Climate Change Concept on Environment & Health Sustainability 1st SEHAT 2016 Seminar on Environment & Health 2016 Mr Sharad Adhikary, Environmental Health Officer World Health Organization Country Office, Indonesia

Some of the Fact Findings Climate Change and Health on Climate Change and Health

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Climate Change and Health Inter-linkages NRC 2012

Climate change introduces huge unknowns - Emphasis for our research is on the Unanticipated change, as this is the uncharted territory with regard to policymaking. The ability of policies to adapt to anticipated conditions is more conventional in policy design, but not to say that it is done very well.

Health impacts are unfairly distributed World Health Organization 20 November 2017 Health impacts are unfairly distributed Cumulative emissions of greenhouse gases, to 2002 (demanding mitigations in industrialized countries) WHO estimates of per capita mortality from climate change, 2000 (demanding adaptations in developing countries) References: McMichael, A. et al., 2004. Climate Change. In: M. Ezzati, A. Lopez, A. Rodgers and C. Murray (Editors), Comparative Quantification of Health Risks: Global and Regional Burden of Disease due to Selected Major Risk Factors. World Health Organization, Geneva. Patz, J., Gibbs, H., Foley, J., Rogers, J. and Smith, K., 2007. Climate Change and Global Health: Quantifying a Growing Ethical Crisis. Ecohealth, 4: 397–405. WHO, 2009. Protecting Health From Climate Change: Connecting Science, Policy and People, World Health Organization, Geneva. Map projections from Patz et al, 2007; WHO, 2009. How does climate change affect health?

World Health Organization 20 November 2017 Some of the largest disease burdens are climate-sensitive Each year: - Undernutrition kills 3.5 million. - Diarrhoea kills 2.2 million. - Malaria kills 900,000. - Extreme weather events kill 60,000. WHO estimates that the climate change that has occurred since the 1970s already kills over 140,00 per year. References for all figures given in WHO, 2009. Protecting Health From Climate Change: Connecting Science, Policy and People, World Health Organization, Geneva; page 7. http://www.who.int/globalchange/publications/reports/9789241598880/en/index.html Image from CDC Public Health Image Library. How does climate change affect health?

World Health Organization Evidence: Benefits of healthy mitigation measures documented 20 November 2017 Sustainable urban transport – could cut heart disease and stroke by up to 20%. Improved stoves could save 2 million lives over 10 years in India alone, and reduce warming from black carbon. Health benefits from actions to reduce greenhouse gas emissions could substantially offset mitigation costs. "while the climatic effects of mitigation measures are long-term and dispersed throughout the world, the health benefits are immediate and local" – WHO director-General Margaret Chan, 2009 References: Haines, A. et al., 2009. Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers. Lancet, 374(9707): 2104-14. Chan, M., 2009. Cutting carbon, improving health. Lancet. 374(9707) What has been done? Scientific evidence

Regional Framework for action to protect human health from effects of climate change in the South East Asia and Pacific Region Bali, Indonesia 12 December 2007 Goal:    To build capacity and strengthen health systems in countries and at the regional level to protect human health from current and projected risks due to climate change. Objectives: Increase awareness of health consequences of climate change; Strengthen the capacity of health systems to provide protection from climate-related risks & substantially reduce health system’s greenhouse gas emissions; Ensure that health concerns are addressed in decisions to reduce risks from climate change in other key sectors.

