Download Climate-based early warning systems: implications for public health

CLIMATE-BASED EARLY WARNING SYSTEMS:
IMPLICATIONS FOR PUBLIC HEALTH IN THE PACIFIC
DR LACHLAN MCIVER
CLIMATE CHANGE AND HEALTH OFFICER
(ACTING HEAD, ENVIRONMENTAL HEALTH UNIT)
HEALTH & NUTRITION CLUSTER COORDINATOR,
PACIFIC HUMANITARIAN TEAM
WHO DIVISION OF PACIFIC TECHNICAL SUPPORT
SUVA, FIJI
OVERVIEW OF PRESENTATION
How weather & climate information can add value to
“traditional” public health surveillance and response systems
Types of early warning systems used in the health context
Examples of climate-based early warning systems mechanisms
in the Pacific
Discussion of possible implications for other sectors/clusters
EARLY WARNING OR SURVEILLANCE?
Surveillance systems are intended to detect disease outbreaks
Early warning systems are designed to alert the community in
advance and to implement effective measures to reduce adverse
health outcomes
EARLY WARNING VS. SURVEILLANCE
Certainty
Early Warning
Response
Surveillance
Epidemic
Early cases
Sentinel cases
Environmental observations
Climate forecasts
Time
EARLY WARNING SYSTEMS
The system should be developed with all relevant stakeholders to
ensure that the issues of greatest concern are identified and
addressed
A basic requirement is that the community or region has
sufficient public health and social infrastructure to undertake
its design and implementation
EARLY WARNING SYSTEMS (CONT.)
The principal components of an early warning system include
•
•
•
•
Identification and forecasting of weather conditions
Prediction of possible health outcomes, based on past events
An effective and timely response plan
Ongoing evaluation of the system and its components
IDEAL EARLY WARNING SYSTEMS
Provide warning in sufficient time for action
Are affordable
• Require minimal skill and training to operate and maintain
Give acceptable false positive or false negative rates
The effect on health impacts is robust, reproducible, and
verifiable
Can be easily modified to address a changing climate
Using information across time-scales…
Long
Lead
Time
Climate change
rising risks, trends, more
surprises
Seasonal forecasts
Decades, end of century
level of risk in coming
months
next 3-6 months
Weather forecasts
impending hazard
10 days or less
Short
Lead
Time
EXAMPLES OF TEMPORAL RELATIONSHIPS BETWEEN
CLIMATE AND DISEASE IN THE PACIFIC
Example #1: Extreme weather events and
infectious diseases in Fiji (Ba subdivision)
Extreme weather event
Odds ratio (OR)* of CSD outbreak in the following month
Drought
Dengue fever: OR = 5.17
Diarrhoeal disease: OR = 9.0
Floods caused by tropical
Dengue fever: OR = 10.57
depressions
All Floods
Diarrhoeal disease: OR = 3.5
EXAMPLES OF TEMPORAL RELATIONSHIPS BETWEEN
CLIMATE AND DISEASE IN THE PACIFIC
Example #2: Temperature and respiratory disease
(left) and diarrhoeal disease (right) in Pohnpei
(FSM)
EXAMPLES OF TEMPORAL RELATIONSHIPS BETWEEN
CLIMATE AND DISEASE IN THE PACIFIC
Example #3: Rainfall and diarrhoeal disease in Suva
subdivision (Fiji)
EXAMPLES OF TEMPORAL RELATIONSHIPS BETWEEN
CLIMATE AND DISEASE IN THE PACIFIC
Example #4: Temperature, rainfall, humidity, infectious diseases
and diabetes in Majuro (Marshall Islands)
EXAMPLES OF TEMPORAL RELATIONSHIPS BETWEEN
CLIMATE AND DISEASE IN THE PACIFIC
Example #5: Long term health impacts of heat in
Palau
A CAUTIONARY TALE FROM TAVUA…
During a SWOT analysis of the health sector’s response to
the Fiji flood events in early 2012, a MoH team visited all six
subdivisions in the Western Division of Fiji
Included in these meetings was a discussion of the potential
utility of climate-based early warning systems for infectious
disease epidemics
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01 Jan 95
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mydate
01 Jan 10
WHAT HAVE WE LEARNED FROM OTHER SYSTEMS?
Early warning systems can save lives
(e.g., hurricanes, famine)
Climate is only one of many determinants that can help in early
warning systems
Early warning of a crisis is no guarantee of prevention
Capacity and willingness to respond is essential
SUMMARY POINTS
Climate/weather information may be useful to the Health
Cluster (specifically) and the health sector (generally) to
strengthen existing surveillance systems
Clear implications in terms of climate change
Early warning systems only provide warning  effective
preparedness and response still required if EWS info is to
have any impact
DISCUSSION
How is this type of information
currently used, or could be made
more useful, for other Clusters
and sectors in the Pacific?