMESTIC ENVIRONMENTAL HEALTH GOVERNANCE IN DEVELOPING COUNTRIES William Onzivu Lecturer in Law Bradford University Law School Bradford University United Kingdom

Some Questions What are the key threats posed by climate change and for public health specifically? What public health and other interventions have been proposed and are effective in mitigating the public health effects of climate change? What role can the health and relevant sectors play in shaping domestic climate laws and policies in developing countries? What role can domestic governance mechanisms play in translating adaptation and mitigation options into effective measures to tackle public health effects of climate change?

Impacts of climate change Four main consequences of climate change have been identified and include: temperature rise, sea level rise, extremes in the hydrologic cycle and accelerated ozone depletion. Climate change causes variants in the geographical range of disease organisms and vectors, air, food, water and soil. It affects the stability of ecosystems on which human health depends. [1] Diarmid Campbell-Lendrum, Carlos Corvalán, Maria Neira, Global climate change: implications for international public health policy, Bulletin of the World Health Organization, Volume 85, Number 3, March 2007,

Public Health Impacts of Climate Change Pathways by which climate change affects human health: Temperature related illness and death, extreme weather related health effects such as floods, hurricanes, air pollution related health effects(SE Asia forest fires), water and food borne diseases, vector borne diseases, effects of food and water shortages on health, mental, nutritional, infectious and other health effects Patz, J. et al,.....Environmental Health Perspectives, 108: (2000)

Health impacts of climate change “ Climate change will have a disproportionate negative public health impact on developing countries including small Island States, resulting in increases of infectious diseases such as malaria, dengue fever, schistomiasis, chagas disease, sleeping sickness, river blindness, and encephalitis. The vulnerability of water sources to climate change increases prevalence of water borne diseases such as cholera and diarrhea” (Peru, South East Asia, Africa). Intergovernmental Panel on Climate Change (IPCC), Climate Change 2001:third assessment report, impacts, adaptations and vulnerability of climate change, McCarthy JJ et al.eds. Cambridge University Press, 2001

Key features of impact of climate change on health - Cause and effect chain is complex, environmental health conditions, behavioural -Exacerbates existing environmental health conditions - The health impacts are diverse, globalized and potentially irreversible - the impacts are huge - The health risks are inequitable - Impacts can be prevented through mitigation and adaptation in public health and other sectoral measures, water, agriculture

The double (and now triple) health jeopardy Developing countries face double burden of disease Infectious disease Non-infectious disease Environmental health and climate change threats pose an additional burden. (WHO, World Health Report, 1999; Jeffrey D. Sachs, WHO Commission on Microeconomics and Health: Investing in Health for Economic Development, 2001)

Health in the global climate law: WHO Resolution WHA61.19 of 24 May 2008 Endorsed the findings of the IPCC on the health impacts of climate change and linked health and climate change with MDGs Calls upon countries to integrate climate change concerns into health policies and other strategies including promoting health in adaptation measures. Calls upon WHO members to build capacity as well as promote multi-sectoral cooperation on matters of climate change and health. Strengthen health systems

Health in the global climate law - Bridging the anthropocentric/eco-centric divide?: conceptual challenges -adverse effects of climate change includes deleterious effects on health(Art.1). - Parties required to integrate climate change into their policies to minimize its adverse effects on public health(Art.4(1)(f) - The Convention emphasizes the role of science and technology(Art.4(1)(g)) and Art.9(1). Health is also a science based, evidence driven sector.

Climate change and Health: Trends in developing countries. Tackling climate change is a public health concern, with attempts to integrate climate change into health programmes. Health is one of the priority sectors for adaptation(see the NAPAs) as well as under climate change regime generally. Domestic institutional mechanism for climate change often include the health sector(with limitations) The health sector contributes scientific expertise domestic implementation of the climate change legal regime. Increasing environmental health jurisprudence but slow corresponding statutory legal reforms.

Options to counteract health impact of Climate Change: International Law Adaptation and mitigation: Emission reduction: CDM? Legislative measures Institutional changes Economic instruments Assessments and monitoring

Governance related limitations: The health perspective. Poor health infrastructure and systems Weak environmental and health governance structure Obsolete/inadequate legal, policy and institutional frameworks Poor or inadequate adaptation capacity to face challenges of climate change (Mc Michael A.J et al, Climate Change and Human Health, Risks and Responses, WHO, WMO, UNEP, 2003)

Governance frameworks, issues and challenges National Action Plans: Most lack broad climate change policy. NAPAs identify health as a key sector. There is a challenge of integrating relevant Plans. Domestic environmental/Health laws: No climate specific statutes, obsolete, slow legal reforms. Institutional mechanisms: Both the IPCC and UNFCC emphasize the importance of institutional frameworks. Challenges include sectoral conflicts, fractious collaboration mechanisms, budgetary limitations etc.

CHALLENGES Environmental/health impact assessments Health often peripheral in many EIAs. Methodological challenges-plethora of assessments, specific projects vs macro-social, biophysical impacts. Health systems and infrastructures: Environmental health not well considered in broad public health, emphasis on curative measures. Capacity building: Legal, technical and financial assistance: High disease burdens, Challenges of external technical assistance, limited technological transfer, limitations of GEF projects for health financing

CHALLENGES The role of the civil society Sub-national, local and community environmental participation is a challenge.

The North – South context Climate change is a global problem that requires global solutions Technology transfer Financial transfer Development of a liability regime Role of global and regional health laws and policies

CONCLUSIONS: LOOKING TO THE FUTURE -Strengthening the key tenets of the climate change regime generally and especially enhancing visibility of health in implementing the climate change regime at both the international and domestic levels. - Domestic action: Legal and institutional reform

Merci à tous