Rio+20 Outcomes Document: The Future We Want Thematic areas and cross-sectoral issues Poverty Eradication: social protection systems are essential for eradicating poverty and advancing MDGs Food Security, Nutrition & Sustainable Agriculture: right of everyone to have access to safe, sufficient & nutritious food & sustainable agriculture Energy: critical role of energy in sustainable development Sustainable transport: importance of environmentally sound, safe and affordable transportation as a means to improve social equity and health Sustainable cities: well planned and integrated cities can be economically, socially and environmentally sustainable Health and population: Health is a precondition for, an outcome of, and an indicator of all three dimensions of sustainable development; and Promoting full and productive employment, decent work for all, and social protections: need full and productive employment and decent work for all

Rio+20 Outcome Document: Health and population Health is a precondition for, an outcome of, and an indicator of all three dimensions of sustainable development. Sustainable development will not be achieved in presence of high burden on communicable/non communicable diseases. Acknowledge that the global burden and threat of non-communicable diseases (NCDs) constitutes one of the major challenges for sustainable development in the twenty-first century. Commit to strengthen health systems toward the provision of equitable, universal coverage and promote affordable access to prevention, treatment, care and support related to NCDs, especially cancers, cardiovascular diseases, chronic respiratory diseases and diabetes. Commit to establish or strengthen multi-sectoral national policies for the prevention and control of non-communicable diseases. Reaffirm the full right to use TRIPS provisions and Doha Declaration on TRIPS to promote access to medicines for all and encourage development assistance in this regard. Call to strengthen health systems through increased financing and the recruitment, training & retention of health workers, improved distribution & access to improving health infrastructure. Commit and consider population trends in development policy, emphasize need for universal access to reproductive health including family planning and protection of human rights

Environmental Health Concerns of Climate Change

Environmental Hazards Traditional hazards Open defecation practices Household supply of contaminated waters Food & personal hygiene Indoor air pollution Inadequate control on disease vectors Forest fires Informal gold mining Healthcare waste disposal Modern Hazards Urban air pollution Road traffic accidents Sea-level rise and coastal effects Avian Influenza (H5N1, H7N9) risks in traditional markets Increasing use of chemicals on agriculture and industry Climate caused degradations Nano pollutions

Climate change undermines the environmental determinants of health World Health Organization 20 November 2017 Climate change undermines the environmental determinants of health Without effective responses, climate change will compromise: Water quality and quantity: Contributing to a doubling of people living in water-stressed basins by 2050. Food security: In some African countries, yields from rain-fed agriculture may halve by 2020. Control of infectious disease: Increasing population at risk of malaria in Africa by 170 million by 2030, and at risk of dengue by 2 billion by 2080s. Protection from disasters: Increasing exposure to coastal flooding by a factor of 10, and land area in extreme drought by a factor of 10-30. References for all figures given in WHO, 2009. Protecting Health From Climate Change: Connecting Science, Policy and People, World Health Organization, Geneva; page 7. http://www.who.int/globalchange/publications/reports/9789241598880/en/index.html How does climate change affect health?

Over the last 50 years, human activities - particularly the burning of fossil fuels - have released sufficient quantities of carbon dioxide and other greenhouse gases to affect the global climate. The atmospheric concentration of carbon dioxide has increased by more than 30% since pre-industrial times, trapping more heat in the lower atmosphere. The resulting changes in the global climate bring a range of risks to health, from deaths in extreme high temperatures to changing patterns of infectious diseases.

From the tropics to the arctic, climate and weather have powerful direct and indirect impacts on human life. Weather extremes - such as heavy rains, floods, and disasters like Hurricane Katrina that devastated New Orleans, USA in 2005, and Myanmar in 2008 - endanger health as well as destroy property and livelihoods. Approximately 600 000 deaths occurred worldwide as a result of weather-related natural disasters in the 1990s, some 95% of which took place in developing countries.

Intense short-term fluctuations in temperature can also seriously affect health - causing heat stress (hyperthermia) or extreme cold (hypothermia) - and lead to increased death rates from heart and respiratory diseases. The recorded high temperatures in western Europe in the summer of 2003 were associated with a spike of an estimated 70 000 more deaths than the equivalent periods in previous years.

Increasing global temperatures affect levels and seasonal patterns of both man-made and natural air-borne particles, such as plant pollen, which can trigger asthma. About 300 million people suffer from asthma, and 255 000 people died of the disease in 2005. Asthma deaths are expected to increase by almost 20% in the next 10 years if urgent actions to curb climate change and prepare for its consequences are not taken.

