Mark Keim, M.D. Centers for Disease Control and Prevention Disaster Risk Reduction as a sustainable adaptation to climate change 1 5th International Conference on Environmental and Occupational Medicine 7-10 April 2010 Mark Keim, M.D. Centers for Disease Control and Prevention 1 Keim M. Building Human Resilience. Am J Prev Med 2008;35(5):508-516

Climate Change “Warming of the climate system is unequivocal” 3 Definition “Any changing climate, over time, whether due to natural variability or as a result of human activity” 2 2 IPCC Working Group II, Impacts, Adaptation and Vulnerability, 2007 http://www.ipcc.ch/SPM13apr07.pdf 3 IPCC Working Group I, The Physical science Basis, 2007 http://ipcc-wg1.ucar.edu/wg1/Report/AR4WG1_Pub_SPM-v2.pdf

Global climate change will increase the probability of extreme weather events 2 High precipitation disasters Storms Floods Landslides Low precipitation disasters Heat Drought Wildfire 2 IPCC Working Group II, Impacts, Adaptation and Vulnerability, 2007 http://www.ipcc.ch/SPM13apr07.pdf

Definition of Disasters “A serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources.” 5 Disasters occur when a population is exposed and is vulnerable to a hazard. Hazards are potential threats to humans and their welfare. Examples of “hazards” may include natural events such as geological events (volcanic eruptions, earthquakes, tsunamis, and landslides), hydro-meteorological events (floods, storms: tornadoes, hurricanes; drought; and wildfire) and biological events (human disease-communicable and non-communicable including zoonotic disease, and botanical disease); technological hazards (those induced by man) include transport crashes, hazardous material releases, violence, fires/explosions or structural collapses. When these hazards impact on humans, plants, or animals the potential for a “disaster” occurs. To be defined as a disaster, the effects must exceed the ability of community or society to cope with the effects of its own. 5 UNISDR. (2009). Terminology on Disaster Risk Reduction. Available at: http://www.unisdr.org/eng/library/UNISDR-terminology-2009-eng.pdf

Future trends in extreme weather disasters 2 Drought Wildfires Crop failure Heavy precipitation Inland flooding Landslides Cyclones Coastal storm surge Sea level rise Coastal flooding Population displacement 2 IPCC Working Group II, Impacts, Adaptation and Vulnerability, 2007 http://www.ipcc.ch/SPM13apr07.pdf

The public health impact of extreme weather events Between 1970-1999, climate related hazards account for 90% of all global disasters 6 Hydrologic Meteorological The world’s poor are disproportionately affected 7 6 Center for Research on the Epidemiology of Disasters (CRED) http://wwwemdat.net/index.htm 7 Munich Re Group. Annual Review Natural Catastrophes. Munich Re Group, 2002. http://munichre.com/publications/302-03631_en.pdf

Future trends in health 2 Increased malnutrition Increased disaster deaths due to Heat waves Floods Storms Wildfires Droughts Increased cardio- respiratory diseases Altered distribution of infectious disease vectors 2 IPCC Working Group II, Impacts, Adaptation and Vulnerability, 2007 http://www.ipcc.ch/SPM13apr07.pdf

The most vulnerable Small Island Developing States 8 Coastal communities that are:2 Poor Dependent upon local food Dependent upon local water 2 IPCC Working Group II, Impacts, Adaptation and Vulnerability, 2007 http://www.ipcc.ch/SPM13apr07.pdf 8 Ministerial Conference on Environment and Development in Asia-Pacific, 2000 http://www.uescap.org

Disasters are increasing worldwide 9 Due to increasing vulnerability of populations at risk Interventions must therefore address the causes of vulnerability not merely the response 9 Noji E, The Nature of Disaster. In Public health consequences of disasters. In Noji E, Ed., Oxford University press. 1997

What is a hazard? A threatening event or potentially damaging phenomenon

What is human vulnerability? “Susceptibility to physical or emotional injury” Factors of human vulnerability Exposure to the hazard Susceptibility to harm Resilience to cope with or recover from losses

Vulnerability to Natural Disasters 95% of natural disaster deaths occur among 66% of the poorest countries 10 The Pacific is the most disaster prone area in the world followed by Asia; Latin America and Africa; and North America, Europe, and Australia, the least. Reasons why disaster deaths occur more frequently in developing countries among the poor: Housing: Poor are least able to afford housing that can withstand natural disasters such as earthquakes and hurricanes; they often live along the coast in developing countries where hurricanes, storm surge, or tsunamis may affect them; or in flood planes; on unstable slopes that are susceptible to landslides; or next to hazardous industrial sites. Education: poor generally aren’t as educated in preparedness behaviors or actions they can take in disasters to save their lives. Building codes: Generally, in developing countries building codes are either not present or not as strict and not enforced if present and therefore are less likely to withstand earthquakes and hurricane Disaster warnings and alerts as well as evacuation plans are not as well developed as in industrialized countries. Disaster planning and education of the public generally not as developed as in industrial countries. Developing countries have the less resources for emergency medical response and less highly trained responders. If disasters do happen, the developing countries have less resources and have decreased capacity to reconstruct. 10 Anderson M, Managing Natural Disasters and the Environment. World Bank Washington, DC. 1991

An evolution in approach To Risk Management From Response and Relief

Disaster Risk Management Cycle Risk reduction measures are Delivered pre-impact Most cost-effective Community based Sustainable

Reducing human vulnerability as an adaptation of climate change Climate change adaptation policies focus on reducing vulnerability “Reducing human vulnerability is a key aspect of reducing climate change risk” 11 11 Schipper L, Pelling M. Disaster risk, climate change and international development. Disasters 2006;30:19-38

Vulnerability reduction: reducing exposures Floodplain management Dams, levees, weirs Population protection measures Evacuation Mass care Land use planning and regulation

Vulnerability reduction: reducing susceptibility Health promotion Health care Poverty reduction Community planning

Human resilience as a means for vulnerability reduction The ability to cope with and recover from disasters Resilience is comprised of: Absorptive capacity Organizational capacity Adaptive capacity Human behaviors that increase disaster resilience Preparedness Response Recovery

Sustainable development and climate change 14 Sustainable development reduces vulnerability to climate change Enhances adaptive capacity Increases resilience Climate change could impede nations abilities to achieve sustainable development Increases exposure to hazards Erodes adaptive capacity 14 United Nations. 1987. "Report of the World Commission on Environment and Development." General Assembly Resolution 42/187, 11 December 1987. http://www.un.org/documents/ga/res/42/ares42-187.htm

Thank you mkeim@cdc.gov