Download Doctors & health professionals – Environmental obligations

Mandela
• Its not a tragedy to die with dreams unfulfilled, but it is a
tragedy not to dream.
• Mandela’s dream , shared by me and billions of others,
is of all humanity living with each other in harmony and
balance, and living in the world without destroying it.
• So develop a flourishing global civilisation.
• And in Ghandi’s words ‘Live simply, so that other may
simply live.’
GMC duties of Doctors/health
professionals
• Two equal obligations:
• To care for individual patients in a humane
compassionate and scientifically effective
way, without regard to status, sexual
orientation, origin or any other.
• To ensure that the society we live in is
health creating, so that all global
inhabitants can enjoy good health.
• Same for all health professionals
Preconditions for a health creating
civilisation
• All peoples have reasonable access to economic and
social resources.
• Earths gifts are shared amongst humans fairly without
compromising future generations and other than humans
• Present attempts to be create this healthy world are
undermined by two great problems-global climate
change and the everywhere prevalent gap in resources
between the materially rich and the materially poor
• If we are to fulfil our obligations health professionals
must play a prominent role in addressing these
problems.
What do we need to do?
•
•
•
•
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Inform
Affirm
Advocate
Innovate
Disseminate
What do we need to do?
• Inform
-- health consequences of Climate
change and the widening resource gap
– policies for mitigation:
– policies for adaptation:
– co-benefits of the above
What we need to do
• Affirm. Measure and reduce personal CO2
emissions. Ensure that the organisations
we are associated with do likewise.
• Informing and affirming -putting our own
house in order- wont solve the problem,
but give us the moral right to advocate for
global solutions which will.
• When in place, these global solutions will
accelerate our own local initiatives.
What do we need to do?
• Advocacy, stressing the need for a global
framework which simultaneously tackles climate
change and the resource gap, and so is health
promoting.
• So a fair shares solution—a fair share of the
residual carbon we can emit consistent with a
450 ppm CO2 target, and of the resources which
come from these emissions.
• Most feasible present fair shares option is
Contraction and Convergence.
Contraction
• Set a globally agreed carbon Budget, aimed at keeping
atmospheric CO2 levels below 450ppm.
• Reduce this over an agreed, but negotiable time scale
(probably 50 years) until the amount emitted equals the
amount the world can cope with.( approx 8 billion tons of
CO2: 1.4 tons/person/year).
• But this amount depends on protecting carbon sinks.
• By CONTRACTING the amount of Carbon emitted, this
process will stabilise atmospheric CO2 levels.
• Allocate an equal entitlement of this capped budget to
every global citizen.
Convergence
•
Move rapidly to an equal entitlement of the carbon budget to each person in the
world. A CONVERGENCE to an equal share of earths bounties and support systems.
•
Then frugal emitters( usually the poor) will be able to sell their unused entitlements to
the profligate emitters( the rich). For compelling financial reasons, all will invest in low
carbon initiatives.
•
Given that each ton of CO2 entitlement will have a substantial financial value, this
process will enable a framework based market transfer of money to the poor to
fourish.
•
This would more than cover $ 120/person which the UN millennium project has
estimated will be required to deliver the millennium goals in Africa.
Contraction and Convergence
• Creates a policy virtuous cycle at a global level, enabling
economic and social progress within environmental
limits.
• Unleashes a worldwide boom in low carbon
entrepreneurial activity.
• Facilitates the development and implementation of
virtuous cycles for coping with the ‘problems ‘ of waste,
excessive fossil fuel use, biodiversity loss, noise at
National, regional , community and personal levels.
• Implementing virtuous cycles is essential for promoting
sustainability and wellbeing.
• The many virtuous cycles of policy facilitated by C and C
will deliver major health benefits.
Health Benefits of C and C.
• Those arising from the mitigation of
Climate change. ‘KEEPING our COOL’
• Those arising from the related transfer of
resources. ‘NARROWING the GAP’
• Those rising from the facilitation of other
virtuous cycles, moving those living in the
Rich North to more physically active non
obesogenic societies, in which obesity
related disease will be less prevalent.
Virtuous cycles facilitated by C and
C
• * Regional/National Level : Distributed energy networks.
• * Community level: Influence procurement to create virtuous cycles
of activity.-( the health service buys around £11 billion worth of
products each year) . e.g:
• a) locally grown organic food supplying health facilities.
• b) Influencing new buildings to improve the economic,
environmental and social circumstances of the localities in which
they are built.
• * Personal level: Set and promote good examples :e.g.
• a) ride a bicycle,
• b) Insulate our homes using local materials and local workers.
What do we need to do?
• Innovate-seeking new institutional forms
for delivering the C and C framework and
• Disseminate—recruiting as many partners
as possible.
Take home message-1
• Global agreement to tackle climate change is
imperative for our global good health-health
professionals have a crucial advocacy role.
• Participation of the majority world is dependent
on carbon constraint being coupled to a transfer
of resources to the yet to industrialise and
industrialising countries.
• These countries can then share in non fossil fuel
dependent progress.
• The framework based market of Contraction and
Convergence is the most feasible presently
available tool to achieve this end.
Take home message -2.
• C and C will facilitate many other virtuous
cycles, providing a boost to sustainability
and wellbeing, and therefore public health.
