[By Stanslous Ngosa]
CLIMATE change and variability poses a challenge on human health and may affect the attainment of Universal Health Coverage if the effects remain unaddressed.
However, the government of His Excellency Mr Edgar Chagwa Lungu, President of the Republic of Zambia, recognises the negative impact of climate change on development goals such as attainment of health for all and the need to respond to this threat. The government has come up with several impactful interventions aimed at addressing the effects of climate change.
But, before I delve into these measures, it is important that we look at the impact of climate change on human health. According to the World Health Organisation, although global warming may bring some localised benefits such as fewer winter deaths in temperate climates and increased food production in certain areas, the overall health effects of a changing climate are likely to be overwhelmingly negative. Climate change affects social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter.
Extreme high air temperatures contribute directly to deaths from cardiovascular and respiratory diseases, particularly among elderly people. In the heat wave of summer 2003 in Europe, for example, more than 70, 000 excess deaths were recorded.
High temperatures also raise the levels of ozone and other pollutants in the air that exacerbate cardiovascular and respiratory diseases.
Pollen and other aeroallergen levels are also higher in extreme heat. These can trigger asthma, which affects around 300 million people. Ongoing temperature increases are expected to increase this burden.
Natural disasters and variable rainfall patterns
Globally, the number of reported weather-related natural disasters has more than tripled since the 1960s. Every year, these disasters result in over 60,000 deaths, mainly in developing countries.
Rising sea levels and increasingly extreme weather events will destroy homes, medical facilities and other essential services.
More than half of the world’s population lives within 60 kilometres from the sea. People may be forced to move, which in turn heightens the risk of a range of health effects, from mental disorders to communicable diseases. Increasingly variable rainfall patterns are likely to affect the supply of fresh water. A lack of safe water can compromise hygiene and increase the risk of diarrhea disease, which kills over 500, 000 children aged under 5 years every year.
In extreme cases, water scarcity leads to drought and famine. By the late 21st century, climate change is likely to increase the frequency and intensity of drought at regional and global scale. Floods are also increasing in frequency and intensity, and the frequency and intensity of extreme precipitation is expected to continue to increase throughout the current century.
Floods contaminate freshwater supplies, heighten the risk of water-borne diseases, and create breeding grounds for disease-carrying insects such as mosquitoes. They also cause drownings and physical injuries, damage homes and disrupt the supply of medical and health services.
Rising temperatures and variable precipitation are likely to decrease the production of staple foods in many of the poorest regions. This will increase the prevalence of malnutrition and undernutrition, which currently cause 3.1 million deaths every year.
Patterns of infection
Climatic conditions strongly affect water-borne diseases and diseases transmitted through insects, snails or other cold-blooded animals. Changes in climate are likely to lengthen the transmission seasons of important vector-borne diseases and to alter their geographic range. For example, climate change is projected to widen significantly the area of China where the snail-borne disease schistosomiasis occurs.
Malaria is strongly influenced by the climate. Transmitted by Anopheles mosquitoes, malaria kills over 400, 000 people every year – mainly African children under 5 years. The Aedes mosquito vector of dengue is also highly sensitive to climate conditions. And studies suggest that climate change is likely to continue to increase exposure to dengue.
Measuring the health effects
Measuring the health effects from climate change can only be very approximate. Nevertheless, a WHO assessment, taking into account only a subset of the possible health impacts and assuming continued economic growth and health progress, concluded that climate change is expected to cause approximately 250, 000 additional deaths per year between 2030 and 2050: 38, 000 due to heat exposure in elderly people, 48, 000 due to diarrhoea, 60, 000 due to malaria, and 95, 000 due to childhood undernutrition.
Who is at risk?
All populations will be affected by climate change, but some are more vulnerable than others. People living in small island developing states and other coastal regions, megacities, and mountainous and polar regions are particularly vulnerable.
Children – in particular children living in poor countries – are among the most vulnerable to the resulting health risks and will be exposed longer to the health consequences. The health effects are also expected to be more severe for elderly people and people with infirmities or pre-existing medical conditions. Areas with weak health infrastructure – mostly in developing countries – will be the least able to cope without assistance to prepare and respond.
Addressing these effects from climate change requires effective adaptation measures. In consolidating the gains made in the health and wellbeing of the people, Ministry of Health director of Health Promotion, Environment and Social Determinants Dr Abel Kabalo says the government, through the Ministry of Health and the stakeholders, conducted the vulnerability and risk assessment to climate change which has been integrated in the Health National Adaptation Plan to climate change.
Dr Kabalo, who is also Ministry of Health spokesperson, explained that the Health National Adaptation Plan to climate change is aimed at strengthening health systems through various action plans that address climate variability and change, including dealing with upstream drivers of health risks associated with climate change.
The development of Health National Adaptation Plan to climate change as part of the National Adaptation Plan is a clear affirmation of government’s resolve to mitigate effects of climate change through the Health in All Policies (HiAP) strategy using the ‘whole of government and whole of society’ approach.
“The Health National Adaptation Plan to climate change, therefore, is designed to ensure that the health of the Zambian population is protected from the effects arising from climate change,” Dr Kabalo said.
Other robust interventions the ministry has implemented in addressing the problem of climate change include reinforcing the collaboration with other key sectors involved in addressing climate change issues through available policies such as the Health in All policies
The government has introduced the non- incineration methods as means of waste disposal to contribute to the reduction of greenhouse gases released in the environment. Introduced sustainable health in procurement project to incorporate sustainability issues in procurement and promotion of climate change related public health plans are other impactful interventions that have been implemented.
The other interventions are promotion of the communities’ ability to develop physical and social infrastructure that are resilient to the adverse effects of climate change and strengthening the mechanism for identifying risks and hazards in order to facilitate planning and early warning.
“We are strengthening surveillance and control of climate change related pests and diseases and promote community-based risk management activities and use of social safety nets for the most vulnerable,” said Dr Kabalo.
It is highly anticipated that these interventions will help reduce risks, while advancing local and national adaptive capacity and resilience in the health system, with an overall goal of minimising vulnerability to the negative impact of climate change.
The Author is head of media relations at the Ministry of Health.