fourth ministerial conference on environment and health, budapest, 23-25 june 2004 global public...

Fourth Ministerial Conference on Environment and Health, Budapest, 23-25 June 2004

Global public health and climate change

Roberto Bertollini, MD MPHSenior AdviserPublic Health

and the EnvironmentWHO – Geneva

Fourth Ministerial Conference on Environment and Health, Budapest, 23-25 June 2004

Climate change

Global public health and climate change4 |

UN High level meeting on climate change, September 2007

72 Heads of State

67 Senior Ministers


Global Climate Change and Human HealthGlobal Climate Change and Human Health

How are climate change and human health linked?

What health effects have been observed already, and what can we expect in the future?

How do we need to respond?


The Intergovernmental Panel of Climate Change Fourth Assessment Report

The Intergovernmental Panel of Climate Change Fourth Assessment Report

70000 new studies

>2500 scientists involved

6 years -1 report

4 governmental approval sessions


Rising atmospheric temperature

Rising sea level

Reductions in North

Hemisphere snow cover

Warming is UnequivocalWarming is

Unequivocal


Last Ice Age

Last interglacial

350

300

250

200

Carb

on

Dio

xid

e A

mou

nt

(pp

mv)

600 500 400 300 200 100 0

Thousands of Years Before Present[Adapted from Figure 6.3, ©IPCC 2007: WG1-AR4]

CO2 has not been this high in more than half a million years.


Extreme events are more frequentExtreme events are more frequent

Adapted from IPCC (2007) Summary for Policymakers. Contribution of Working Group I.


Stott et al, nature, 2004

Climate change made the European heatwave of 2003 more likely…

Climate change made the European heatwave of 2003 more likely…

2003 Heatwave

Climate change

Direct exposures(temperature, precipitation, sea level rise, extreme events)

Environ-mental

conditions

Indirect exposures (changes in water, air, food quality; vector ecology; ecosystems, agriculture, industry and settlements)

Health impacts

Health system

conditions

Social & economic disruption

Social conditions(‘upstream’ determinants

of health)

Modifying influence

*

*

Confalonieri, Menne et al, 2007

The relationship between health and climate change


Health effects

•Temperature-related illness and death•Extreme weather- related health effects•Air pollution-related health effects•Water and food-borne diseases•Vector-borne and rodent- borne diseases•Effects of food and water shortages•Effects of population displacement

CLIMATECHANGE

Based on Patz et al, 2000

The health effects of climate change

The health effects of climate change

Some expected impacts will be beneficial but most will be adverse. Expectations are mainly for changes

in frequency or severity of familiar health risks

29 augustEstablished surveillance

system. Serological analysis confirms

Chikungunya

Cronology of an epidemic

21 juneFirst imported case

to Castiglione di Cervia from India

23 juneFirst case develops

symptoms of Chikungunya

4 julyFirst case of

Chikungunya in a locally resident

person

18 augustStart of disinfection of

public areas and information to people

on how to protect themselves

13 september

254 cases. 79 laboratory confirmed

Age between 1-95 anni. 52% females.

3° week in August

Epidemic peak


…is exposing additional populations to infection with Schistosoma japonicum…

…is exposing additional populations to infection with Schistosoma japonicum…

(Yang, Vounatsou, et al. 2005).

Freezing zone 1960-90

Freezing zone 1970-2000


What will happen, and what could happen?What will happen, and what could happen?

1.8oC = 3.2oF

2.8oC = 5.0oF

3.4oC = 6.1oFppm CO2 Eq850

600

Even if we stop emitting today

0.6oC = 1.0oF

IPCC, WG 1


Many of the major killers are climate sensitiveMany of the major killers are climate sensitive

- Each year:

- Undernutrition kills 3.7 million

- Diarrhoea kills 1.8 million

- Malaria kills 1.1 million

Each of these is highly sensitive to temperature and precipitation:


How sensitive is health to climate?Diarrhoea

How sensitive is health to climate?Diarrhoea

Incidence of diarrhoeal disease is strongly related to climate variables. In Lima, Peru, diarrhoea increased 8% for every 10C temperature increase.

