Annual Environment Health and Wellbeing Conference - EPA, HSE and ESRI - 21 November 2019, Radisson Blu Royal Hotel, Golden Lane, Dublin

1. Who is WHO?
Main areas of work:
• Health systems
• Promoting health through the life-course
• Noncommunicable diseases
• Communicable diseases
• Preparedness, surveillance and response.
Who is WHO?
• Since 7 April 1948
• 7000 people working in 150 country offices
• 6 regional offices and headquarter in Geneva

2. WHO’s key functions
1. providing leadership on matters critical to health and engaging
in partnerships where joint action is needed;
2. shaping the research agenda and stimulating the generation,
translation and dissemination of valuable knowledge;
3. setting norms and standards and promoting and monitoring
their implementation;
4. articulating ethical and evidence-based policy options;
5. providing technical support, catalysing change, and building
sustainable institutional capacity; and
6. monitoring the health situation and assessing health trends.

3. WHO European Centre for Environment and Health
Programmatic and technical areas of work

4. Health in climate change adaptation: good
practices and lessons learned from the
WHO European Region
Dr Vladimir Kendrovski
Water and Climate
WHO European Centre for Environment and Health
Bonn, Germany

5. Source: Wantedinrome, 2017 Source: Manu Fernandez, 2008
Heatwave in northern Europe, summer 2018
Euro-Mediterranean heat, summer 2017
Europe heatwave 2019
(Јune, July)

6. Climate change is breaking records (globally and in Europe)
European land temperature
(1850-2015)
Global temperature
(1850–2018/19)
2018: 1.1–1.3 °C
above pre-
industrial level

7. Multiple diseases can be prevented through a healthy
environment
The vast
majority due
to
cardiovascular
diseases.
http://who.int/mediacentr
e/news/releases/2016/d
eaths-attributable-to-
unhealthy-
environments/en/
12,6 million
deaths occur
annually globally
from
environmental
determinants.

8. 8
How does climate variability and climate change impact health?
Source: Adapted from IPCC 2014, WGII-AR5
Climate extremes
and change
Environmental conditions
• Geography
• Weather
• Air pollution
• Land use (soil/vegetation)
• Green/blue infrastructure
• other
Public health system and adaptive capacity
• Health warning systems
• Socioeconomic status
• Health and nutrition status
• Healthcare infrastructure
• Social cohesion
• other Injury, disability, loss of
life and economic costs
Societal infrastructure
Direct impacts: heat, drought, floods, ....
Indirect effects mediated through natural
systems: air pollution, food/water-borne
diseases, VBD, ....
Economic/social effects mediated by
human systems: occupational impacts,
population displacement, malnutrition,
mental stress, ....
Moderating
influences

9. Health impacts of climate change

10. Extremes & their impacts
Changes in
natural physical
environment
Changes in
ecosystems
Adverse effects on
human conditions

11. 2000
deaths
10 million in European Region
UNEP-GTU, 2018
GAP-Health Report

12. Heatwaves are getting stronger
Exceptionally warm days
(1960–2015)
Frequency of extreme heat waves
(two time horizons and two scenarios)
Source: EURO-CORDEX (Jacob et al., 2014)
Source: HadEX2
(Donat et al. 2013)
Source: JRC
(Russo et al. 2013)

13. Heavy precipitation events are getting stronger
Heavy daily precipitation
(projected change for 2080s, RCP 8.5)
Source: EURO-CORDEX (Jacob et al., 2014)
Heavy daily precipitation
(1951–2013)
Source: Fischer & Knutti (2016)
 Heavy daily
precipitation in
Europe has
increased
substantially in
the last 60
years.
 Further
increases in
heavy daily
precipitation are
projected, in
particularly in
winter.

