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Climate change and health_ NAP Expo
- 1. Climate Change andHealth: need of frameworks for building resilient health systems Sharm El Sheikh, April 5, 2018, 09:00 – 09:30 Plenary: Risk Management Frameworks Guéladio Cissé1,2,3 1 Swiss Tropical and Public Health Institute, Basel, Switzerland 2 University of Basel, Basel, Switzerland 3 James Cook University, Townsville, Australia
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- 3. Swiss Centre for International Health Medicine Education andTraining Epidemiology and Public Health Medical Parasitology and Infection Biology < Swiss Tropical and Public Health Institute Staff members 770from 60+nations 138working abroad, 632in Basel Swiss TPH/University of Basel 5 Departments
- 4. • To recalla few major terms and concepts about “health” • To highlight with a few examples the importance of research on relevant health components for NAP • To highlight the need for increasing the resilience of health systems to face climate change risks • To present an operational framework for increasing the resilience of health systems • To emphasise the importance of health research adaptation plans Objectives of the talk
- 5. 1. Background: health,health sector, health systems 2. Climate and health research: a few illustration of health systems challenges in face of climate change 3. Operational framework for resilient health systems 4. Adaptation Research Plans 5. Questions and Outlook Outline
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- 7. Background Health: a stateof complete physical, mental and social well-being and not merely the absence of disease or infirmity Determinants of health - Individual determinants of health - Social determinants of health - Environmental determinants of health “Health” requires more than treating diseases and injuries Taking care of these is key and at the roots WHO
- 8. Background Health care sector Includesfacilities that provide direct health treatment procedures for patients. (Health care vs Public health?) Public health All organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Not only by heath care sector (but an entire “health system”?)
- 9. Background Health system: Allorganizations, people and actions whose primary intent is to promote, restore or maintain health WHO: “health systems and health determining sectors (e.g. water and sanitation, food and agriculture, energy, urban planning)” (Source : WHO 2015) Human Health, Animal Health, Environmental Health Ecosystem Health, …
- 10. Background Ecohealth • How changesin the earth’s ecosystems affect human health • Changes in the biological, physical, social and economic environments and how these changes relate to human health • Together physicians, veterinarians, ecologists, economists, social scientists, planners and others. • Components: Human – Ecosystems – Social Environment
- 11. Background One Health • Designingand implementing programs, policies, legislation and research, particularly for the control of zoonoses (diseases that can spread between animals and humans, such as flu, rabies and Rift Valley Fever). • Components: Human – Animal - Environment Example of Zoonotic diseases
- 12. Climate change andhealth Source: www.cdc.org
- 13. 2. Climate changeand Health Research • Vulnerabilities of water and sanitation systems • Water-borne diseases • Vector-borne diseases
- 14. Municipal Solid Waste Currentlyglobal # 1.3 billion tonnes per year Expected by 2025 # 2.2 billion tonnes per year Increase faster than population growth Change in consumption patterns … Solid Waste on rise (Source: WB 2012; Photo: turbosquid.com )
- 15. Wastewater on rise Wastewater 1,500km3 per day worldwide >80-90% urban wastewater improperly discharged, insufficiently treated, and directly or indirectly reused Wastewater from industries is on rise! Source: UN World Water Development Report 2003; Corcoran et al 2010
- 16. Urban water -withdrawal and pollution discharge 16 • Agriculture • Domestic • Industry
- 17. 2.1 Vulnerabilities ofWater and Sanitation Systems Côte d’Ivoire
- 18. • What arethe climate trends in the area? • Where are the areas and communities most physically vulnerable to floods within the city? • What are the main water supply systems and sanitation facilities in the city different zones? • To what extent may floods impact health, through water and sanitation systems in the most vulnerable areas? Research questions
- 19. Zone 1 Zone 3 Zone2 City zones Korhogo
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- 21. Peri-urban agriculture Photos: KouakouE. Activities around the dam
- 22. Photos: Kouakou E. Environmentalhealth challenges
- 23. Stagnant Wastewater inthe city Rainy seasonDry season Photo: Kouakou E.
