Climate Services as a Resource for Protecting Human Health Dr. Diarmid Campbell-Lendrum,

1. Climate Services as a Resource for Protecting Human Health Dr. Diarmid Campbell-Lendrum, Public Health and Environment DepartmentWorld Health Organization,Geneva

2. Long-recognized need for climate/health collaboration WHO and WMO have had a formal agreement since 1952

3. “Whoever wishes to investigate medicine properly, should proceed thus: in the first place to consider the seasons of the year, and what effects each of them produces for they are not at all alike, but differ much from themselves in regard to their changes. Then the winds, the hot and the cold, especially such as are common to all countries, and then such as are peculiar to each locality” On Airs, Waters and Places. Hippocrates (Circa 400 B.C)

4. CLIMATE CHANGE Weather and climate affects health both directly and indirectly Modulating influences • 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 • Human exposures • Regional weather • changes • Heat waves • Extreme weather • Temperature • Precipitation • Contamination • pathways • Transmission • dynamics • Agroecosystems, • hydrology • Socioeconomics, • demographics Based on Patz et al, 2000

5. Direct Health Effects: Health Hazards of extreme weather events Deaths During Summer Heatwave. Paris Funeral Services (2003) Impacts of Hurricane Katrina

6. Climate change is likely to worsen existing problems Hay et al, 2006, best estimate, that by 2015, climate change from the 1961-1990 average would increase the population at risk of malaria in Africa by about 17% (+ 107 million) - on top of effects of demographic change and urbanization. Hay SI, et al. Population at malaria risk in Africa: 2005, 2015 and 2030. Foresight Report for UK Office of Science and Innovation, 2006.

7. The inconvenient truth for health • Each year:- Undernutrition kills 3.5 million - Diarrhoea kills 2.2 million- Malaria kills 900,000 • - Hydromet. events kill 10s of thousandsThese, and others, are highly sensitive to temperature and precipitation.

8. The inconvenient truth for the poor Cumulative emissions of greenhouse gases, to 2002 WHO estimates of per capita mortality from climate change, 2000 WHO Comparative Risk Assessment estimated that by 2000, climate change that had occurred since the 1970s was causing over 150,000 additional deaths per year (WHO, 2002, McMichael et al 2004) Map projections from Patz at al 2007; WHO 2008

9. Climate change adds a new urgency to protect health193 Nations agree on actions to protect health from climate change World Health Assembly Resolution 61.19

10. Main objectives for international public health 1) Raising awareness: of the health implications of climate change 2) Strengthening partnerships: to (re-) place health at the centre of climate change policy and improve health decision-making 3) Generating evidence: on the health effects of climate, adaptation and mitigation policies 4) Strengthening public health systems to cope with additional threats posed by climate, including disaster preparedness and early warning systems Adequate and timely climate information is important to inform these objectives

11. Some basic principles Choose "no regrets" interventions. Climate is just one of many determinants of health, and projections of future climate are uncertain – so need to choose interventions that should be effective in any plausible future climate Invest in health-enhancing sustainable development: Many "good deals now" (e.g. water and sanitation) will protect health immediately - and reduce vulnerability to CV and CC Invest in climate risk management: Improved ability to deal with climate variability is a critical component of improved response to climate change

12. Public health decision-making can be enhanced by climate & environmental information

13. Multiple public health actors could benefit from enhanced climate services • Regional and Central Ministries of Health • National development planners including disaster risk reduction • Civil society (including NGO and humanitarian actors) • Community Health workers • Public-Private Partnerships – e.g. supply chain logistics, water infrastructure • Research Community • Media

14. The potential for a climate informed health sector is not fully developed "Forecasts based entirely on scientific objectives have little impact on policy because there is no stakeholder." Clark et al, Ecological forecasts: an Emerging Imperative, Science, 2001 "Development of early warning systems should involve active participation of the system's end users". US National Research Council, Under the Weather, 2001. "……The published literature to date, however, includes no full descriptions of climate-based early warning systems being used to influence control decisions for infectious disease. WHO, 2005."

15. Main constraints on improving the links • End-users want suppliers to give them what they want, but often don't know what that is • Health actors lack resources, or are spending them on things other than early warning and prevention • Health data is often weaker than meteorological data • Health is mainly a non-market sector – so "business case" is often blurred • The climate-health bridge needs support: either externally, or by showing how a joined up decision-making system pays for itself

16. Progress in recent years • Need for "demand-driven" services repeatedly identified Beijing, Espoo, Barcelona, WCC-3, Atlanta, Antalya… • Global Framework for Climate Services as a very positive direction • Joint operational guidance on heat-health warning systems • Formation of climate and health partnerships in several countries • Operational health early-warning systems

17. Need I: Improved partnerships and networks WHO and WMO have long-standing collaboration on assessments and workshops Need to build on these to support more operational partnerships, particularly at regional and lower levels

18. Need II: Increased Capacity Meteorological professionals need to learn more about the practical challenges of disease control & health protection Health professionals need to learn more about how climate and environmental information can help them control diseases

19. Need III: Meteorological Services to support health decision-making Adding climate-based risk mapping and early warnings for e.g. heatwaves and infectious disease outbreaks …to… Strengthen core public health interventions to cope with climate-sensitive disease

20. Possible next steps • Review and renewal of global collaboration arrangements, and support for partnerships at regional and national level • Collaboration on technical products, e.g. principles and practice of met. based warning systems for health • Sustained support for end-to-end pilot projects, with evaluation of health benefits and resource costs • Using success stories as a lever for increased demand for climate services to health

21. Thank you for your attention World Health Organization http://www.who.int/ Health and climate change: http://www.who.int/globalchange/climate