14. Meteorological droughts are increasing in southern Europe
Drought frequency
(trend for 1950–2012)
Source:
JRC (2016)
Drought severity
(trend for 1950–2012)

15. Examples of vector-borne diseases in the WHO European
RegionMosquito-borne
• Dengue fever
• Chikungunya
• Malaria
• West Nile fever
(WNF)
•Zika
Sandfly-borne
• Leishmaniasis
Tick-borne
• Lyme disease
• Tick-borne
encephalitis (TBE)
• Crimean–Congo
haemorrhagic
fever
• 77 000 Europeans on average fall sick from vector-borne diseases every year.
• Mosquito species, such as Aedes aegypti, are re-emerging, and Ae. albopictus is emerging.

16. Social impacts
• Social impacts of disasters and
extreme weather events
– Household income
– Displacement
• Isolation
• Stress
– Loss of personal possessions
– Household costs
• Loss of cultural landscapes
– Alpine meadows

17. High level of diversity

18. Cities in EU most affected by extreme weather due to climate change
• a worsening of
heatwaves for all 571
cities
• increasing drought
conditions,
particularly in
southern Europe
• an increase in river
flooding, especially in
north-western
European cities
• for the worst
projections, increases
in all hazards for most
European cities
Flooding Heatwaves Drought
Dublin Athens Athens
Helsinki Nicosia Lisbon
Riga Prague Madrid
Vilnius Rome Nicosia
Zagreb Sofia Sofia
Stockholm Valletta
Valletta
Vienna
Source: Guerreiro S. et al, 2018

19. 2019 Report: 220 million more vulnerable people were
subjected to a heatwave last year than
1986–2005 climatological baseline, higher
than ever previously tracked
(31 million additional exposures in the EU)
133 billion hours of work were lost in
2018 due to extreme heat as a result of
climate change.
Europe and the East
Mediterranean are particularly at
risk, most likely due to ageing
populations living in cities, with
42% and 43% of over 65s
vulnerable to heat exposure.
Data from all major crops tracked—
maize, wheat, rice, and soybean—
showed that increases in
temperature have reduced global
crop yield potential
The number of suitable days per year
in the Baltic for pathogenic Vibrio
transmission reached 107 in 2018, the
highest since records began, and two
times higher than the early 1980s
baseline

20. • The first is that the greater the warming, the
greater the risks to health overall.
• The second message is that there can be
important health gains from the actions that
will be necessary to limit warming.
• The final message is that the speed of
reducing emissions will affect the level of
adaptation ambition required. The longer it
takes to reduce emissions, the greater the
adaptation needed to protect population
health.

21. The Need for a Global Approach to Climate Change
Climate change is a global
problem and a “common
concern to mankind”
GHG emissions contribute to
climate change irrespective of
their origin
All countries will be affected
if no action is taken
A global agreement is needed
to regulate emissions and
help countries to adapt

22. The United Nations Framework Convention
on Climate Change

23. SDG 13 underlines that the task is being advanced under the UNFCCC in
order to minimize the duplication of efforts and optimize finite resources.
• Sets ambitious limits to warming – Less than 2oC, aim for 1.5oC
• Obliges countries to make "Nationally Determined Contributions" to reduce
carbon emissions and to increase resilience
• Commits to mobilizing US$100 billion/year in climate financing
The Paris agreement as a public
health treaty

24. Health and well-being
are an outcome,
a determinant and
an enabler
of the Goals.
…….progress
on all of these
aspects of
sustainable
development
will be
undermined if
the world is
not successful
in SDG 13, on
‘Climate
Action’.

25. Two Broad Responses Adopted by
the UNFCCC
Actions taken to cut net emissions of
greenhouse gases to reduce climate change
and to preserve and enhance GHG sinks
and reservoirs
Actions taken to help cope with changing
climate conditions and impacts
Mitigation Adaptation
25
Source: UN CC Learn: Section 1: The International Climate Change Policy Framework
http://uncclearn.org/sites/www.uncclearn.org/files/images/infocus/module_2_introduction_to_the_international_legal_and_policy_fram
ework_to_address_climate_change.pdf, accessed 11 February 2015

26. …a common health and climate change agenda
Developing an action plan on
climate change and health in the
small island developing states
Informing and empowering the
health sector to engage on climate
change
Mobilising the health community
behind a common global action
agenda