- 24. Major waste dumpsin the city Dry season Rainy season
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- 26. Vulnerability map forwater wells Vulnerability maps
- 27. Urban contexts Vulnerabilities Water, sanitationand hygiene systems Communication and bridge with policy actors
- 28. 2.2 Vulnerabilities ofWater and Sanitation facilities South Africa Informal settlements, Diarrhea
- 29. Research Program ofa Joint Swiss-South Africa Chair on Global Environmental Health Areas/Projects • Project 1: Pesticides • Project 2: Air pollution • Project 3: Water pollution • Project 4: Climate change • University of Cape Town • Swiss Tropical and Public Health Institute / University of Basel Source: Röösli et al. 2016 Illustration : Cape Town
- 30. 30 • Africa isurbanizing quickly • At # 3.9%/year, urban population growth rates in Africa = highest in the world • Urban growth highly correlated to growth in slums • Poor continuity of water service and inadequate water quality • Cape Town: more than 20% of the city households are located in informal settlements Urban Informal Settlements Population Living in Slums in Africa Source: World Bank
- 31. • Cape Flatsrivers (Big and Little Lotus rivers) in the Southern Management Area of the City of Cape Town • Due to urbanisation and encroachment: poor water quality in these ‘rivers’ • Many of greater Cape Town’s urban rivers water : unfit for domestic or recreational use River Water Quality in South Africa Source: River Health Programme
- 32. The Lotus Rivercatchment area d service areas. Communities in the catchment range lements, to low-and middle income communities ! own (left) and different land use types in the Lotussocio- to high aquifer Figure 5 Land use • Cape Flats Aquifer • 90,000 of 380,000 inhabitants in informal settlements • Great and Little Lotus River • Variety of land use types • Poor informal settlers : low and middle income
- 33. Field toilet WeltvredenSolidwaste- b/n Phola & Lotus park Waste water discharged into L.R. -Lotus Park Pictures along the Lotus River Canal near Ottery - commercial + Industrial site Photos: N. Redi
- 34. Kids playing aroundL. River Animals in L. Park area A man cleaning his paint brush Weltvreden area after rain Pictures along the Lotus River
- 35. Environmental health anddiarrhea
- 36. 2.3 Climate andDiarrhea Senegal Thiam et al. 2017
- 42. 2.4 Climate andMalaria Cote d’Ivoire Impact of climate variability on the transmission risk of malaria in northern Côte d’Ivoire Richard K. M’Bra1,2,3,4*, Brama Kone2,5, Dramane P. Soro1,2, Raymond T. A. S. N’krumah2,6, Nagnin Soro1 , Jacques A. Ndione7, Ibrahima Sy7 , Pietro Ceccato8 , Kristie L. Ebi9 , Jürg Utzinger3,4, Christian Schindler3,4, Guéladio Cissé3,4 Mbra et al. 2018, submitted Malaria Journal
- 43. Climate change andmalaria
- 44. 2.4 Climate, Diarrheaand Malaria Mozambique Horn et al. 2018, accepted IJERPH Journal Fernanda Zermoglio, Anna Steynor, Chris Jack, Izidine Pinto, Kris Ebi, Lindsay Horn, Colin Quinn, James Colborn
- 45. 3. Operational Frameworkfor Increasing the resilience of health systems Source: WHO 2015
- 46. 46Source: WHO 2015 Asound climate adaptation plan will therefore include many, if not all, of the 10 components 10 Components of WHO Framework
- 47. 1. Leadership andgovernance 2. Health workforce 3. Vulnerability, capacity and adaptation assessment 4. Integrated risk monitoring and early warning 5. Health and climate research 6. Climate resilient and sustainable technologies and infrastructure 7. Management of environmental determinants of health 8. Climate-informed health programmes 9. Emergency preparedness and management 10. Climate and health financing For each component: A) Objectives of the implementation and B) Examples of measurable outputs Components of WHO Framework
- 48. A) Objectives forthe implementation of this component • Research agenda: multidisciplinary national research agenda on climate change and health defined and endorsed by stakeholders • Support for research: research capacity on climate change and health built by supporting relevant multidisciplinary networks, making available financial resources and creating training opportunities. • Connect to policy: research findings on climate change and health disseminated to and used by policy makers #5 Health and climate research (WHO framework)
- 49. B) Examples ofmeasurable outputs Research agenda National research agenda on climate change and health defined through the organization of a stakeholder forum involving representatives from health and other government ministries, research institutions, nongovernmental organizations, the private sector and vulnerable populations Support research • Access to and linkage of data on meteorological information, health determinants and outcomes enabled. • Multidisciplinary research partnerships, knowledge management networks and rosters of local experts established #5 Health and climate research (WHO framework)
