Health Vulnerability & Adaptation to Climate Change

Transcription

1 Health Vulnerability & Adaptation to Climate Change Part 3: Adaptation Assessment Identifying Adaptation options, and Planning, Implementing, and Monitoring Health protection from climate risks Joy Guillemot Public Health and the Environment WHO Geneva

2 Assess & Plan Adaptation Options 2

3 Frame & Scope Assessment Assess Vulnerability: Current burden of disease Current health protection programs Manage & Monitor Risks Health harms & benefits in other sectors Review Mandates & Policy context Define scope & objectives Stakeholder engagement Management & Communication plan Future Impacts: Changing burden without climate change Projected health impacts of climate change Communicate Plan & Implement Adaptation: Identify, prioritize additional interventions Identify resources & barriers to implementation Monitor & evaluate

4 What is Climate "Adaptation"? In public health, climate change adaptation = prevention But, health prevention to respond to climate risks often focuses on : CSD: diseases that are sensitive to climatic conditions Risk based: Prioritizes populations at greatest risk of harm if exposed to hazard or pathogen Climate Informed - Uses information about climate variability (weather extremes) and long term climate change to inform decisions Ecosystem Perspective considers upstream determinants and linkages Implemented across sectors: works to prevent harm upstream via coordination Time & Space: looks for changes in time or geographic occurrence, based on climate/env influences. Considers long time horizons. Flexible & Iterative: Incorporates mechanisms of tracking risks and risk mgmt, Identifies thresholds: identifies thresholds of acute risk or coping capacity for when changes in strategies are needed, early warning to early action Implemented across scales: global scale models may inform local interventions 4

5 What Actions can help "Adapt" to Climate Change? 5

6 Preparing for Climate Change Simple Goals of "Adaptation" Figure out what needs to be done to minimize future health risks affected by climate? Monitor health outcomes to make sure disease burdens are not increasing, and systems are able to manage outbreaks or emergencies. Have surveillance systems that can quickly identify surprises or emergent diseases, and act 6

7 (4.0) Identify & prioritize policies & programmes to address current and projected health risks 4.1 Identify additional public health and health care policies and programmes to prevent likely future health burdens 4.2 Prioritize public health and health care polices and programmes to reduce likely future health burdens 4.3 Identify resources needed for implementation, and potential challenges to be addressed 4.4 Estimate the costs of action and of inaction 4.5 Identify possible policies and programmes to reduce the potential health risks of decisions made in other sectors (adaptation and greenhouse gas mitigation policies and programmes) 7

8 4.1 Identify additional public health and health care policies & programmes to prevent likely future health burdens What is needed to better manage climate related risks today? What is needed to address additional risks? Should activities focus on: Reduce vulnerability? Address future risks? Build Adaptive Capacity? = all 3? Should Investments be made in: Surveillance, Preparedness, Response = all 3? 8

9 4.1.1 Identify all possible adaptation policies and programmes Approach Generate a list of all potential choices, without regard to technical feasibility, cost, or other limiting criteria May include currently implemented interventions, new or untried interventions policies and programmes used in other jurisdictions and in other societies other interventions that are theoretically possible. Possible Methods brain storming session with scientists, practitioners, and affected stakeholders. Benefits Gives policy makers greater choice and flexibility to consider programmes that could be implemented Gives information about which choices are constrained because of a lack of technology, information or resources, or as a consequence of other policies and programmes. 9

10 4.1.2 Evaluate policies and programmes to determine those that can be implemented in the near-term Approach Narrow down options by considering: Technical feasibility. Is the choice technically viable and available? Operationally feasible: does the health system have adequate workforce, sustainable financial resources, service delivery mechanisms, or technical knowledge and capacity to deliver the interventions or programmes. Degree of effectiveness. How effective is the proposed intervention in reducing the incidence of the adverse health outcome? Environmental acceptability. Does the proposed intervention have environmental consequences that are unacceptable? Economic efficiency. How costly is the intervention in relation to expected benefits? Social and legal acceptability. Is the proposed intervention in accordance with the laws and social customs and conventions of the community or country? 10