(Checkley et al, Lancet, 2000)

Dia

rrh

oea

ad

mis

sio

ns

Daily measurements Jan 1993 – Dec 1998

Tem

per

atu

re


Climate change is expected to increase the proportion of the global population exposed to dengue from about 35% (upper figure), to 50-60% (lower figure), by 2085.Hales et al, Lancet 2002

Future climate change and dengue


Cumulative emissions of greenhouse gases

Countries scaled according to cumulative emission in carbon equivalent to 2002. Patz et al, Ecohealth, December 2007


Health impacts of climate change

WHO regions scaled according to WHO estimates of mortality per million people in the year 2000, attributable to the climate change that occurred from 1970s to 2000. Patz et al, Ecohealth, December 2007


1. Health security

2. Strengthening health systems

3. Health development

4. Evidence and information

5. Delivery

6. Partnerships

Six focus areas for WHO, public health, and climate change


1. Health Security 1. Health Security


2. Strengthening health systems


Health sector actions as climate change adaptations

Healthy development

Environmentalhealth capacitybuilding

Integrated vectormanagement

Health actionin emergencies

Infectious diseasesurveillance

Safe drinkingwater

Diseases affected by

climate


3. Health Development


BuildingsIndoor air pollution

Heat and cold protection

Protecting health while reducing EmissionsProtecting health while reducing Emissions

Energy supply & conversion

Occupational risks;Construction and transport

AgricultureNutrition,Water /

vector-borne disease

TransportAir pollution

Traffic injuriesPhysical inactivity

IndustryOccupational risks,

mining and transport

WasteOccupational,

chemical

Greenhouse GasEmissions


The opportunity for improving health determinantsThe opportunity for improving health determinants

Can we reduce:

The 800,000 annual deaths from urban air pollution

The loss of 1.9 million deaths, and 19 million years of healthy life, from physical inactivity

The 1.2 million deaths and over 50 million injuries from road traffic accidents


Evidence, Delivery, Partnerships


Research for Improved Tools

Can you accelerate development of tools to control diseases which are increasing rapidly, such as dengue?

Can you help us measure the effectiveness of interventions to address emerging health threats, such as heatwaves?


Research for Improved Health Systems

Can you help us adapt existing surveillance systems, anticipate risks and reduce human health impact?

Can you help us improve delivery systems to meet the new challenges of climate change?


Research for Improved Policies

Can you help assess better the health impacts of major policies related to climate change?

Can you help assess the costs to health of (in)action to mitigate and adapt to climate change?


“The health sector has been much too separatist in the past. It has been thinking that all it has got to do is run a healthcare system and traditional public health. Climate change is telling us that no, that’s not good enough. We’re going to have to be more imaginative, more collaborative, and be prepared to look to a more distant future as well as deal with the problems that press on us in the here and now.”

“We’ve got to get more imaginative about working with other sectors, other arms of government, making the argument that every ministry is a health ministry.

British Medical Journal, 29 September 2007; 335:636


La salute e l’ambiente

Strumenti di prevenzione sanitaria – R. Bertollini, OMS Europa


Just as we fought so long to secure a high profile for health on the development agenda, we must now fight to place health issues at the centre of the climate agenda.

I personally believe that the inevitability of climate change makes it all the more imperative for us to reach the Millennium Development Goals.

Director General’s Speech at the 57 session of the WHO Regional Committee for Europe

Beograd,

18 September 2007


The face of climate change ?


World Health DayApril 7th 2008

Protecting Health from Climate Changewww.who.int/globalchange/climate

fourth ministerial conference on environment and health, budapest, 23-25 june 2004 global public...

Documents

health effects of climate

climate change slide

global climate change

global public health

human health

heatwave slide

unequivocal slide

geneva slide