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Participants of the regional workshop on
climate change and human health, held in Bali, Indonesia from 10 to 12
December 2007, officially representing the governments of Bangladesh, Bhutan,
Brunei Darussalam, Cambodia, China, Fiji, Indonesia, Japan, , Lao People’s
Democratic Republic, Malaysia, Maldives, the Federal States of Micronesia,
Nauru, Nepal, New Zealand, Palau, the
republic of Korea, Solomon Islands, Sri Lanka, The kingdom Of Tonga, the
Philippines,, The Republic of Vanuatu and Viet Nam, jointly developed a
regional framework to guide regional and national action towards reducing the
potential burden of disease linked to the effects of global warming and
climate change.
PREAMBLE
During the last 100 years, human activities
related to the burning of fossil fuels, deforestation and agriculture have led
to a 35% increase in the carbon dioxide (CO2) levels in the atmosphere,
causing increased trapping of heat and warming of the earth’s atmosphere. The
Fourth Assessment Report (AR-4) of the Intergovernmental Panel on Climate
Change (IPCC) states that most of the observed increase in the
globally-averaged temperatures since the mid-20th century was very likely due
to the increase in anthropogenic greenhouse gas (GHG) concentrations. Eleven
of the last 12 years (1995-2006) rank among the 12 warmest years in the
instrumental record of global surface temperature. The IPCC also reports that
the global average sea level rose at an average rate of 1.8 mm per year from
1961 to 2003. The total rise in the sea level during the 20th century was
estimated to be 0.17 m.
The globally averaged surface warming
projected for the end of the 21st century (2090–2099) will vary between 1.16.4 degrees centigrade. The global mean sea level is projected to
rise by 3060
cm by the year 2100, mainly due to thermal expansion of the ocean. It is very likely that hot extremes, heat
waves and heavy precipitation events will continue to become more frequent.
It is likely that future tropical cyclones (typhoons and hurricanes) will
become more intense, with larger peak wind speeds and heavier precipitation,
causing loss of life and an increase in injuries. These climatic changes will
cause disruption of the ecosystem’s services to support human health and
livelihood, and will impact health systems. The IPCC projects an increase in
malnutrition and consequent disorders, with implications for child growth and
development. The disruption in rainfall patterns can be expected to lead to
an increased burden of diarrhoeal disease and to
the altered spatial distribution of some infectious-disease vectors. WHO
estimates that the modest anthropogenic climate change that has occurred
since 1970, claims 150 000 lives annually.
Therefore, the IPCC urges a drastic reduction
in GHG emissions to mitigate global warming and an urgent implementation of
adaptation measures.
The current and emerging climate
change-related health risks in Asia and the Pacific include heat stress and
water- and food-borne diseases (e.g. cholera and other diarrhoeal
diseases) associated with extreme weather events (e.g. heat waves, storms,
floods and flash floods, and droughts); vector-borne diseases (e.g. dengue
and malaria); respiratory diseases due to air pollution; aeroallergens, food
and water security issues; malnutrition; and psychosocial concerns from
displacement. These risks and diseases are not new, and the health sector is
already tackling these problems. However, the capacity to cope with
potentially increasing levels of these risks and diseases is limited,
particularly in developing countries.
There is a growing, but still limited,
political commitment to integrate health considerations into efforts to
mitigate and adapt to climate change at national and international levels in
the Region. Also, there is also
insufficient awareness among the general public about climate change and its
impact on health.
The availability of relevant
hydro-meteorological, socioeconomic and health data is limited and available
data are often inconsistent and seldom shared in an open and transparent
manner. Furthermore, there is insufficient capacity for assessment, research
and communication on climate-sensitive health risks in many countries, as well
as insufficient capacity to design and implement mitigation and adaptation programmes. There
is an urgent need to incorporate health concerns into the decisions and
actions of other sectors while they plan to mitigate and adapt to climate
change, to ensure that these decisions and actions also enhance health. By promoting the use of non-motorized
transport systems (e.g. bicycles) and fewer private vehicles, greenhouse gas
emissions would be reduced, air quality would improve and more people would
be physically active. Such an approach would produce associated benefits
(i.e. reduce the burden of disease while lowering greenhouse gas emissions)
and needs to be promoted.
GOAL AND OBJECTIVES OF THE REGIONAL
FRAMEWORK
Goal:
To build capacity and strengthen health
systems in countries and at the regional level to protect human health from
current and projected risks due to climate change.
Objectives:
1. Increase awareness of health consequences of climate change;
2. Strengthen the capacity of health systems to provide protection from
climate-related risks and substantially reduce health system’s greenhouse gas
emissions;
3. Ensure that health concerns are addressed in decisions to reduce
risks from climate change in other key sectors.
