Climate Change Vulnerability Assessment in Ghana ( )

Transcription

1 Climate Change Vulnerability Assessment in Ghana ( ) Edith Clarke Occupational & Environmental Health Unit Ghana Health Service Ministry of Health, Ghana San Jose, Costa Rica (20-23 July 2010)

2 Ghana Land Area: 240,000km 2 Bordered in south by 560km long coastline & north by Latitude o Population:22 million Workforce: >50% in agriculture contributing 30% GDP High Illiteracy rate: 40% Life Expectancy: 60.5yrs

3 Vulnerability Assessment & Health Adaptation : Mechanisms I. Integrated Assessment of Sectoral Vulnerabilities & Adaptation : II. Adaptation Project : Development of Proposal : To be co-sponsored by GEF Facility III. Consideration of Climate Change within the SANA process of the Libreville Declaration

4 Integrated Assessment : Integrated assessment of sectoral Vulnerabilities & Adaptation led by the EPA /MEST Purpose: Was to provide inputs towards the formulation of an Integrated National Climate Change Adaptation Policy Framework. Health Vulnerability & Adaptation assessment was conducted as part of integrated national assessment

5 Health Assessment within Integrated Assessment Objective: Examine the association between climate change and human health vulnerability. Identify impact of climate change on 5 endemic tropical diseases: malaria, diarrhoeal diseases, guinea worm, measles and cerebrospinal meningitis Investigate consequences of climate change on the livelihood systems of poor communities Draft WHO Guidelines for V&A assessment for the assessment not yet available

6 The Process Process led by Environmental Protection Agency : focal point for Climate Change Study conducted by researchers from the University of science & Technology Stakeholder involvement : at inception and dissemination of results : though involved MOH, excluded managers of environmental health programme and disease programme areas under consideration

7 Methodology i. Observation of time series data of; Monthly incidence of outpatient morbidity from 2 regions :Ashanti and Upper West Regions : Climate variables (mean, maximum & minimum air temperature, rainfall and relative humidity data for period for of Ghana. ii. studied above against their seasonal changes & modelling scenarios for 2020, 2050 and 2080 iii. Estimation of the socio-economic burden :direct & indirect cost of treating malaria.

8 Major Findings: Results: Analysis predicts general increases in temperature and decreases in rainfall Predicts: upsurge of diarrhoeal diseases, meningitis and guinea worm and :decreases in incidence of malaria Total Disease Cost/Direct & Indirect to patient & carers : Approximately $5 million Dollars per annum (2003)

9 Results. Fig. 1 Climate scenario for baseline and the years 2020, 2050 and Mean air temperature baseline Mean air temperature 2020 Mean air temperature2050 Mean air temperature M Mean air temperature Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Period (Months)

10 Distribution of number of malaria cases and mean air temperature: Inverse relation ( ). Number of malaria cases Mar Jun Mar Jun Feb May Feb Dec Aug Mar Feb Oct Mar Sep Jul Mean air temperature Sep Jan Jul Aug Aug Aug Generally high mean air temperature values corresponds to periods of Time ( ) low number of malaria cases and vice versa. Number of malaria cases Mean air temperature Jan- Apr Jul- 99 Oct- Jan- Apr Jul- 00 Oct- Jan- Apr Jul- 01 Oct- Jan- Apr Jul- 02 Oct- Jan- Apr Jul- 03 Oct- Jan Apr- 04 Aug Jul- 04 Oct

11 Baseline values of Rainfall and Average Number of Outpatient Malaria Cases Average number of malaria cases Rainfall baseline Number of outpatient malaria cases (Averaged) Baseline rainfall amount(mm) The maximum number of malaria cases occurs in June and the mean air temperature is 25.8 C. Low number ofmalaria cases occur in February, January February March April May June July August September October March and Aril where mean air temperature Period (1999 ranges ) from 27.6 C in April, 27.9 C in both February and March respectively. November 31.9 December 0.0

12 Meningitis and Climate Change Distribution of meningitis cases and mean air temperature. Mar Mar Feb Feb Mar-03 Mean air temperature 29.3 Feb Oct-99 Jan-00 Apr-00 Jul-00 Oct-00 Jan-01 Apr-01 Jul-01 Oct-01 Jan-02 Apr-02 Jul-02 Oct-02 Jan-03 Apr-03 Jul-03 Oct-03 Jan-04 Apr-04 Jul-04 Oct-04 Jan-99 Apr-99 Jul-99 Period ( ) Number of meningitis cases Number of meningitis cases Mean air temperature High meningitis cases corresponds to periods of high mean air temperature and vice versa.