- 50. B) Examples ofmeasurable outputs (cont.) Support research (cont.) • Financial backing mechanisms to support research programmes and postgraduate training programmes established Connect to policy • Mechanism established for researchers to inform planning, policy and stakeholder groups • Policy makers included in the definition and review of research agendas #5 Health and climate research (WHO framework)
- 51. #7 Management ofenvironmental determinants of health
- 52. A) Objectives forthe implementation of this component • Monitoring: joint monitoring of climate-sensitive environmental risks against evidence based standards • Regulation: regulatory policies protecting populations against climate-sensitive environmental risks defined, revised and enforced • Coordinated management: environmental determinants of health jointly managed, with clear roles and responsibilities defined across sectors Health and climate research (WHO framework)#7 Management of environmental determinants of health
- 53. B) Examples ofmeasurable outputs Monitoring • Integrated monitoring systems allowing collection and analysis of data on environmental hazards, socioeconomic factors and health outcomes established • Evidence-based quality standards for climate-sensitive environmental conditions defined Regulation • Regulations on key environmental determinants of health (air quality, water quality, food quality, housing safety, waste management) revised and enforced to reflect broader ranges of expected climatic conditions • Building regulations and waste management infrastructure, environmentally sustainable and resistant to likely local extreme events promoted #7 Management of environmental determinants of health
- 54. B) Examples ofmeasurable outputs (cont.) Coordinated management • Health impact assessments for policy and programmes in sectors such as transport, agriculture and energy, implemented • Joint multisectoral risk management approaches to health risks related to disasters, water, waste, food and air pollution (e.g. food safety, diarrhoeal disease control, integrated vector management, joined-up risk communication) undertaken #7 Management of environmental determinants of health
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- 56. National Climate ChangeAdaptation Research Plan Australia The Australian Government established the National Climate Change Adaptation Research Facility (NCCARF) in 2008 NCCARF developed National Climate Change Adaptation Research Plans (NARPs) for eight themes: 1. Emergency management 2. Human health 3. Marine biodiversity and resources 4. Settlements and infrastructure 5. Terrestrial biodiversity 6. Primary industries 7. Social, economic and institutional dimensions of climate change; and 8. Freshwater biodiversity
- 57. National Climate ChangeAdaptation Research Plan Australia The Australian Government established the National Climate Change Adaptation Research Facility (NCCARF) in 2008 NCCARF developed National Climate Change Adaptation Research Plans (NARPs) for eight themes: 1. Emergency management 2. Human health 3. Marine biodiversity and resources 4. Settlements and infrastructure 5. Terrestrial biodiversity 6. Primary industries 7. Social, economic and institutional dimensions of climate change; and 8. Freshwater biodiversity
- 58. National Climate ChangeAdaptation Research Plan Human Health Heat • Which people are most vulnerable to short-term extremes of heat? - Do levels of understanding of the nature of the risks, and personal/household-level ways to ameliorate them, vary between these population sub-groups? - Are changes needed to mainstream public health policy? • Do early warning systems for heat waves and other extreme weather events reduce adverse health impacts? - Which types of early warning systems are most effective? Extreme weather events Vector-borne diseases Food, air and water quality
- 59. National Climate ChangeAdaptation Research Plan Implementation Plan Evaluation of NCCARF , report 2017
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- 61. • How manycountries have a National Climate Change Adaptation Research Plan? • How many countries have developed specific Health National Climate Change Adaptation Plan? • How many countries have developed a National Climate Change Adaptation Research Plan for Health? • How many countries have already used the WHO framework for climate resilient health systems? • How many countries have implemented the component 7 of the framework? • What difficulties to anticipate for research on environmental health challenges? Questions
- 62. • Collaboration betweencountries on Health Adaptation Plans • Regional collaboration on Health Adaptation Plans • Collaboration on Health Research Adaptation Plans Outlook
- 63. Thank you verymuch Contact: [email protected] [email protected]