RECOMMENDED ACTIONS
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Objective 1: To increase awareness of
health consequences of climate change
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Governments, through relevant agencies,
should:
1. Undertake studies on the health
implications of climate change and share information to understand how to
promote changes in individual and corporate behaviours
that mitigate climate-related health risks, while protecting and promoting
health.
2. Enhance political commitment and strengthen institutional capacity
and arrangements to achieve adaptation and mitigation goals.
3. Facilitate national working groups, nongovernmental organizations and
civil society to develop coordinated mitigation and adaptation plans by
including relevant sectors, regions and disciplines.
4. Develop awareness-raising programmes and
learning resource materials to educate and engage a broad range of
stakeholders, including local communities, health and other relevant
professionals, and the media on the potential health impacts of climate
variability and change and on appropriate measures to reduce
climate-sensitive risk factors and adverse health outcomes.
WHO should:
1. Provide specific climate
change-related technical guidance for vulnerability and adaptation
assessments and surveillance systems, which provide methods for identifying
risks to vulnerable groups, quantifying the burden of disease from climate
change, and quantifying costs and benefits of health adaptation measures to
ensure comparability across countries.
2. Support countries in the
development of vulnerability and adaptation assessment and analysis tools,
and in the development of a set of indicators on climate change-related
health risks.
3. Encourage and facilitate
regional knowledge-sharing and networking on climate change and human health
within the health sector as well as between disciplines.
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Objective 2: To strengthen health systems
capacity to provide protection from climate-related risks, and
substantially reduce health system’s GHG emissions
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Governments, through relevant agencies, should:
1. Develop and implement national
action plans for health that are integrated into existing national plans on
adaptation and mitigation to climate change.
2. Develop integrated strategies to
incorporate current and projected climate change risks into existing health
policies, plans and programmes to control
climate-sensitive health outcomes, including integrated vector management,
and health risk management of disasters.
3. Strengthen existing
infrastructure and interventions, including human resource capacity,
particularly surveillance, monitoring and response systems and risk communication,
to reduce the burden of climate-sensitive health outcomes. Key concerns vary by country; common
concerns include vector borne diseases, air quality and food and water
security.
4. Strengthen public health systems
and disaster/emergency preparedness and response activities, including
psychosocial support, through increased collaboration and cooperation across
sectors. This should include documentation, sharing and evaluation of the
effectiveness of local knowledge and practices.
5. Provide early warning systems to
support prompt and effective responses to current and projected health
burdens. In order to achieve this, national and regional climate forecasting
information, including climate change projections, should be fully utilized.
6. Implement adaptations over the
short, medium or long term; be specific to local health determinants and
outcomes of concern; and facilitate the development of community-based
resource management. The costs and
benefits of different interventions should be determined.
7. Establish climate change focal
points or mechanisms within national health institutions to ensure the
implementation, monitoring and evaluation of health mitigation and adaptation
actions and ensure that health issues are adequately addressed in these
actions.
8. Establish programmes
through which then health sector substantially reduces GHG emissions; by
doing so, it could also serve as a best practice model for other sectors.
WHO should:
1. Facilitate greater contribution
of funds from donor agencies for climate change- and health-related programme implementation.
2. Support countries technically
and financially to build national capacities to develop and implement
national action plans on mitigation and adaptation, including conducting
research on the health impacts of climate change.
3. Support countries technically
and financially by providing training programmes on
methodologies and assisting in the assessment and management of health risks
due to climate change.
4. Develop and provide technical
guidance on good adaptation and GHG emission reduction practices within the
health sector.
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Objective 3: To ensure that health
concerns are addressed in decisions to reduce risks from climate change in
other key sectors^.
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Governments, through relevant agencies, should:
1. Develop integrated strategies to
incorporate current and projected climate change risks into existing
policies, legislation, strategies and measures of key development sectors to
control climate-sensitive health outcomes.
Examples include the promotion of public and non-motorized
transportation, clean energy and disaster risk management.
2. Facilitate the health sector to
actively participate in national communications to the United Framework
Convention on Climate Change (UNFCCC), and include health issues as the core
elements in the negotiation process.
3. Ensure active health
participation in the national climate change team.
WHO should:
1. Support the establishment of a
regional centre on climate change and health, which has links to results of
vulnerability and adaptation assessments and data sources, both between
countries within and outside the Region, and links to hydro-meteorological
services at global, regional and national levels. This centre will support a
regional network of practitioners working on climate change and health, with
access to international technical expertise to facilitate the sharing of best
practices.
2. Identify and establish WHO
collaborating centres on climate change and health
in the Region.
Bali,
Indonesia,
12 December 2007
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