13 Process of the GEF Adaptation Project Process initiated by EPA / UNDP An Adaptation project (for 3 diseases) NOT Vulnerability Assessment Project Did not take cognizance of gaps in Health assessment within the Integrated assessment Health sector s /WHO input received only after agreement to project, Hence limiting extent of inclusion of comprehensive sector Vulnerability Assessment & Health System Strengthening approach it proposed. Final proposal submitted

14 GEF Adaptation Project Objective Identify, implement & evaluate adaptations to reduce current & likely future burdens of Malaria, Diarrhoeal diseases & meningococcal meningits Project Components i. Strengthening technical capacities to manage climate change related health risks ii. Mainstreaming CC into decision making iii.strengthen CC health risk knowledge

15 SANA: 19 Country Task Team Members Led by 2 Focal Persons : Hlth & Env MOH:1 GHS : 3 PPME, Environmental Health, Disease Control Min of Env: 1 EPA : 3 Ministry of Local Government :Env Health Dept Min of Agriculture Min of Finance National Development Planning Commission Academia Community Water & Sanitation Standards Board WHO (UNDP)

16 Analysis by Country Task Team of SANA Driving Forces for Health Effects of Climate Change Drought Flooding Heat Waves Dry winds Pre-existing Poor Sanitation Potential Impacts on Health Increase in Vectors of disease transmission eg mosquitoes Increase or decrease in vector borne diseases : Malaria, yellow fever, filariasis Increase in water-related diseases eg diarrhoeal diseases, Guinea worm, Increasing malnutrition Increase in Cardiovascular & respiratory ailments Risks to vaccine potency due to increasing unreliability of energy supply Increasing pressure on National Health Insurance Scheme

17 Major Challenges to Integrated Assessment As assessed also by SANA process- Limitations of study include: i. Inadequate Data daily morbidity data not available at regional level to compare with meteorological data; short period of disease incidence data used for establishing time series trends ii. Influence of natural increases in population on incidence of the diseases studied not explicitly factored into projections of disease incidences

18 Limitations of study (II) iii. Limited scope of analysis: eg Absence of research into CC impacts on vectors of disease transmission eg mosquito vector of malaria Does not consider information on perceptions of the population regarding knowledge and understanding of the disease conditions & local prevention & treatment practices excludes potential impacts of health systems and impact of on-going disease control interventions /programmes including vulnerability of infrastructure & support services like energy supplies for cold chain maintenance on evolution of selected diseases

19 Views of a ravaged Health Center in Northern Ghana (roof blown off by storm) due to bad weather (2008) 19

20 Limitations of study (III) iv. Involvement of stakeholders in health not broad enough eg program managers, field service staff excluded v. Health implications of potential impact of climate variability on other sectors not determined e.g. agricultural productivity increasing malnutrition as a result of decreased food security

21 Utility of Assessment of Integrated Study Study succeeded in demonstrating that there is a linkage between trends of some common endemic communicable diseases and climate variability. It demonstrated fact of increase in disease burden over time but does not analyse the extent to which CC effects contribute to additional burden of disease Demonstrated cost of managing malaria but does not relate it to earning capacity / ability to pay Since modifying effects of disease control programs, human treatment seeking behaviours etc omitted, may weaken evidence base for some of the adaptation decisions

22 Lessons Learnt i.processes employed in integrated assessment have led to incomplete health V & A assessment ii. Need for thorough stakeholder analysis at onset of V & A projects cannot be overemphasized iii. Need for health sector to be more pro-active in CC issues iv. Urgent Need for a more comprehensive assessment incorporating all the elements in WHO s V&A guidelines still exists via? modification of GEF Adaptation project or?new project within Libreville Declaration framework