Preventing disease Promoting and protecting health. C James Hospedales, Executive Director

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1 Preventing disease Promoting and protecting health C James Hospedales, Executive Director

2 Water and Sanitation Security SDG6: Clean Water and Sanitation for All Reducing water and sanitation insecurity in the Caribbean Protection of human health and well-being

3 Down sizing the Climate Science: Hotter, drier times, more monster storms, extreme rain events. Profound social, economic and environmental implications (ICCCC 2017) but health professionals sleepwalking Changes in average temperature are: An annual warming by the 2080s of between 1 o and 5 o C depending on the region and scenario Greater warming in the northwest Caribbean territories (Jamaica, Cuba, Hispaniola, Belize) than in the eastern Caribbean island chain. Greater warming in the summer months than in the cooler and traditionally drier earlier months of the year. * Coral bleaching events Changes in average rainfall are: A drier main Caribbean basin in the annual total by the 2080s, except for W Cuba, south Bahamas, Costa Rica and Panama. Pronounced north-south gradient in rainfall Change during the Caribbean dry season (January to April). Summer drying is more severe i.e. during the Caribbean wet season.

4 Paradise on Earth; the Caribbean

5 Problems in Paradise: bigger storms and inundations Alarm bells of climate change sounding! WATER INSECURITY FOR WEEKS, MONTHS POST-DISASTER Bridges and water lines out all over island City flooded

6 Hurricane Maria over Dominica, Sept 2017

7 Problems in Paradise: Poverty and water insecurity Poor housing Water Insecurity SHANTY TOWN WATER INSECURITY #1 in SUICIDE GANGS ATTEMPTING TO ACCESS WATER HUMAN TRAFFICKING driven in part by Water insecurity

8 Breeding sites with water of Aedes aegypti mosquito STORED WATER DUE TO WATER INSECURITY

9 Chikungunya, Zika Gap in regional health security Climate sensitive vector Associated with Water Insecurity

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12 WASH Focus of CARPHA-EHS Our work in health and the environment contribute to WRM and supported by our Environmental Laboratory Manage natural resources and the environment to protect human health

13 Guiding Instruments are aligned to SDGs and Targets : All instruments incorporate targets of SDG 6

14 Down sizing the Climate Science: Hotter, drier times, more monster storms, extreme rain events. Profound social, economic and environmental implications (ICCCC 2017) but health professionals sleepwalking Changes in average temperature are: An annual warming by the 2080s of between 1 o and 5 o C depending on the region and scenario Greater warming in the northwest Caribbean territories (Jamaica, Cuba, Hispaniola, Belize) than in the eastern Caribbean island chain. Greater warming in the summer months than in the cooler and traditionally drier earlier months of the year. * Coral bleaching events Changes in average rainfall are: A drier main Caribbean basin in the annual total by the 2080s, except for W Cuba, south Bahamas, Costa Rica and Panama. Pronounced north-south gradient in rainfall Change during the Caribbean dry season (January to April). Summer drying is more severe i.e. during the Caribbean wet season.

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17 Proposed Plan of Action items ( ) Outcomes Main Action Collaborators Surveillance Database and Surveillance mechanism Potable Capacity building WQM and Ambient Waters Analytical equipment at EHS + CMS Water and Sanitation Safety Planning Internal HCE, ICT, POS-Lab, THP, VBDs External GIZ, UNEP, IDB, CMS Epidemiology, climate change and WRM Acquisition of hydro-meteorological data Training in data reporting Annual reports on CC&H and WQM Internal FELTP, Research, HCE, Comms, OED, THP External CIMH, UWI-MORI Water security through SLM and IWRM Pollution reduction measures, surveillance of pollutants Ambient and wastewater quality management Climate change resilience building measures in WRM GIZ, UNE, IDB

18 Expected Results Output Indicator Yearly targets Public health surveillance Surveillance mechanism Established 2018 mechanism for water established and functional Fully functional 2020 WSPs WSPs reports 1 country/yr Water quality database Training in data analyses and reporting Epidemiology of climate change and water Watershed pollution prevention and surveillance Public health surveillance of ambient waters Water security & climate change Database established and functional Training reports Climate change health and water resources reports Pollution management interventions WQM reports Adaptation interventions Populated 2019 Fully functional 2020 Developed 2018 Implemented Research Reports 2020 > 6 CMS 2018, 10 CMS CMS 2020 Develop programme CMS 2019, 10 CMS 2020 Planning 2018 Implementation

19 Work programme covers all indicators of SDG6 Emphasis on partnerships and development public private partnership for water security focus of our programme

20 The special case of Haiti

21 Partnerships for Agenda 2030 Major collaborations that will contribute to meeting the targets of Agenda 2030 IWEco project co-execution with UN-E Focus on WRM Component 2: Scientific Research and Indicators EHS/CARPHA

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23 IDB MORI - PPCR Component 4.1 Climate Change Adaptation in WRM Component 4.4 Climate Change and Health

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25 PAHO Smart Hospital Initiative Over $40M from UK DFID via PAHO/WHO for Program

26 Climate change and Physical health Water Safe drinking water Floods Droughts Food security: seafood, agriculture Vector borne diseases Air Greenhouse gasses Fine particulates PMH Roseau Dominica 2017 (Maria)

27 Rationale for emphasis in WASH Water is the most important natural resource "Water and Sanitation is one of the primary drivers of public health (WHO, 2009) CARPHA: Protect human health, the environment, promote well-being, sustain livelihoods Improvements in drinking-water quality can lead to a reduction of diarrhoea episodes by between 35% and 39%. Water security for health & environment: Advance Agenda 2030 interlinkages) Incorporating surveillance mechanism in IWRM initiatives Impacts of climate change on water resources Water safety planning to reduce health risk in water supply systems (WHO, 2009)

28 Why investments in WASH public goods? Management of water borne diseases Lack of investment in water and sanitation will compromise the health and wealth of the region Interventions sustained through capacity building for WQM, WRM, Surveillance in CMS and at EHS Contribute to surveillance, lab strengthening, food hygiene and research Complements all initiatives in water security and health Between 2018 and 2020 coverage may not extent to all CMS All countries have expressed WQM and WRM as a priority