Presentation at 3rd GRF One Health Summit 2015 Poverty and Health - One Health Approaches for Sustainable Development Esther Achieng ONYANGO, Griffith University School of Environment: Centre for Environment and Population Health and Environmental Research Futures Institute, Brisbane, Australia

1. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
A Conceptual Framework for
Conducting and Integrated
Vulnerability Assessment in
Climate Change and Malaria
Transmission
Esther A. Onyango1
1 PhD Candidate, Griffith University School of Environment, Brisbane Australia

2. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
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3. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
Climate Change and Human Health
Climate Change could cause approximately 250 000
additional deaths per year between 2030 and 2050.
WHO, 2014
Climate change is the biggest global health threat of
the 21st Century
The Lancet Climate Change Commission, 2009
Tackling climate change could be the greatest global
health opportunity of the 21st century
The Lancet Commission on Health and Climate Change, 2015
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4. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
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Climate change will impact health through 3 processes:
IPCC 2014

5. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
Malaria Transmission
Found in 97 countries, mostly in sub-Saharan Africa
(WHO 2015)
198 million cases and 0.5 million deaths annually
(WHO 2015)
Upto 3.3 billion people are at risk of infection by the disease!
(WHO 2015)
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6. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
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Warming over the African continent is faster than global average
(IPCC, 2013)
Most areas will exceed 2⁰C by end of this century
(Niang et al., 2014)
Under high scenarios – 3⁰C to 6⁰C by end of century
(Peterson, 2009)

7. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
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Climate Change
Temperature, Rainfall
Malaria
Transmission
Ecosystem Regulation
Land Use and
Land Use Change
(Deforestation & Agricultural
practice)
Biological Factors
(age, gender, immunity)
Socio-Economic
Factors
(Vector control, disease control population
migration and transportation)

8. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
Complex System
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Climate Change / Climate Variability
Land Use and Land
Use Change
Temperature Precipitation-Humidity
Larval maturity
time
Fecundity
Vector density
Gonotrophic
cycle
Parasite development
in vector (EIP)
Biting frequencyInfection rate
Disease risk
Habitat
productivity
habitat
availability
vector abundance
Deforestation Agricultural practice
Parasite
development (host)
Density of
reservoir hosts
Mosquito larval
development
Human (host)
behaviour
Economic, Social,
ecological, technological,Coping capacity
Institutional /
governance
Individual /
Community
Gender
Ecosystems and
human behaviour
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Host immunity
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Age
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migration
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treatment,
environmental controls
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it is important not only to understand how changes in climate
and land use will impact on the current burden of the disease
and the resultant impact on vulnerable communities
Biophysical Vulnerability
(Adger, 2006; Eriksen & Kelly, 2007; Ebi, 2007; WHO, 2010)
but also to identify how sensitive these populations are to these
impacts and their capacity to respond
Social Vulnerability
(Adger, 2006; Eriksen & Kelly, 2007; Ebi, 2007; WHO, 2010)
Climate Change
Land Use
and
Land Use Change
Malaria Transmission
Human Activities

9. A Framework for Integrated Assessments
Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland

10. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, SwitzerlandVulnerability Assessments
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From disaster risk reduction and climate change
adaptation: used to map and interpret current
and future risks related to climate change
Very few vulnerability assessments on climate
change and malaria in East Africa exist in
published literature (Bizimana et al., 2015; Castro, 2015; Kienberger and Hagelocher,
2014).
Only one integrated assessment (Wandiga et al., 2009).

11. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
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Vulnerability
Exposure Sensitivity Adaptive
Capacity
Sutherst (2004): Framework for integrated vulnerability
assessments for vector-borne diseases such as malaria
humans to
pathogens
with
environmental
change
technology,
infrastructure, disease
control, education
Pg. 6-7
Differential:
geographical,
economic,
environmental; gender,
age, poverty

12. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
IPCC, 2014
LOCAL IMPACTS
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13. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
Land use and land use
change
Biophysical
Temperature and
Rainfall
Framework for Assessment: Adapted from
Sutherst (2004) and IPCC (2014)
Social
Biological Sensitivity
Generic Sensitivity
Current burden of malaria
How climate and land use will impact on the current burden of the disease
Sensitivity of the population Current coping capacity
Individual
Institutional
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14. Application of the Framework
Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland

15. Centre for Environment and Population HealthEnvironmental Futures Research Institute
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Davos, Switzerland
Research Aim
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To assess community vulnerability to malaria
transmission in the context of climate change by
investigating and documenting local dynamics that
may influence vulnerability in the Western Kenya
highlands
Does climate and influence vulnerability to malaria
transmission among agricultural communities in
Western Kenya?
What are the potential adaptation responses?
Primary Research Questions

16. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
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Study Location
8/10/2015
L. Victoria
Kakamega (highland): malaria
epidemic prone and endemic areas
Rarieda (lowland): Malaria endemic
Climate-malaria risk models predict (2055) an
expansion into the highland areas

17. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
Key Informant
Interviews
Final Set of Indicators
Stakeholder
Identification
Literature Review
Conceptual
Framework
Scoping
Secondary Data
Possible Indicators
Expert Ranking
Step 1. Scoping – initial literature review, data
sources
Step 2. Developing the conceptual framework
Step 3. Focused literature review and
identification of relevant stakeholders
Step 4. Secondary data from published studies;
interviews and focus groups with stakeholders
Step 5. Initial list of possible indicators for
hazard, vulnerability and exposure
Step 6. Validation of indicators derived from
literature and empirical data through expert survey
Step 7. Final set of indicators for integrated
vulnerability assessment using Bayesian networks
Research
Setting
Steps in the Assessment
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18. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, SwitzerlandAdded Value to One Health
Systems thinking: trans-disciplinary, mixed methods,
stakeholder engagement and expert input
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= more robust model
identification of targeted
response strategies informed by
specific community needs and
capabilities
pathways for sustainable
adaptation strategies
Place-specific connections between the environment, people
and their social arrangements
Setting baseline for holistic measurements of climate change-
malaria risk

19. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, Switzerland
Conclusion
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Application of this framework will be important in:
1. Contributing to the evidence base linking climate change,
and malaria transmission.
2. Contributing to knowledge to enhance local adaptation
response options for managing climate change and health
impacts.
3. Providing a methodological basis for addressing climate
change adaptation research in Africa or other areas globally
with similar vulnerability profiles.

20. Supervisory Team:
Prof. Brendan Mackey, Griffith Climate Change Response Program
Prof. Cordia Chu, Griffith University Centre for Environment and Population
Health
Dr. Shannon Rutherford, Griffith University Centre for Environment and
Population Health
Dr. Alex Awiti, East African Institute, Aga Khan University
Dr. Andrew Githeko, Kenya Medical Research Institute
Acknowledgements
Funding:
School of Environment
Environmental Futures
Research Institute
Asia Institute

21. Centre for Environment and Population HealthEnvironmental Futures Research Institute
3rd GRF One Health Summit
4th – 6th October, 2015
Davos, SwitzerlandKey References
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2. Attaway, D. F., Jacobsen, K. H., Falconer, A., Manca, G., Bennett, R., & Waters, N. M. (2014). Mosquito habitat and dengue risk potential in Kenya : alternative methods to traditional risk
mapping techniques. Geospatial Health, 9(1), 119–130.
3. Bizimana, J., Twarabamenye, E., & Kienberger, S. (2015). Assessing the social vulnerability to malaria in Rwanda. Malaria Journal, 14(2), 1–21. doi:10.1186/1475-2875-14-2
4. Brooks, N., Neil Adger, W., & Mick Kelly, P. (2005). The determinants of vulnerability and adaptive capacity at the national level and the implications for adaptation. Global Environmental
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