• Think, advocate and implement Virtuous
cycles at all levels, including those which
protect the globe’s carbon sinks.
• Join the many others who are clamouring
for the global virtuous cycle of C and C.
• Make C and C the framework promoted
by the UK at COP 15 ,Copenhagen 2009.
Conference of the parties to
UNFCCC ( COP)
• COP is the supreme decision making
body of the UNFCCC. It is open to all
signatories, and meets each year.
• First steps to a new global framework
were taken at COP 13, in Bali Dec 07
• We must aim to make C and C the policy
the UK proposes at COP 15 , Copenhagen
2009
Atmospheric CO2 levels, global
warming and fossil fuel use.
• Stable level from 10,000 years ago to 1800-280ppm.( not above
300ppm for 400,000 years)
• Present level 380ppm,increasing by 2ppm/year.
• Global temp has risen in parallel-predicted increases for 21st century
are around 0.5 C/decade.
• Fossil fuel is burned predominantly by the rich North. 80 million
barrels oil/day- USA 20 million, China 6, Japan 5, Germany 3, India
3,UK1.9.
• Per capita emissions (tons of CO2 ):USA-20: UK-10: Africa>1:
China-3.0 : India-1.5.
• ‘Sustainable’ per capita emission is approx 1 ton/year. This amount
is dependent on preservation of carbon sinks.( The biomass,
particularly tropical forests ,and the sea)
Ecosystems and Health-Impacts of
climate change
• A Source of energy and materials.
• A Service for water, food , micronutrients and
carbon recycling.
• A Sink for pollutants.
• A Space for living working and aesthetics.
• 60% of all ecosystems are already degraded or
being used unsustainably.
• Global warming will aggravate the situation.
Global climate change-aggravating
the problem
• Unpredictable exposure to extremes of weather
affecting water supply and crops.
• Expansion of range of disease vectors.
Falciparum Malaria already causes 500 million
cases/year, with one million deaths.
• Thermal expansion of water plus melting land
based ice leading to sea level rises.100 million
people and many cities are within half a metre of
present sea level.
• Ensuing demographic, social and economic
dislocation, with the likelyhood of 100 million
new climate refugees.
Deprivation and disparity, which will
get worse with global warming.
• 800 millions go to bed hungry. 1 billion have no access
to clean water.
• Of 700 million primary school children, 125 million,
mostly girls, don’t go to school.
• 2 billion people live on incomes below $1,000 /year: 1
billion on $30,000 /year.
• This disparity exists in both rich and poor countries.
• Personal income is a good marker of this disparity.
Globally, ratio of income between top 20% and bottom
20% has moved from 1:135 (1998) to 1:150 (2004). Gini
coefficient in UK was 0.29 (1980), 0.4 (2002).
Atheroma and global warming
• Atheroma, narrowing of the arteries, is the
basis of most deaths in the developed
world.
• Half of the 550,000 deaths /year in the UK,
• 11% of global deaths.
• Commonest in non exercising obese (
diabetic), eating high salt high cholesterol
and energy dense foods, smoking and
suffering from low status.
Atheroma and global warming
• Atheroma occurs in the obesogenic societies of the
minority world.
• These societies have flourished with the availability of
cheap and plentiful fossil fuel energy.
• And are therefore the societies which provoke global
warming.
• In carbon constrained societies, there will be a move to
localism. We will once again use more human effort, as
was the case in societies before the availability of cheap
fossil fuel.
• The move to localism will unleash a series of virtuous
cycles moving us toward a non obesogenic society. The
reduction in the prevalence of atheroma will be an
excellent marker of improvement.
UN Framework Convention on
Climate Change:UNFCCC
• UNFCCC came into force on 21.03.1994.Its
three objectives are to:
• Gather and share info on GHG emissions ,
national policy and best practice.
• Launch national strategies for addressing GHG
emissions and adapting to expected impacts,
including the provision of financial and technical
support to developing countries.
• Co-operate in preparing for the impact of climate
change.
Take up of C and C.
• Senior advocates in the European Union , India, Africa
and UK.
• Archbishop of Canterbury , Michael Meacher, Ken
Livingstone,and Colin Challen, chairman of the UK
parliamentary all parties climate change group.
• German Advisory Council on Global climate Change.
• Aubrey Meyer, director of the GCI and inspiration behind
C and C gets City of London 2005 lifetime achievement
award.
• Fleming, the Tyndall centre and Domestic Tradeable
Quotas ( Local variant of C and C).
Millennium goals-2015
• Reduce by 75% maternal mortality rate.
• Halt and reverse AIDS/HIV epidemic.
• Halve number of people living without
access to water/sanitation.
• Reduce under 5 mortality by 66%.
• Halve the number of people living on less
than $1/day.
• Universal primary education.
Energy equivalents.
• The energy in a kilo ( litre) of oil is 10 kilowatt
hours, equivalent to between 100 and 200hours
of human work.
• An hour of human work is therefore equivalent to
5-10 grms ( I teaspoonful) of oil
• A 40 litre fill up of a petrol tank is equivalent to
between 2 to 4years of human work.
• 1 kilowatt hour=860 kilocals,3.6 megajoules