1. L.SINISI Convention of the Protection and Use of Transboundary Watercourses and International Lakes First meeting - Task Force on Water and Climate “extreme events and health” Cooperation with the Task Force “extreme events and health” established under the Protocol on Water and Health Luciana Sinisi, APAT, Italy “extreme events and health” Task force “extreme events and health” Leadership Ministry of Environment,Italy Protocol on Water and Health luciana.sinisi@apatluciana.sinisi@apat. Federal Ministry for the Environment, Nature Conservation and Nuclear Safety,Bonn, Germany, 22–23 November 2007

2. L.SINISI THIS PRESENTATION “extreme events and health” Task Force “extreme events and health” established under the Protocol on Water and Health: The institutional background The scientific background : current evidence on extreme events and health The governance of prevention of “Water-related disease” First suggestions of common activities

3. L.SINISI The institutional background

4. L.SINISI The Protocol : Article 1 OBJECTIVE The objective of this Protocol is to promote at all appropriate levels,nationally as well as in transboundary and international contexts, the protection of human health and well-being, both individual and collective,within a framework of sustainable development, through improving water management, including the protection of water ecosystems, and through preventing, controlling and reducing water-related disease. Definition: “Water-related disease” means any significant adverse effects on human health, such as death, disability, illness or disorders, caused directly or indirectly by the condition, or changes in the quantity or quality, of any waters; Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes,

5. L.SINISI Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes, With the latest ratication in May 2005, the Protocol enters into force on 4 August 2005 as the first legally binding instrument for the prevention and control of water-related diseases through improved and harmonized water supply and management. Parties and Signatories The 21 ratifying Countries (Parties) Albania, Azerbaijan, Belgium, Croatia, the Czech Republic, Estonia, Finland, France, Germany, Hungary, Latvia, Lithuania,Luxemburg, Moldova, Norway, Portugal, Romania, the Russian Federation, Slovakia, Switzerland and Ukraine. Other signatory Countries Armenia, Cyprus, Denmark, Georgia,Greece, Iceland, Italy, Malta, Monaco, the Netherlands, Poland, Slovenia, Spain, Sweden, the United Kingdom. The Protocol implementation is jointly supported by the United Nations Economic Commission for Europe (UNECE) and the WHO Regional Office for Europe

6. L.SINISI Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes, First meeting of the Parties: Geneva, 17–19 January 2007First meeting of the Parties: Geneva, 17–19 January 2007 Approval of work plan 2007-2009 * prepared by Protocol WG includingApproval of work plan 2007-2009 * prepared by Protocol WG including specific bodies to carry out the different programme elements: specific bodies to carry out the different programme elements: (a) A Task Force on Surveillance; (b) A Task Force on Indicators and Reporting; (c) A Task Force on Extreme Weather Events. * PROGRAMME AREA III: SHARING OF EXPERIENCE Rationale: Activities in this programme area will support exchange between Parties and non-Parties on progress achieved in the implementation of the Protocol. The goal is to promote common approaches and sharing of problems and identify solutions at the regional and subregional levels, including the preparation and implementation of guidelines and documents on good practices.

7. L.SINISI Task force: leadership Italy,Ministry of Environment. Final goals: Guidelines based on shared experience for prevention of healths risks from water scarcity, unsafe water supply and sanitation (WORKSHOP) Supporting a strategy paper on adaptation focus on health concern to mitigate health risks and potential health impacts in extreme events (Cooperation with other Protocol/Water Convention task force) EXTREME EVENTS & HEALTH

8. L.SINISI EVIDENCE AND KNOWLEDGE INTEGRATED ACTIONS IN ADAPTATION PROGRAMME

9. L.SINISI The scientific background : current evidence on extreme events and health

10. L.SINISI Source : CRED “Annual disaster statistics review: numbers and trends”, Maggio 2007 * Hydrometeorological disasters: floods, slides, drought, avalanches, wind storm, heat waves Extreme events: The global occurrence in the past ten years

11. L.SINISI Source: HOYOIS Ph. GUHA-SAPIR D. (2003). Three decades of floods in Europe : a preliminary analysis of EMDAT data. Working paper (draft). Brussels, CRED, 2003. [ID n197] FLOODS in UN EUROPEAN REGION 1973-2002

12. L.SINISI DROUGHT occurrence: the global data Criteria to be included in CRED data base for all events: -at least 10 victims -at least 100 people affected requiring assistance - declared state of emergency - request of international assistance

13. L.SINISI Source : APAT adapted from EM-DAT, 2007 Centre for Research on the Epidemiology of Disasters (CRED), Université catholique de Louvain EXTREME EVENTS: MORTALITY Average 2000-2005 compared to 2006

14. L.SINISI EXTREME EVENTS: AFFECTED POPULATION Average 2000-2005 compared to 2006 Source : APAT adapted from EM-DAT, 2007 Centre for Research on the Epidemiology of Disasters (CRED), Université catholique de Louvain

15. L.SINISI *Source: CRED/ ISDR/UCL “Annual disaster statistics review: numbers and trends”, May 2007 UN European Region: signals of effectiveness of response system Increase N° of eventsdecrease N° of victims 200520062000-04 average Floods443328.6 drought24 18 Wind storms etc 23 13.2 20052006 2000-04 average floods119.000179.000495.000 drought1.13966.267265.000 Wind storms 406.0001.828566.000

16. L.SINISI DIRECT EXPOSURE Death, psycho-phisical trauma INDIRECT EXPOSURE short term Microbiological contamination of food and drinking water; Increase of emerging toxic risks: synergy sea warming & contaminated discharge in coastal areas; -Increase of vector borne diseases long term Chemicals mobilization FLOODS Chemical contamination of drinking water (stronger clorination) Increased chemical concentration in environmental media & biota (synergy with increased use of pesticides) Food safety and security (synergy with warming) Assessment of Land use DROUGHT Prevention: major environment and health concerns

17. L.SINISI The governance of prevention of “Water-related disease” In extreme weather events

18. L.SINISI Health risks governance in extreme events Diseasessurveillance Land use & Territory vulnerability: Hazard and risk maps Safe (reliable) water supply in emergencies: in emergencies: contingency plan and recovery measures Environmental early warning warning Waters contamination: Post event monitoring and recovery Assessment for land use – GUIDE LINES? Public health early warning Public health infrastructure infrastructure Emergency and recovery recovery Information to affected population population Indicators & reporting Social impacts of extreme events: Data base development Technologicalimprovement Health ass of Adaptation measures measures

19. L.SINISI (first) CONCLUSIONS Increased occurrence of extreme events urge adaptation measures and a “new way” of planning monitoring, surveillance, land use and water management, preparedness including adaptation of preventive systems. The governance of water related diseases in extreme events is complex and can be achieved only by integrated actions The cooperation between the two task forces is a key issue and facilitating mechanism should be promoted ( joint meetings, exchange/integrated documents, workshop etc)