“Climate Change and human health in Africa” Potential health benefits of SLCP mitigation Dr J. D. van Hasselt Intergovermental Consultation on Near-Term Climate Protection and Clean Air Benifits in Africa Accra September 2012

WHO Estimated effect of climate change in year 2000 by region (DALY’s per million population) African region 3071.5 SE Asia 1703.5 Dev countries 8.9 Campbell-Lendrum DH, Corvalán CF, Prüss Ustün A. How much disease could climate change cause? In: McMichael AJ, Campbell-Lendrum DH, Corvalan CF, et al, eds. Climate change and human health: risks and responses. Geneva: WHO, 2003. Loss of health life years as a result of climate change. Look at the comparative numbers. SE Asia as next most severely affected. Due to socio economic determinants of health and existing disease burden in SSA, together with greater exposure to CC

Impact Climate change is the biggest global health threat of 21st Century’ Lancet and University College London Institute for Global Health Commission: 2009 Report Loss of healthy life years as a result of global environmental change predicted in poor African populations 500 > European Global environmental change and health: impacts, inequalities, and the health sector. BMJ 2008; 336: 191–94. McMichael AJ, et al.

Mortality Related to Climate Change Source: Climate Change and Global Health: Quantifying a Growing Ethical Crisis, 2007, Jonathan A. Patz, Holly K. Gibbs, Jonathan A. Foley, Jamesine V. Rogers, and Kirk R. Smith

Mozambique “Climate change is having a severe and tangible effect … with devastated communities and destroyed infrastructure” CVM Mid Year Report 2010

Intersectoral basis of mortality (WHO 2009) Sectors assessed for adaptation support (World Bank 2009) Agriculture, forest & fisheries Infrastructure Water supply Health Coastal zones Extreme weather Annual deaths linked to selected related risks (WHO 2008, 2009) 3.5 million undernutrition 2 million indoor air pollution 2 million diarrhoea 900,000 malaria 30,000- 60,000 extreme weather Somewhat artificial separation as many of the sector impacts are inter related wrt health, but illustrates the current health impacts reported and estimated by WHO. 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.ht ml WHO estimates that climate change currently causes over 140,000 deaths/year – with highest impacts in Africa 6 6

Climate Change Health Impacts Increased malnutrition & related disorders, including those relating to child growth and development (FOOD) Diarrheal/water borne/water washed diseases (WATER) Higher temperatures expand range of vector-borne diseases, such as malaria (OUTBREAKS) Floods, storms, fires and droughts (DISASTERS) Multiplier effect on existing health problems, small tipping points adversely affecting large numbers of people at risk (large scale vulnerability), extreme weather events, increased risk of new and unexpected outbreaks. 7

Hunger and Food Security One out of four children in West Africa are underweight ~600,000 children under the age of five in the region die annually from causes related to malnutrition UNICEF September 2011 Daily calorie intake in almost half of all SADC countries has declined compared to the early nineties De Wit, M. and Midgley, S.J.E. 2012. Hunger and Climate Change: An analysis of key variables in southern Africa. OneWorld Sustainable Investments, Cape Town, South Africa. If SCLP’s contribute, even in a small way to declining food security, the impacts may be large ie small incremental shifts tipping points 8

SLCP’s: Adverse Health Impacts Exposure to IAP from solid biomass fuels associated with COPD (adults) and ALRI’s (children) plus several other adverse health effects Acute lower respiratory infections (ALRI’s) are the single leading cause of death of children under 5 years old worldwide Risk factors include nutritional status, crowding Poverty Hunger Respiratory Disease Young children especially susceptible to ALRI through IAP for a number of reasons including immaturity of lung linings and immune systems which are not fully developed. Also a gender bias. Also clearly inter related factors of hunger and poverty 9

South Africa: SLCP and IAP Relatively well researched Post 1994 policies aimed at reducing IAP Relative risk for childhood mortality due to ALRI is 1.95 in homes burning polluting fuels Introduction of cleaner energy (electricity) significantly protective of respiratory health Barnes, B. Mathee, A. Thomas E. and Bruce, N. 2009. Household energy, indoor air pollution and child respiratory health in South Africa. Journal of Energy in South Africa. Vol 20 No 1. Young children especially susceptible to ALRI through IAP for a number of reasons including immaturity of lung linings and immune systems which are not fully developed. Also a gender bias. Also clearly inter related factors of hunger and poverty 10

Key Gaps Few recognized studies and little regional research International literature-extrapolated/derivative data Health sector–more immediate priorities Inadequate disease surveillance and poor public health data SLCP’s –direct health benefits through IAP/outdoor air pollution particularly through improved cookstove tech positive impact incl gender and child health but also improved food security. Complex interrelated-but intuitively it is clear that even small improvements have potential to dramatically increase resilience and adaptive capacity.

Leadership commitments ‘2nd Interministerial Conference on Health and Environment in Africa ‘Joint Statement on Climate Change and Health’ Angola 2010 Resolution (AFR-RC61-10) ‘Framework for Public Health Adaptation to Climate Change in the African Region’ September 2011 Second Interministerial Conference on Health and Environment in Africa that took place in Angola in 2010, African ministers of health and of environment committed to adopt the Joint Statement of on Climate Change and Health in Africa

Responses ‘ ..while there is uncertainty  regarding the exact impact of climate change on health,  fortunately, there is much less uncertainty around the best responses. These include, .. greater and more resilient coverage of water and sanitation resources. They also include improvements to protect health both from extreme weather events, and any long-term degradation in the environmental determinants of health, such as air quality, the availability of fresh water, and food security. All of these interventions would both save lives now, and increase resilience to gradual climate change.’  Campbell-Lendrum D et al: Bulletin of the World Health Organization 2010;88:242-242. In period of uncertainty, need to be careful to advocate actions and responses that will meet current and anticipated future needs. This statement from WHO advocates a pragmatic approach that is valid and responsible. No regret strategiesThey also include improvements in climate-risk management, to protect health both from extreme weather events, and any long-term degradation in the environmental determinants of health, such as air quality, the availability of fresh water, and food security. All of these interventions would both save lives now, and increase resilience to gradual climate change.

Thank You