Presented by: Gerardo Sanchez 8.1 Approaches / adaptation solutions (2/2) The section will provide best practices regarding various adaptation approaches or solutions at various scales based on latest science. Examples to be featured include ecosystem-based approaches, community based adaptation, responses to heat waves and ways to deal with shifting growing seasons in agriculture. The session will also feature practical experiences from countries in addressing issues at multiple scales.

1. Preventing health impacts from heat
in a changing climate
Gerardo Sanchez Martinez
WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR EUROPE
Bonn, Germany

2. WHO Regional Office for Europe
Slide courtesy of Dr Diarmid Campbell-Lendrum

3. WHO Regional Office for Europe
Slide courtesy of Dr Diarmid Campbell-Lendrum

4. WHO Regional Office for Europe
Source: Confalonieri et al. 2007
Impacts of climate change on health

5. WHO Regional Office for Europe
A specific example: Heat and health (I)
Individual exposure and risk factors
Complex causal network including social and
environmental determinants of health

6. WHO Regional Office for Europe
15 20 25 30
-0.10.00.10.20.30.40.5
tmean.lag03
s(tmean.lag03,5)
Heat and health (II)
Population exposure-response function

7. WHO Regional Office for Europe
15 20 25 30
-0.10.00.10.20.30.40.5
tmean.lag03
s(tmean.lag03,5)
2000 2020 2040 2060 2080 2100
500000550000600000650000700000750000800000
Year
Population
Exponential model
Logistic model (K=1000000)
Logistic model (K=900000)
Logistic model (K=800000)
Logistic model (K=700000)
2000 2020 2040 2060 2080 2100
0200400600
year
AttributableDeaths
Median scenario
2000 2020 2040 2060 2080 2100
0200400600
year
AttributableDeaths
Minimal scenario
2000 2020 2040 2060 2080 2100
0200400600
year
AttributableDeaths
Maximal scenario
Population projection
Temperature-response
relationship at baseline Climate
change
scenarios
Adaptation
scenarios
Example from case
study in Skopje,
Macedonia. Source:
Sanchez, Baccini et
al. (2016)

8. WHO Regional Office for Europe
Estimated 250,000 additional deaths/ year by 2030

9. WHO Regional Office for Europe
1. Agreement on a lead body;
2. Accurate and timely alert systems;
3. Heat-related health information plan;
4. Reduction in indoor heat exposure;
5. Particular care for vulnerable population
groups;
6. Preparedness of the health and social care
system;
7. Long-term urban planning;
8. Real-time surveillance and evaluation.
KEY ELEMENTS OF A HEAT-HEALTH ACTION PLAN

10. WHO Regional Office for Europe
ARE COUNTRIES PREPARED? (EUROPEAN PERSPECTIVE)
Countries / Indicators Lead body Alert system Information
plan
Indoor heat
reduction
Vulnerable
groups
Health care
preparedness
Urban
planning
Real-time
surveillance
Evaluation
Austria* **
Belgium **
Croatia
France **
Germany* **
Hungary
Italy
Luxembourg ** **
Macedonia
Moldova
Monaco **
Netherlands **
Portugal **
Romania
Serbia **
Spain ** **
Switzerland* **
UK
Total: 18 Source: Bittner et al. 2013 * regional level plans ** in other documents

11. WHO Regional Office for Europe
What is the situation like in the WHO EURO region?
• HHAP Adoption rate is low; only 18 member states have nominally
taken action, but many more are at risk of heat-related mortality
and morbidity
• Implementation is patchy particularly regarding long-term
measures, timeliness of surveillance and notification, as well as
monitoring and evaluation
• Heat and health treated as a static phenomenon!
– Climate change poorly or not incorporated
– Within season variations not taken into account
– Provisions for revising the HHAP not clearly established
– New or improved climate services not well taken advantage of

12. WHO Regional Office for Europe
Operational Framework to strengthen
health resilience to climate change

13. WHO Regional Office for Europe
Health in the National Adaptation Programmes of
Action (NAPAs) – WHO assessment (2010)
• 95% of the NAPAs identified health as a priority sector.
• 73% of the NAPAs identified health interventions within
their list of adaptation needs and proposed actions.
• 11% of the priority projects focused on health
• 4% of the portfolio of the LDC Fund supporting the
NAPA process targeted health adaptation.
• Potential explanations for this lack of support for health
sector adaptation:
• health community largely absent from the NAPA process;
• health sector did not submit proposals to the LDCF; and
• limited technical guidance made available failed to ensure minimum
technical requirements of health adaptation proposals.

14. WHO Regional Office for Europe
…opportunity for the health
sector to get involved into the
NAP process …
Ebi et al, WHO Guidance for health
in national adaptation plans
Leadership and governance: Health
component of NAPs (H-NAP)

15. WHO Regional Office for Europe
WHO’s support to national adaptation planning
• Awareness raising and guidance to support greater health sector
engagement in climate-change adaptation programming.
• Technical and policy support for vulnerability and adaptation
assessment based on newly revised WHO guidance.
• Integration of adaptation measures within approaches to health
systems strengthening.
• Sharing of lessons learned and technical resources from WHO pilot
projects on health adaption to climate change (e.g. through the
Nairobi Work Programme).
• Technical and policy support for new projects and programmes on
health adaptation to climate change.
• Technical support in developing national strategies and action
plans.

16. WHO Regional Office for Europe
In conclusion
• Health needs to feature more prominently in Adaptation planning,
at all levels;
• High temperatures are a clear example of exposure exacerbated
by climate change; Heat-health action plans are a prime example
of health adaptation to climate change;
• Implementation is low, particularly outside Europe and North
America;
• Many new tools and climate services can help in planning,
adoption, implementation and reevaluations;
• We need to involve all stakeholders that can help, particularly
local authorities, which have effective outreach, fluid interaction
with stakeholders, and clear competencies over urban planning.

17. WHO Regional Office for Europe
THANKS
Write to us at:
euroclimate@who.int
Visit us at:
http://www.euro.who.int/climatechange