Climate Change: The Impact on Human Health in the SADC Region James van Hasselt 28 th Feb 2011 ICLEI Cape Town
Regional Climate Change Programme (RCCP) -The purpose of RCCP is to enable trans boundary adaptation to climate change in southern Africa -Collate, generate and disseminate information that will allow policy makers and planners to make informed choices on how they might respond to impact on local populations and livelihoods. http://www.rccp.org.za
Climate change and human health Environ Health Perspect. 2007 August; 115(8): 1216 1223
Climate change and human health Priority impacts Water (quality and quantity) Food security Extreme weather
Water Sanitation and hygiene Reproductive health Diarrhoea Parasites and Vector borne eg Malaria WATER Nutrition (food production) Migration Urban Health Conflict Heat stress HIV
Extreme Weather (eg Flooding) Sanitation and hygiene Injury and Death Diarrhoea Mental health Flooding Nutrition (Food stores and production) Migration and urbanisation Malaria Disrupted health services HIV Sudden demand for resources
Infectious Diseases eg Malaria Anaemia Maternal and child health HIV Malaria Migration and Urbanisation Nutrition (decreased production)
Lancet and University College London Institute for Global Health Commission: 2009 Report Climate change is the biggest global health threat of 21 st Century
WHO Estimated effect of climate change in year 2000 by region (DALY s per million population) African region 3071.5 SE Asia 1703.5 Dev countries 8.9 Campbell-Lendrum DH, Corvalán CF, Prüss Ustün A. How much disease could climate change cause? In: McMichael AJ, Campbell-Lendrum DH, Corvalan CF, et al, eds. Climate change and human health: risks and responses. Geneva: WHO, 2003.
Regional perspective Loss of healthy life years as a result of global environmental change (including climate change) is predicted to be 500 times greater in poor African populations than in European populations. McMichael AJ, Friel S, Nyong A, Corvalan C. Global environmental change and health: impacts, inequalities, and the health sector. BMJ 2008; 336: 191 94.
SADC Food FAO estimate 95 million people in SADC undernourished (> 40% of the population) Dependency on cassava or maize* Large proportion of households spend 50% of income on food Water Stress Burden of Disease (Malaria; HIV; other parasites) Limited Capacity and Socio Economic factors
Water and food insecurity Migration to peri urban informal or slum settlements, overwhelming capacity of water supply networks Informal sanitation vulnerable and can flood rapidly, contaminating water sources
Extreme weather Flooding WHO Report Pakistan Sept 2010: -20 million people affected, 8 million required direct humanitarian assistance -Of 3000 hospitals and clinics in affected districts, 400 destroyed or seriously damaged
RCCP Risk and Vulnerability Study SADC (Davies and Midgley 2010) GIS -Geographic hot spot analysis of areas where cc stressors currently have the greatest impact on food security, and to an extent health. Best available geo referenced data for 51 variables. Weighted overlay analyses across the SADC region. Results presented as summary layers, illustrating current problem hot spots.
RCCP Risk and Vulnerability study Malnourishment in Children under 5 years old (wt 3) web-link: http://sedac.ciesin.org/povmap/ds_global.jsp Health Expenditure (wt 2) web-link: http://hdr.undp.org/en/reports/global/hdr2007-2008 Malaria Incidence (wt 1) web-link: http://www.map.ox.ac.uk/ HIV Prevalence (wt 2) http://hdr.undp.org/en/reports/global/hdr2007-2008/ Access to Improved Water (wt 3) http://hdr.undp.org/en/reports/global/hdr2007-2008/ Protein Consumption web-links: http://www.rccp.org.za Dietary Diversity (wt 1) web-links: http://www.fao.org
Approach to mapping Exposure Sensitivity Impact Adaptive capacity Vulnerability
Exposure
Sensitivity
Impact Vulnerability mapping: impact 2008 & 2050
Risk and Vulnerability study Zimbabwe, Swaziland and Lesotho contained the highest impact areas ie Most environmentally/nutritionally sensitive Eastern Seaboard droughts, floods and cyclones Arid South-West also exposed to risk. Capacity for adaptation alters vulnerability. Hotspots and problem areas along network of high pop density areas along the major transport networks.
Risk and Vulnerability study Intended value of the study to enable spatially explicit planning at regional level Graphically illustrates food security and health impacts on the region (and eg alignment with HIV pandemic v high prevalence areas) http://www.rccp.org.za
Key gaps in health sector Reliable, relevant and up-to-date information No comprehensive assessment of the effect of climate change on health in Africa (Lancet UCL report 2009) RCCP Health report 2010 found no significant studies underway Need for improved surveillance and primary health information systems in region
Lack of awareness National Adaptation Programmes of Action for climate change in least-developed countries found that health was not a priority. 11% of priority projects focused on health and only 3% of total NAPA budgets were allocated to health projects (Manga 2010).
Opportunities for adaptation strategies -MDG s -New emphasis on Health Systems Strengthening (eg PEPFAR 2) -Health attracts political attention -Support for other sectors
Conclusion Relevant, reliable, up to date information needed Health needs to be aligned with, and support other sectors Opportunity for adaptation strategies to use existing response strategy frameworks eg MDG s Return to fundamentals of public health
Finally..while there is uncertainty regarding the exact impact of climate change on health, fortunately, there is much less uncertainty around the best responses. These include,.. greater and more resilient coverage of water and sanitation resources. They also include improvements to protect health both from extreme weather events, and any long-term degradation in the environmental determinants of health, such as the availability of fresh water, and food security. All of these interventions would both save lives now, and increase resilience to gradual climate change. Campbell-Lendrum D; Bertollini R Bulletin of the World Health Organization 2010;88:242-242.