STATEMENT BY THE DIRECTOR-GENERAL OF THE WORLD HEALTH ORGANIZATION
Last year marked a turning point in the debate on climate change. The scientific evidence continues to mount. The climate is changing, the effects are already being felt, and human activities are a principal cause.
In selecting climate change as the theme for this year’s World Health Day, WHO aims to turn the attention of policy-makers to some compelling evidence from the health sector. While the reality of climate change can no longer be doubted, the magnitude of its consequences – especially for health – can still be reduced. Consideration of the health impact of climate change can help political leaders move with appropriate urgency.
The core concern is succinctly stated: climate change endangers health in fundamental ways.
The warming of the planet will be gradual, but the effects of extreme weather events – more storms, floods, droughts and heatwaves – will be abrupt and acutely felt. Both trends can affect some of the most fundamental determinants of health: air, water, food, shelter, and freedom from disease.
Although climate change is a global phenomenon, its consequences will not be evenly distributed. Scientists agree that developing countries and small island nations will be the first and hardest hit.
WHO has identified five major health consequences of climate change.
First, the agricultural sector is extremely sensitive to climate variability. Rising temperatures and more frequent droughts and floods can compromise food security. Increases in malnutrition are expected to be especially severe in countries where large populations depend on rain-fed subsistence farming. Malnutrition, much of it caused by periodic droughts, is already responsible for an estimated 3.5 million deaths each year.
Second, more frequent extreme weather events mean more potential deaths and injuries caused by storms and floods. In addition, flooding can be followed by outbreaks of diseases, such as cholera, especially when water and sanitation services are damaged or destroyed. Storms and floods are already among the most frequent and deadly forms of natural disasters.
Third, both scarcities of water, which is essential for hygiene, and excess water due to more frequent and torrential rainfall will increase the burden of diarrhoeal disease, which is spread through contaminated food and water. Diarrhoeal dis- ease is already the second leading infectious cause of childhood mortality, and accounts for a total of around 1.8 million deaths each year.
Fourth, heatwaves, especially in urban “heat islands”, can directly increase morbidity and mortality, mainly in elderly people with cardiovascular or respiratory disease. Apart from heatwaves, higher temperatures can increase ground-level ozone and hasten the onset of the pollen season, contributing to asthma attacks.
Finally, changing temperatures and patterns of rainfall are expected to alter the geographical distribution of insect vectors that spread infectious diseases. Of these diseases, malaria and dengue are of greatest public health concern.
In short, climate change can affect health problems that are already huge, largely concentrated in the developing world, and difficult to combat.
On this World Health Day, I am announcing increased WHO efforts to respond to these challenges. WHO and its partners are devising a research agenda to obtain better estimates of the scale and nature of health vulnerability and to iden- tify strategies and tools for health protection. WHO recognizes the urgent need to support countries in devising ways to cope. Better systems for surveillance and forecasting, and stronger basic health services, can offer health protection.
Citizens, too, need to be fully informed of the health issues. In the end, it is their concern that can spur policy-makers to take the right actions, urgently.
Dr Margaret Chan Director-General World Health Organization
Climate change puts at risk the basic determinants of health
There is now widespread agreement that the earth is warming, due to emissions of greenhouse gases caused by human activity. It is also clear that current trends in energy use development and population growth will lead to continuing – and more severe – climate change.
The changing climate will inevitably affect the basic requirements for maintaining health: clean air and water, sufficient food and adequate shelter. Each year, about 800 000 people die from causes attributable to urban air pollution, 1.8 million from diarrhoea largely resulting from lack of access to clean water supply and sanitation, and from poor hygiene, 3.5 million from malnutrition and approximately 60 000 in natural disas- ters. A warmer and more variable climate threatens to lead to higher levels of some air pollutants, increase transmission of diseases through unclean water and through contaminated food, to compromise agricultural production in some of the least developed countries, and to increase the hazards of extreme weather.
Climate change also brings new challenges to the control of infectious diseases. Many of the major killers are highly climate sensitive as regards temperature and rainfall, including cholera and the diarrhoeal diseases, as well as diseases including malaria, dengue and other infections carried by vectors. In sum, climate change threatens to slow, halt or reverse the progress that the global public health community is now making against many of these diseases.
In the long run, however, the greatest health impacts may not be from acute shocks such as natural disasters or epidemics, but from the gradual build-up of pressure on the natural, economic and social systems that sustain health, and which are already under stress in much of the developing world. These gradual stresses include reductions and seasonal changes in the availability of fresh water, regional drops in food production, and ris- ing sea levels. Each of these changes has the potential to force population displacement and increase the risks of civil conflict.
All populations are vulnerable – but some are more vulnerable than others
All populations will be affected by a changing climate, but the initial health risks vary greatly, depending on where and how people live. People living in small island developing states and other coastal regions, megacities, and mountainous and polar regions are all particularly vulnerable in different ways.
Health effects are expected to be more severe for elderly people and peo- ple with infirmities or pre-existing medical conditions. The groups who are likely to bear most of the resulting disease burden are children and the poor, especially women. The major diseases that are most sensitive to climate change – diarrhoea, vector-borne diseases like malaria, and infections associated with undernutrition – are most serious in children living in poverty.
We have a common interest in facing up to health risks wherever they occur. Ongoing climate change, coupled with globalization, will make it more difficult to contain infectious diseases within their current ranges. Health challenges arising from population displacement and conflict are unlikely to stay confined within national borders. Improved health con- ditions for all populations, alongside more rapid and effective interna- tional disease surveillance, constitute a vital contribution to global public health security.
Protecting human health is the “bottom line” of climate change strategies
Climate change can no longer be considered simply an environmental or developmental issue. More importantly, it puts at risk the protection and improvement of human health and well-being. A greater apprecia- tion of the human health dimensions of climate change is necessary for both the development of effective policy and the mobilization of public engagement.
Strengthening of public health services needs to be a central component of adaptation to climate change. The international health community already has a wealth of experience in protecting people from climate-sensitive hazards, and proven, cost-effective health interventions are already available to counter the most urgent of these. Broadening the coverage of available interventions would greatly improve health now. Coupled with forward planning, it would also reduce vulnerability to climate changes as they unfold in the future.
The diverse, widespread, long-term and inequitable distribution of health risks makes climate change a truly global challenge, calling for an unprecedented degree of partnership. An effective response will require actions from across society: from individuals, the health sector, and community and political leaders. A fair and effective response will require a sharing of responsibilities between the populations that make the greatest contribution to climate change and those that are most vulnerable to its effects, in order to safeguard and enhance global public health security.