Rising sea levels - another outcome of global warming - increase the risk of coastal flooding, and could cause population displacement. More than half of the world's population now lives within 60 kilometres of shorelines. Some of the most vulnerable regions are the Nile delta in Egypt, the Ganges-Brahmaputra delta in Bangladesh, and small island nations such as the Maldives in the Indian Ocean, and the Marshall Islands and Tuvalu in the Pacific Ocean. Floods can directly cause injury and death, and increase risks of infection from water and vector-borne diseases. Population displacement could increase tensions and potentially the risks of conflict.

Malnutrition causes millions of deaths each year, from both a lack of sufficient nutrients to sustain life and a resulting vulnerability to infectious diseases such as malaria, diarrhoea, and respiratory illnesses. Increasing temperatures on the planet and more variable rainfalls are expected to reduce crop yields in many tropical developing regions, where food security is already a problem. Mali is a good example. Unless adaptive measures are taken, climate change is projected to approximately double by the 2050s the percentage of its population at risk of hunger and associated health effects.

Globally, water scarcity already affects four out of every 10 people. More variable rainfall patterns are likely to compromise the supply of fresh water. Globally, water scarcity already affects four out of every 10 people. A lack of water and poor water quality can compromise hygiene and health. This increases the risk of diarrhoea, which kills approximately 1.8 million people every year, as well as trachoma (an eye infection that can lead to blindness) and other illnesses.

Climate-sensitive diseases are among the largest global killers. Climatic conditions affect diseases transmitted through water, and via vectors such as mosquitoes. Climate-sensitive diseases are among the largest global killers. Diarrhoea, malaria and protein-energy malnutrition alone caused more than 3 million deaths globally in 2002, with over one third of these deaths occurring in Africa.

Health impacts from changes in transmission dynamics of communicable diseases Changes in climate may alter the distribution of important vector species (e.g. mosquitoes) and may increase the spread of disease to new areas which lack a strong public health infrastructure.

Climate Change & Health Areas of Work on Climate Change & Health

Data and observations Improving collection, management, exchange, access to and use of observational data and other relevant information on current and historical climate variability and change.

Methods and tools Developing and disseminating methodologies and tools for impact and vulnerability assessments; mitigation and adaptation planning.

Technologies for adaptation Promoting the development and diffusion of technologies, know-how, and practices for adaptation, addressing identified adaptation priorities and building on lessons learned from current adaptation projects and strategies.

Climate related risks and extreme events Promoting understanding of impacts and vulnerability, emphasizing current and future climate variability and extreme events, and the implications for sustainable development, health and environment. Helps promoting mitigation & adaptation measures.

Mitigation/Adaptation planning and practices Collecting, analyzing and disseminating information on past and current practical mitigation/adaptation actions and measures, including projects, short- and long-term strategies, and local and indigenous knowledge. This will be done through facilitating communication & cooperation between stakeholders.

Research Promoting research on (a) slow-paced impacts, (b) vulnerability and (c) mitigation/adaptation options

Health is currently neglected in climate change support mechanisms LDCs identifying health as adaptation priority Number of adaptation projects submitted What is the status of health in the UNFCCC ? Funds requested for health Funds awarded for health - Over 95% of LDCs identified health as a priority sector for climate adaptation - 73% included health interventions within adaptation needs and proposed actions - Less than 30% had adequate health vulnerability assessments and health adaptation plans. References: IPCC, Summary for policy makers, 4th Assessment report, 2007; WHO, health in Green economy; Haines A, McMichael AJ, Smith KR, et al. Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers. Lancet 2009; 374:2104-14.

Key focus areas Raise education & awareness Share knowledge and good practices Generation of evidence Build country capacity Inter-sectoral collaboration on health, env., & climate Resource mobilization Act on both mitigation & adaptation

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