World Health Organization 21 April 2017 Climate Change, Health & Health Professionals Diarmid Campbell-Lendrum, Public Health and Environment Department, World Health Organization, Geneva

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 living in areas climatically suitable for dengue globally 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

The largest disease burdens are highly climate sensitive Each year: - Undernutrition kills 3.5 million - Diarrhoea kills 2.2 million - Malaria kills 900,000 - Extreme weather events kill 60,000 These, and others, are highly sensitive to changing climate. Climate change is now widely considered to be a serious public health issue, because it interacts with so many of the important determinants of health, feeding into our largest current health burdens.

World Health Organization 21 April 2017 Weather-related disasters kill thousands in rich and poor countries References: 1) European Environment Agency: http://www.eea.europa.eu/data-and-maps/figures/number-of-reported-deaths-and-minimum-and-maximum-temperature-in-paris-during-the-heatwave-in-summer-2003 , based on data from IVS (2003): Impact sanitaire de la vague de chaleur en France survenue en aout 2003, Rapport d'etape, 29 aout 2003. Saint-Maurice, Institut de Veille Sanitaire. 2) NASA: http://www.nasa.gov/images/content/126421main_image_feature_398a_ys_full.jpg Deaths During Summer Heatwave. Paris Funeral Services (2003) Colorado, June 2012

Public discussion is disconnected from the evidence 2008 US Gallup poll of US public and scientists: Do you think human activity is a significant contributing factor in changing mean global temperatures? Doran et al, EOS, 2009

Everyone acknowledges that health is central to climate change- but not followed through to action LDCs identifying health as adaptation priority Number of adaptation projects submitted Funds requested for health Funds awarded for health

We neglect prevention – and pay the price Other Alcohol Unsafe Sex Tobacco Physical Inactivity Illicit drugs Environment Treatment & Overhead Prevention < 5% Factors influencing health World-wide health expenditures US $ 5.3 Trillion Each year from 2000-2008: life expectancy rose 0.5% health costs rose 6 % Source: Estimated from OECD, WHO, and Prevention Institute data

So what do we need to do about it?

Build on public interest in climate/health connections World Health Organization 21 April 2017 Build on public interest in climate/health connections 2001 Globescan poll in 30 countries: “Now I would like to ask you some questions about climate change, which is sometimes referred to as global warming or the greenhouse effect. Which ONE of the following possible impacts most concerns you personally, if any?”

Build on public health actions as effective "adaptation" measures We have proven interventions for climate-sensitive risks – we need to expand coverage, and ensure that they are climate resilient. Change in malaria endemicity class, 1900-present: (Gething et al, Nature, 2010) 10

World Health Organization 21 April 2017 We can protect health while reducing emissions Improved stoves could save 2 million lives over 10 years in India alone, and reduce warming from black carbon. Sustainable urban transport – could cut heart disease and stroke by up to 20%. "Health benefits from reduced air pollution as a result of actions to reduce greenhouse gas emissions… may offset a substantial fraction of mitigation costs" – IPCC, 2007. "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

 Infrastructure costs True Primary Prevention  Cardiovascular diseases CO2 Air pollution Physical activity  Obesity  Depression  Injuries  Social capital  Infrastructure costs Slide courtesy of Howie Frumkin, US CDC

Health care as a key sector 8-10% of the global GDP and 2.6% of the total GHG emissions. Up to 50% of health facilities in some major Sub-Saharan African countries have no electricity.

Health professionals as a key voice

Diarmid Campbell-Lendrum World Health Organization http://www.who.int/ Public Health and Environment http://www.who.int/phe/en/ Climate Change http://www.who.int/globalchange/climate/ campbelllendrumd@who.int With thanks to Susan Wilburn and Elaine Fletcher