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Fourth Ministerial Conference on Environment and Health, Budapest, 23-25 June 2004 Global public health and climate change Roberto Bertollini, MD MPH Senior Adviser Public Health and the Environment WHO – Geneva Fourth Ministerial Conference on Environment and Health, Budapest, 23-25 June 2004 Climate change UN High level meeting on climate change, September 2007 72 Heads of State 67 Senior Ministers 6| Global public health and climate change Global Climate Change and Human Health How are climate change and human health linked? What health effects have been observed already, and what can we expect in the future? How do we need to respond? 7| Global public health and climate change The Intergovernmental Panel of Climate Change Fourth Assessment Report 70000 new studies >2500 scientists involved 6 years -1 report 4 governmental approval sessions 8| Global public health and climate change Warming is Unequivocal Rising atmospheric temperature Rising sea level Reductions in North Hemisphere snow cover 9| Global public health and climate change CO2 has not been this high in more than half a million years. Carbon Dioxide Amount (ppmv) 350 Last interglacial Last Ice Age 300 250 200 600 500 400 300 200 Thousands of Years Before Present 10 | Global public health and climate change 100 0 [Adapted from Figure 6.3, ©IPCC 2007: WG1-AR4] Extreme events are more frequent Adapted from IPCC (2007) Summary for Policymakers. Contribution of Working Group I. 11 | Global public health and climate change Climate change made the European heatwave of 2003 more likely… 2003 Heatwave Stott et al, nature, 2004 12 | Global public health and climate change The relationship between health and climate change Social conditions Environmental conditions (‘upstream’ determinants of health) Direct exposures Health system conditions * (temperature, precipitation, sea level rise, extreme events) Climate change Indirect exposures Health impacts (changes in water, air, food quality; vector ecology; ecosystems, agriculture, industry and settlements) Social & economic disruption * Modifying influence Confalonieri, Menne et al, 2007 The health effects of climate change Some expected impacts will be beneficial but most will be adverse. Expectations are mainly for changes in frequency or severity of familiar health risks Health effects CLIMATE CHANGE •Temperature-related illness and death •Extreme weather- related health effects •Air pollution-related health effects •Water and food-borne diseases •Vector-borne and rodent- borne diseases •Effects of food and water shortages •Effects of population displacement Based on Patz et al, 2000 14 | Global public health and climate change Global Climate Change and Human Health How are climate change and human health linked? What health effects have been observed already, and what can we expect in the future? How do we need to respond? 15 | Global public health and climate change Cronology of an epidemic 21 june First imported case to Castiglione di Cervia from India 23 june 4 july First case develops symptoms of Chikungunya First case of Chikungunya in a locally resident person 29 august 18 august Established surveillance system. Serological analysis confirms Chikungunya Start of disinfection of public areas and information to people on how to protect themselves 13 september 254 cases. 79 laboratory confirmed Age between 1-95 anni. 52% females. 3° week in August Epidemic peak …is exposing additional populations to infection with Schistosoma japonicum… Freezing zone 1970-2000 Freezing zone 1960-90 (Yang, Vounatsou, et al. 2005). 17 | Global public health and climate change What will happen, and what could happen? 3.4oC = 6.1oF 2.8oC = 5.0oF 1.8oC = 3.2oF 0.6oC = 1.0oF ppm 850 CO Eq 2 600 Even if we stop emitting today IPCC, WG 1 18 | Global public health and climate change Many of the major killers are climate sensitive - Each year: - Undernutrition kills 3.7 million - Diarrhoea kills 1.8 million - Malaria kills 1.1 million Each of these is highly sensitive to temperature and precipitation: 19 | Global public health and climate change How sensitive is health to climate? Diarrhoea Temperature Diarrhoea admissions Incidence of diarrhoeal disease is strongly related to climate variables. In Lima, Peru, diarrhoea increased 8% for every 10C temperature increase. (Checkley et al, Lancet, 2000) Daily measurements Jan 1993 – Dec 1998 20 | Global public health and climate change Future climate change and dengue Climate change is expected to increase the proportion of the global population exposed to dengue from about 35% (upper figure), to 50-60% (lower figure), by 2085. Hales et al, Lancet 2002 21 | Global public health and climate change Cumulative emissions of greenhouse gases Countries scaled according to cumulative emission in carbon equivalent to 2002. Patz et al, Ecohealth, December 2007 22 | Global public health and climate change Health impacts of climate change WHO regions scaled according to WHO estimates of mortality per million people in the year 2000, attributable to the climate change that occurred from 1970s to 2000. Patz et al, Ecohealth, December 2007 23 | Global public health and climate change Global Climate Change and Human Health How are climate change and human health linked? What health effects have been observed already, and what can we expect in the future? How do we need to respond? 