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Protecting health from climate change – a seven country initiative
Health adaptation to climate change in the Republic of Macedonia
Assoc. Prof. Vladimir Kendrovski, M.D., Ph.D.WHO National Counterpart on Climate Change and Health
Head of Sector for Environmental HealthInstitute or Public Health of R. Macedonia
Scope of the 7 country initiative
To increase health system resilience to climate change
The specific objectives of the project were to
• develop national (or sub-national) environment and health adaptation plans or integrating health into existing plans;
• to strengthen health systems and build institutional capacity on climate change in relation to:
– extreme weather events preparedness and response
– infectious disease surveillance and response
– respiratory diseases early detection and response
– water, food safety and malnutrition;
– to transfer technology and foster innovation in energy efficiency and the use of renewable energy for health services;
• to provide intelligence and facilitate the exchange of knowledge and experiences on effective adaptation and mitigation measures.
Specific priorities in the 7 European countries
Project objectives in the FYR of Macedonia
Overall objective - to mainstream climate change adaptation issues in
the regular development of health sector policies and strategies
Specific objectives
•Assess the health impacts of climate change and
develop a national health adaptation strategy;
•Building institutional capacity on climate change in
relation to extreme weather events and heat waves
preparedness and response;
•Fostering innovation in energy efficiency and
renewable energy sources
•Develop early information on climate related
infectious disease risks on municipal and national
level
The need for developing a Climate Change
Health Adaptation Strategy…..
1.
Relevance of this issue on a global,
regional and national level
2.
Necessity to prepare and respond to
climate-change-associated health
risks
3.
Need for interdisciplinary cooperation and
exchange of relevant data with
other sectors
WHO Euro provided
Vision
The nature
of the
problem
Identify
interventi
ons
Prioritize
Develop a
plan
Evaluate
and share
learning
• Vulnerability assessment tool
• Health damage and adaptation
costs tool
• Health protection strategies tool
• Energy efficiency assessments
tool
• Emergency management and risk
assessment tools
Menne and Nurse, 2012, forthcoming
Step 1: Vulnerability assessment
• The average increase of temperature is
estimate between 1.0°C in 2025, 1.9°C in
2050, 2.9°C in 2075, and 3.8°C in 2100.
• For some of the winter months decrease
of total mortality
• For the summer months increase of the
monthly mortality rate in the country of
10% average is expected, compared to
the period 1996-2000.
• Increased risk from food or vector-born
diseases,
Assessment methods Climate sensitive diseases and
conditions
Data Sourcees
Qualtitative literature reviews
Interviews,
Focus group
Action research
Floods Ministry of Environment and Physical Planning
Center for Crises management
Protection and Rescue Directorate
literature reviews
Interviews
Focus group
Action research
Droughts Ministry of Environment and Physical Planning
Center for Crises management
Protection and Rescue Directorate
Focus group literature reviews
Interviews
Action research
Wildfires Center for Crises management
Protection and Rescue Directorate
Focus group
literature reviews
on – line research
Air pollution Ministry of Environment and Physical Planning
literature reviews, on – line research UV radiation Available literature
Quantittative Seasonal Index for mortality
Time series analyses
Excess winter mortality
Temperature related
mortality in
Skopje
Meteorological data (National Hydro meteorological
Office)
Air pollution data (Ministry of Environment and Physical
Planning)
Daily counts of deaths (State Statistical Office)
Seasonal Index for Salmonella
poisoning
Poisson regression
Quantifying the current and
projected future burdens of
weather temperature
Salmonella poisoning
distribution in 5
Macedonian
towns
Meteorological data (National Hydro meteorological
Office)
Weekly counts of human Salmonella confirmed cases
(Institute for Public Health of R.Macedonia)
Regression analyses
Quantifying the onset of flowering,
maximum and end of the
length of seasons for each of
pollen
Quantifying the current and
projected future burdens of
weather temperature
Pollen distribution
projections
Meteorological data (National Hydro meteorological
Office)
9 pollen weekly distribution (Betula, Cupressaceae,
Quercus, Fraxinus, Platanus, Urticcaceae,
Plantago, Chenopodiaceae, Poaceae) (Institute for
Occupational Health of R. Macedonia)
The approach in developing the Climate Change
Health Adaptation Strategy…..
Step 1: Definiing of the nature of the problem
Heat waves
Communicable diseases
Aeroallergens, pollens
Floodings, draughts
Wild - fires
UV radiation
Step 2: Identification of effective interventions
Capacity and delivery mechanisms
Data collection for surveillance
Developing plans
Workforce development
Step 3: Definiing of the nature of the problemSpecific strategy for adaptation and health
Single topic strategies/ policies on components of
adaptation and health (e.g. heat wave, flood plan)
Integration of climate change agenda into mainstream
health strategies (e.g. health protection strategies)
Integration of adaptation and health agenda within
cross- governmental strategies on climate change.
Step 4: Creation of an action planDefinition of clear actions,
Process of delivery for each strategy objective
Timetable to manage the process,
Identify roles and responsibilities
Identification of potential barriers, constraints and
processes to overcome problems,
Evaluation of processes and outcomes
Step 5: Evaluation of the implementation Process evaluation (to improve delivery mechanisms),
-Development of monitoring indicators
-Development of evaluation indicators
-Identification of responsibilities for monitoring and
evaluation
Outcome evaluation (to measure health impact)
Economic evaluation (to ensure best value for money)
Climate change health adaptation strategy and
action plan
Priority domains of action:
•Raising awareness of climate change
and the effects on health
•Identifying, registering and monitoring
risks connected with climate change and
their influence on people’s health;
•Improving the health system in its
promotion and prevention activities.
Example on adaptation
Heat health action plan
Heat waves alert system developed
(www.toplotnibranovi.mk)
Heat – related syndromes monitoring in
place
Heat waves protection leaflets
Example on adaptation
Communicable diseases and climate change
Upgrading of the existing early warning
system for communicable diseases
surveillance
Raising awareness on communicable
diseases related to climate change at
regional and local level
Results
General results
• Inter – sectoral cooperation in place
• Information exchange
• Capacity building, awareness raising etc.
• International involvement (Parma Ministerial Conference, UNFCCC)
• Inclusion of the health aspects of climate change into the Parliament debates,
UN country agenda etc.)
• Articles published in international journals
Lessons learning
• Focus on an immediate, recognizable threat!
• Information on climate change impacts needs to be translated from the scientific research domain into language and time scales relevant for policy makers.
• Needs for national data were very important !
• Recognize limited capacity!
• All relevant stakeholders need to be involved-but their needs for information may vary.
• Don’t wait for perfection!
Doing things differently
• Make better use of early warning information available nationally, regionally on climate variability extremes (flooding, drought, storms, heat waves, seasonal rainfall patterns)
• Focus surveillance efforts at areas predicted to be at particularly high risk for changing patterns of disease.
• Where appropriate, invest in win-win solutions that reduce greenhouse gas emissions as well as improve public health.
• Take health risks into account when planning adaptation measures.
Summary
• Climate change does not create new health hazards.Instead it may act as a multiplier of existing health problems or change the location of health concerns.
• A cost-effective and prompt way of handling climate change adaptation is to add the climate dimension into existing national or community-based programs and actions.
• For more long-term adaptive strategies cross-sectoral approaches are needed.
• Strong multi-sectoral co-operation was key success
BETTER HEALTH FOR OUR FUTURE
National Experiences of Climate Adaptation
