Italy in the G7

of the effects of Climate Change on Planetary Health   PREPARATORY PROCESS G7 Health Experts Working Group (G7-HEWG) Towards the G7 HEALTH MINISTERS’ CONFERENCE 5 – 6 NOVEMBER 2017, MILAN Global Strategy for the mitigation of the effects of Climate Change on Planetary Health

RATIONALE Human health and the health of planet Earth are strictly interconnected: damaging the planet damages our own health. Referring to this interconnection, there is a strong need to adopt an inclusive, comprehensive approach to protect planetary health on the basis of the “One Health” and “Health in whole of government and whole of society” principles.

OBJECTIVE The formulation and launch of a “Global Strategy for the mitigation of the effects of Climate Change on Planetary Health”. This should define both the high priorities and policies, and translate these into practical tools. This Global Strategy focuses on policies in the health sector and aims at actively involving other relevant sectors such as environment, energy, agriculture, transportation, urban planning and economy with specific advocacy. Climate changes have an impact on human and animal health in several direct and indirect ways, e.g. leading to alterations in homeostasis and physiopathology, spikes in mortality, worsened living and working environments, also affecting food availability, security and safety. In particular, those changes have major effects on the most vulnerable groups of population.

METHODOLOGY A preparatory process based on: a Matrix: a broad and cross-cutting framework, used as a tool to investigate all the available information, to share strategies and to highlight a set of feasible actions a Delphi questionnaire: structured on the statements and actions identified in the Matrix for a global two step expert consultation This process is based on the best knowledge and collective awareness, with methods used for complex systems analysis, with the aim at identifying policies and strategies to strengthen the resilience of biological, economic and social systems and safeguarding the global health homeostasis.

MATRIX Considering the known climate drivers (Intergovernmental Panel on Climate Change in its assessment reports), eight main topics have been identified: extreme events health effects of air pollution related to climate change vector borne diseases water access and waterborne diseases food system and nutrition animal health at the animal/human interface migrant’s flows antimicrobial resistance Each topic is considered from the ‘exposures’ to the ‘health outcomes’ on human and animal health in order to identify strategies (‘expert statements’) leading to possible corrective ‘actions’.

DELPHI QUESTIONNAIRE The Delphi survey will be developed into two steps: 1st phase (April-May): all experts from different countries are invited to compile an online questionnaire containing statements and related actions. Respondents will be asked to indicate the level of relevance on a scale 1-6. In this first phase, experts are asked to assess the relevance of the actions regardless of their time horizon. Acknowledging that most, if not all, the actions proposed could be considered important, the judgment asked is of "relative" relevance. 2nd phase (June-August): analysis of expert assessments will help identify most relevant actions, central for G7 action. The second Delphi round will be conducted in July. The main objective is to identify specific strategies. For this reason, the second round of the Delphi will focus on the few actions resulted as more relevant in the first phase, and experts will be asked to indicate how to implement them in the short, medium and long term.

Screening of undocumented migrants rescued 2013 – 2017 per month of arrival (updated March 2017) MONTH 2013 2014 2015 2016 2017 Grand total January   1.813 2.833 4.310 4.121 13.077 February 2.331 3.034 4.453 6.792 16.610 March 4.361 1.974 9.096 7.910 23.341 April 11.019 13.225 8.591 32.835 May 11.201 18.305 19.846 49.352 June 17.438 21.669 21.292 60.399 July 20.083 19.010 22.225 61.318 August 1.734 21.480 20.665 17.566 61.445 September 3.591 22.748 14.661 16.257 57.257 October 3.574 12.336 7.697 28.348 51.955 November 1.659 8.753 2.406 12.993 25.811 December 256 6.478 7.973 8.146 22.853 Total 10.814 140.041 133.452 173.123 18.823 476.253