11 4.1.3 Possible additional analyses Approach Further screen practical choices to consider additional variables or constraints. May include Transboundary influence analysis Availability of human or financial resources to sustain interventions Compatibility with current policies Identify additional actions which would be needed to reduce possible negative consequences of the intervention Possible Methods Quantitative or qualitative, expert judgment or stakeholder groups Benefits gives a reality check and further scrutiny to practical choices 11

12 4.2 Prioritize public health and health care polices and programmes to reduce likely future health burdens Approach: Identify which health risks should be addressed first based on locally defined criteria Criteria for Prioritization may include: Significance of risk Where greatest benefits/possibility to reduce harm Costs Feasibility Acceptable risks Possible Methods Qualitative processes that involve relevant stakeholders, multiple criteria analysis, Benefits allocate scarce resources to most likely risk, most vulnerable populations, or weakest aspect of system needed to provide health protection 12

13 4.3 Identify resources needed for implementation, and potential challenges to be addressed Approach: Identify needs, requirements and barriers to be addressed Financial Resources Human Resources & Capacity Service Delivery Mechanisms Technology, Pharmaceuticals and Medical Supplies Information Resources Leadership & Governance Health Partnerships and Community Engagement Possible Methods Write brief description of what is needed to implement Benefits identify requirement for implementation and sustainability identify barriers that need to be overcome 13

14 4.4 Estimate the costs of action and of inaction Approach: Estimate the costs to address current and projected health outcomes (cost of inaction) and compare to the estimate of the costs of the proposed interventions and policies to prevent these additional burdens (cost of action) Possible Methods: WHO toolsets available, Economic Costs of Adaptation, "COST-IT", Benefits: demonstrate to decision-makers costs of inaction to not address risks, identify costs of alternative courses of action and merits 14

15 4.5 Identify possible policies & programmes to reduce the potential health risks of other sector adaptation & greenhouse gas mitigation policies & programmes Approach: Identify upstream opportunities to prevent ill health Collaborate with other sectors to identify health risks and help them make decisions which prevent downstream health problems later Examples: Energy policy and emissions Urban planning Water Housing Agriculture Possible Methods Quantitative or qualitative, Health Impact Assessments, expert review or stakeholder groups Benefits identifies upstream causes of health problems which can be prevented via coordination 15

16 Identify all options Screen Feasibility + Practicality Identify Costs Prioritize Options Identify Resources + Barriers Screen Upstream Options Make a plan to: Develop adaptation plans of action Identify cross cutting needs and resources Identify short, medium, long term priorities Implement Risk Management Process Communicate Implement Monitor and Inform (Early Warning of risks) Re-assess plans to see if they are effective 16

17 5. Manage & Monitor Risks 17

18 5.1 Monitor and Evaluate Outcomes and Approach: Interventions Monitor and evaluate the burden of climate-sensitive health outcomes and interventions to address these burdens, to ensure continued effectiveness in a changing climate. Identify key indicators to monitor disease burdens or system performance Establish review periods and timeframes to feedback into decisions. Possible Methods Surveillance, Operational research Benefits tracks to ensure risks are not increasing or changing Tracks to ensure interventions are working 18

19 5.2 Iterative Risk Management Approach: Active management of immediate and upstream risks with processes that allow for new information, flexible response procedures, and active feedback mechanisms with stakeholders and public Multisectoral coordination Integrated surveillance Active Monitoring of risk conditions and changes Active monitoring of system and community preparedness to cope with onset of extreme events Possible Methods Scheduled periodic reviews for performance and risk review, coordination forums Benefits allows for new risks to be addressed when identified creates active communication so information about upstream risks is widely available 19

20 Conclusions An assessment is not only a product it is an instrument to make decisions & solve problems Assessing health vulnerability and impacts of climate is a continual iterative process to improve understanding and adjust programming Effectiveness of assessments depends on communication and application of new knowledge. 20

21 Next Steps Today Discuss CS Health outcomes in Jordan to highlight V&A process needs Develop Work plans for: Planning Session 1: Overall Timetable & Workplan Planning Session 2: Vulnerability & Future Impact Assessment Planning Session 3: Adaptation Assessment & Planning Planning Session 4: National Strategy Development 21