27. 13th General Programme of Work 2019–2023
1 billion
more people
enjoying better
health and
well-being
1 billion
more people
better protected
from health
emergencies
1 billion
more people
benefitting from
universal health
coverage

28. Formulate
recommendations
for UNFCCC
negotiators and
policy makers on
maximizing the
health benefits
Provide an
overview of
initiatives & tools
provided by the
health community
to accelerate
action under the
Paris Agreement
Synthesize global
knowledge on the
interconnection
between climate
change and health
The (first ever) COP report on health

29. Monitoring of progress on health & climate
change profiles (Survey, 2018)
Systematically track progress in health
resulting from
climate change mitigation
and adaption
Belarus, Croatia, Cyprus, Czechia, Finland, Georgia, Germany,
Hungary, Iceland, Israel, Latvia, Lithuania, Malta, Norway,
Romania, Slovakia, Slovenia, Sweden, Tajikistan, Ukraine.

30. Climate change and health in the
WHO European Environment and Health Process
Frankfurt
1989
Climate change
recognized
London
1999
Early human
health effects
Budapest
2004
Extreme
weather events
Parma
2010
Regional
Framework
Ostrava
2017
Adaptive capacity
and resilience

31. 6th Ministerial Conference
on Environment & Health
Improve indoor and outdoor air quality
Ensure access to safe drinking-water,
sanitation and hygiene
Minimize adverse effects of
chemicals
Strengthen adaptation to and
mitigation of climate change
Prevent/eliminate adverse effects of
waste mgmt. & contaminated sites
Support cities and regions to become
healthier
Build the environmental sustainability of
health systems
Ministerial
Declaration
Develop national
portfolio of action on
environment and health
by end-2019

32. Compendium of
possible actions

33. Climate-resilient health systems

35. Health & economic benefits from carbon reductions
Prevented annual premature deaths from
implementation of INDC (thousands)79 000 premature deaths prevented in
the WHO European Region
Economic benefits amount to
US$ 244–564 billion, or 1–2% of GDP
(at purchasing power parity)

36. Public health and climate change adaptation
Assess progress in tackling health risks from
climate change by analysing adaptation
developments related to public health in EU
countries
Compile a compendium of good practice case
studies from EU countries featuring examples of
adaptation
to climate change in the health sector

37. Health adaptation progresses
0
0.2
0.4
0.6
0.8
1
Governance
Health vulnerability
and impact
assessments
Approved national
health adaptation
policies
Strengthening health
systems
Awareness raising
Governance mechanism
Health vulnerability and
impact assessments
Approved national climate
change health adaptation policy
Strengthening public health
capacity and health systems
Level of awareness of
relevance of health effects

38. Heat health action
planning and
implementation
UV radiation/
sun protection
Surveillance of
vector and other
infectious disease
Building capacity
of doctors
Communication
and coordination
ITA
SWE
SLO
DEU
BEL
DEU
AUT
BEL
CRO
DEU
LTU
SLO
SWE
Good practices in health adaptation

39. Conclusions /1
The health sector is responsible for protecting health from climate risks, but other
sectoral policies too. The health sector needs to engage in intersectoral governance
and development of sectoral policies by providing public health arguments.
A comprehensive approach should be adopted to integrate climate risks into health
systems.
The capacity of the health workforce should be developed to address climate health
risks.
Impact assessment and research in relation to climate change-related health risks
should be established into wider climate change policy planning processes.

40. Conclusions /2
Climate-informed health programming and emergency preparedness needs to be
strengthened.
Finance for health system resilience to climate change should be scaled up. Climate
adaptation should be embedded in the EU budget.
Countries, regions and cities should be further supported and encouraged to develop
plans to build resilience and adapt to climate change, taking population health into
account.

41. Key message
Climate change is
projected to continue
with further impacts on
people and ecosystems
Climate change is
projected to impacting
the economic,
environmental and
social determinants of
health.
The level of effects on
population health will
vary
There is no time to lose.
Greenhouse gas emissions
must be cut to almost half
by 2030 .
The Paris Agreement
also commits countries
to strengthen
adaptation.

42. THANK YOU!
kendrovskiv@who.int