24 | Global public health and climate change Six focus areas for WHO, public health, and climate change 1. Health security 2. Strengthening health systems 3. Health development 4. Evidence and information 5. Delivery 6. Partnerships 25 | Global public health and climate change 1. Health Security 26 | Global public health and climate change 2. Strengthening health systems 27 | Global public health and climate change Health sector actions as climate change adaptations Infectious disease surveillance Health action in emergencies Safe drinking water 28 | Global public health and climate change Integrated vector management Diseases affected by climate Environmental health capacity building Healthy development 29 | Global public health and climate change 3. Health Development 30 | Global public health and climate change Protecting health while reducing Emissions Buildings Indoor air pollution Heat and cold protection Transport Air pollution Traffic injuries Physical inactivity Industry Occupational risks, mining and transport Greenhouse Gas Emissions Energy supply & conversion Occupational risks; Construction and transport Agriculture Nutrition, Water / vector-borne disease 31 | Global public health and climate change Waste Occupational, chemical The opportunity for improving health determinants Can we reduce: The 800,000 annual deaths from urban air pollution The loss of 1.9 million deaths, and 19 million years of healthy life, from physical inactivity The 1.2 million deaths and over 50 million injuries from road traffic accidents 32 | Global public health and climate change Evidence, Delivery, Partnerships 33 | Global public health and climate change Research for Improved Tools Can you accelerate development of tools to control diseases which are increasing rapidly, such as dengue? Can you help us measure the effectiveness of interventions to address emerging health threats, such as heatwaves? 34 | Global public health and climate change Research for Improved Health Systems Can you help us adapt existing surveillance systems, anticipate risks and reduce human health impact? Can you help us improve delivery systems to meet the new challenges of climate change? 35 | Global public health and climate change Research for Improved Policies Can you help assess better the health impacts of major policies related to climate change? Can you help assess the costs to health of (in)action to mitigate and adapt to climate change? 36 | Global public health and climate change 37 | Global public health and climate change “The health sector has been much too separatist in the past. It has been thinking that all it has got to do is run a healthcare system and traditional public health. Climate change is telling us that no, that’s not good enough. We’re going to have to be more imaginative, more collaborative, and be prepared to look to a more distant future as well as deal with the problems that press on us in the here and now.” “We’ve got to get more imaginative about working with other sectors, other arms of government, making the argument that every ministry is a health ministry. British Medical Journal, 29 September 2007; 335:636 38 | Global public health and climate change La salute e l’ambiente health and climate change 39 | Global Strumenti di public prevenzione sanitaria – R. Bertollini, OMS Europa Director General’s Speech at the 57 session of the WHO Regional Committee for Europe Beograd, 18 September 2007 Just as we fought so long to secure a high profile for health on the development agenda, we must now fight to place health issues at the centre of the climate agenda. I personally believe that the inevitability of climate change makes it all the more imperative for us to reach the Millennium Development Goals. 40 | Global public health and climate change The face of climate change ? 41 | Global public health and climate change World Health Day April 7th 2008 Protecting Health from Climate Change www.who.int/globalchange/climate 42 | Global public health and climate change