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Climate change and health in developing countries: Challenges and Opportunities for the OneHealth Approach Diarmid Campbell-Lendrum Team Leader, Climate Change and Health, Public Health and the Environment Department
The largest disease burdens in developing countries 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 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 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.
Climate impacts on health are unfairly distributed (movement of people, and resentment) Cumulative emissions of greenhouse gases, to 2002 WHO estimates of per capita mortality from climate change, 2000 Map projections from Patz et al, 2007; WHO, 2009.
Public make the connection between climate change and health Globescan poll in 30 countries (UNDP 2007): “ 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?”
Health in global sustainable development & climate agreements; and vice versa
1992 Rio declaration
Principle 1: " Human beings are at the centre of concerns for sustainable development. They are entitled to a healthy and productive life in harmony with nature ."
2008 World Health Assembly Resolution 61.19
Commits counties, and WHO, to assess evidence and strengthen health systems to respond to climate change.
Cutting greenhouse gas emissions could bring very large "co-benefits" to health:
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 reduced air pollution as a result of actions to reduce greenhouse gas emissions… may offset a substantial fraction of mitigation costs" – IPCC, 2007
In the Zambian Copper Belt in the 1930s, malaria had major impacts on health, and productivity Environmental-management based control reduced malaria by about 80%, at a cost of US$ 858 per death averted Modern ITN programmes achieve US$ 219 - $2958 per death averted Can we afford to manage the environment? CDC Public Health Image Library Utzinger et al, Tropical Medicine and International Health, 2001
Benefit/Cost ratios for environmental management interventions: US Clean Air Act: 42:1 (USEPA, 1999) Improved water and sanitation throughout 15:1 (WHO, 2004) poor regions of Latin America Environmental management of Catskills 2:1 (MEA, 2005) watershed versus new filtration plant Can we afford to manage the environment?
Can we afford NOT to manage the environment? WHO Image Library
Climate change presents very large health risks – mainly through ecosystem degradation.
The risks are not yet being managed either from the health or the environment side.
We have much of the necessary mandate, public support and evidence, and Onehealth is an appropriate conceptual model.
We need better incentives for integrated approaches and long-term risk management.
World Health Organization http:// www.who.int / Public Health and Environment Department http:// www.who.int / phe Health and climate change http://www.who.int/globalchange/en/ Thank you for your attention