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Editorial

A. Basel Al-Yousfi,¹ Maria Neira ² and Hamed Bakir ³

¹Director, World Health Organization Centre for Environmental Health Action, Amman, Jordan.

²Director, Public Health, Environmental and Social Determinants, World Health Organization, Geneva, Switzerland.

³Coordinator, Environmental Health Interventions, World Health Organization Centre for Environmental Health Action, Amman, Jordan.

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The effects of climate change are being increasingly felt today and forecasts represent potentially disastrous risk to human health in the future. Policy responses are therefore imperative in countries in order to ensure the protection of the people’s health.

“Climate change could be the biggest global health threat of the 21st century”, the Lancet warned in May 2009 (1). Yet in current climate debates, health is still being treated as a peripheral matter. The WHO Conference on Health and Climate in August 2014, reviewed the strong scientific evidence of the grave impact of climate change on health. Notwithstanding extreme weather disasters, WHO estimates that climate change will cause an additional 250 000 deaths per year between 2030 and 2050. Most will likely perish from malaria, diarrhoea, heat exposure and under-nutrition (2). Children and the elderly will be among the most vulnerable. Areas with weak health infrastructure will be least able to cope and developing countries will be hardest hit. The health gaps we have been trying hard to close may grow even wider.

On the brighter side, the latest message from the Lancet report of June 2015 articulated that “Tackling climate change could be the greatest global health opportunity of the 21st century” (3). In addition, the 21st United Nations Climate Change Conference (COP 21) being held in Paris, France from 30 November to 11 December 2015 aims to achieve a new and universal climate change agreement from all the nations of the world. COP 21 offers the world an important opportunity to not only reach a strong international climate agreement, but also to save lives and protect the health of current and future generations of humankind (and co-inhabitant species). As such, WHO considers the Paris treaty a significant public health treaty.

Although historically Member States of the WHO Eastern Mediterranean Region (EMR) have contributed relatively little to the Greenhouse Gases (GHG) emissions and thus to the onset of climate change, EMR is the second worst impacted region after Africa in terms of health consequences (4). A systematic review of research evidence from EMR countries (5), documents and predicts adverse climate impacts on health, such as increases in: waterborne diseases, under-nutrition, drowning, mortality and morbidity during heat waves, mortality due to cardiovascular and respiratory illnesses, the spread of vector-borne diseases (dengue, malaria, schistosomiasis and zoonotic cutaneous leishmaniasis), and mental health and allergic reactions and pulmonary diseases across the Region due to dust storms. A systematic review of published research on climate change and health in the EMR (6), however, found that research on the links between climate change and health is still quite limited, and there are many gaps in our awareness and understanding of these links that may limit mitigation and adaptation activities.

The WHO Regional Centre for Environmental Health Action (CEHA) has been providing capacity building and technical support to all EMR Member States to support their public health response to climate change and improve the resilience of their health systems. In that regard, Jordan has developed its national health and climate adaptation action plan and integrated climate change considerations within its national health policy. The health ministries in several countries have developed their National Framework for Action on Health and Climate Change and contributed to the health and climate change chapters of the National Communication to the United Nations Framework Convention on Climate Change (UNFCCC). However, Member States, still need to take further steps to:

Raise awareness and advocate for protecting health from climate change

Undertake assessment of health vulnerability to climate change

Develop early warning systems and adaptation and mitigation action plans for health protection and resilience from climate change

Support health-promoting climate change policies; and participate in the UNFCCC processes as leaders on health

Identify the health benefits associated with reducing emissions of greenhouse gases and other climate pollutants.

This may require a broad public health approach, including not only the preventive and curative functions under direct control of the formal health sector, but also appropriate leadership, guidance and regulatory functions with regard to health-determining sectors, such as water and sanitation, or disaster risk reduction.

Given the climate change threats to health and the potential health co-benefits that result from mitigation and adaption actions to confront climate change, Member States need a proactive public health response to support such actions and enhance the resilience of health systems (7). This is win-win public health approach will enable mitigation of climate change and reduction in environmental pollution, thus lowering the burden and cost of ill health and generating cost savings that can be re-allocated to strengthen the public health budget in areas such as healthy living promotion and disease prevention and control.

References

1. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the health effects of climate change. Lancet and University College London Institute for Global Health Commission. Lancet. 2009 May 16;373(9676):1693–733. doi: 10.1016/S0140-6736(09)60935-1
2. Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s. Geneva: World Health Organization; 2014.
3. Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health and climate change: policy responses to protect public health. Lancet. 2015 Jun 24. pii: S0140-6736(15)60854-6. doi: 10.1016/S0140-6736(15)60854-6. [Epub ahead of print].
4. Patz J, Campbell-Lendrum D, Gibbs H, Woodruff R. Health Impact Assessment of Global Climate Change: Expanding on Comparative Risk Assessment Approaches for Policy Making. Annu Rev Public Health. 2008;29:27-39. doi: 10.1146/annurev.publhealth.29.020907.090750.
5. Khader YS, Abdelrahman M, Abdo N, Al-Sharif M, Elbetieha A, Bakir H, et al. Climate change and health in the Eastern Mediterranean countries: a systematic review.Rev Environ Health. 2015 Aug;30(3):163–81. doi: 10.1515/reveh-2015-0013..
6. Climate change and health in the EMR – a systematic review of published research. Amman: WHO Regional Office for the Eastern Mediterranean, Regional Centre for Environmental Health Action (in press).
7. Towards a public health response to climate change and air pollution in the Eastern Mediterranean Region. Paper presented at the 61st Session of the World Health Organization Regional Committee for the Eastern Mediterranean, Tunis, Tunisia, 19–22 October 2014 (http://applications.emro.who.int/docs/Technical_Meeting_Climate_Change_Air_Pollution_2014.pdf, accessed 30 November 2015).