Protecting our Health from Professionals Climate Change: a Training Course for Public Health Chapter 18: Regional Action Plan for South-East Asia

Outline  South-East Asia (SEA) countries most vulnerable  Regional consensus on need for climate action  National climate action plans  Conclusions

Map of the South-East Asia Region

Hotspots of Security Risks Associated with Climate Change: The Asian Challenge Source: WBGU, 2007

Hotspots of Security Risks Associated with Climate Change: The Asian Challenge (cont.) Source: WBGU, 2007

Developing Climate Action Plans

Regional Action Plan to Protect Human Health from Climate Change The regional plan has three broader objectives:  To increase awareness of the health consequences of climate change  To strengthen health system capacity to provide protection from climate-related risks and to substantially reduce health systems’ greenhouse gas emissions  To ensure that health concerns are addressed in all decisions on reducing risks from climate change taken by other key sectors

Increasing Awareness of Health Consequences of Climate Change Warmer temperatures will favour outbreaks of water-borne illnesses Diarrhoeal diseases accounted for 20.1% of deaths in children less than five years of age in 2005 in the SEA region

Strengthen Health Systems Capacity  Develop national action plans for health, integrated with existing national plans  Incorporate current and projected climate change risks into existing health policies, plans, and programmes  Strengthen existing infrastructure and interventions, including human resource capacity  Strengthen public health systems and disaster/emergency preparedness and response activities, including psychosocial support

Strengthen Health Systems Capacity (cont.)  Provide early warning systems to support prompt and effective responses to current and projected health burdens  Implement adaptations specific to local health determinants to facilitate the development of community-based resource management  Determined costs and benefits of different interventions  Establish climate change focal points  Establish programmes to reduce GHG emissions by the health sector

Reduce Risks from Climate Change in Other Key Sectors  Incorporate current and projected climate change risks into existing policies, legislation, strategies, and measures of key development sectors to control climate-sensitive health outcomes  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  Ensure active health participation in the national climate change team

WHO Support: Global Work Plan to Protect Health from Climate Change  Aim: Support health systems in all countries, identify strategies and actions, share knowledge and good practices 1.Provide awareness and capacity building in addressing the challenges posed to health by climate change for health- sector professionals, other key sector NGOs, youth groups, and consumer organizations and networks 2.Support the empowerment of local communities to become more climate change resilient 3.Strengthen health systems capacity and notably that of public health programmes that are already addressing climate-sensitive diseases 4.Engage in partnerships with other sectors and agencies at national, regional, and international levels 5.Promote and support the generation of scientific evidence through research

Creating Awareness: World Health Day 2008  World Health Day (WHD) 2008 focused on the theme “Protecting health from climate change” and was commemorated in all SEA region countries  WHO-SEARO (Southeast Asia Regional Office) produced an information kit containing materials to promote commitment and drive action for change among all sectors of society to work together and reduce the adverse impacts of climate change on human health  Most WHD 2008 celebrations in SEA countries saw the active participation of national health authorities who declared their commitment – such as in India, Maldives, and Myanmar – to engage the health sector much more in addressing the challenges posed by climate change  More at:

Bangladesh  Objectives for health action: –To increase knowledge and awareness of the health consequences from climate change within and outside the health sector –To prepare mitigation and adaptation plans based on a vulnerability assessment of the national health systems –To ensure coordination with, and advocate for, decisions on climate change in other key sectors that enhance public health

Bhutan National health priorities are: 1.Overall awareness on climate change and climate variability and its adverse impacts on human health are increased and staff are trained 2.Emergency preparedness plans to reduce life loss and injury from flash floods are developed 3.The burden from disease vectors is reduced through the implementation of community-based, integrated vector management 4.Rural water quality and sanitation are improved and maintained by the concerned communities

Indonesia  Priority activities outlined to be initiated: –Increase public awareness –Develop and disseminate IEC materials to minimize GHG emissions –Capacity building within the health sector –Expand research and development on climate change and health effects –Update national health policy to increase resilience to climate change issues –Adapt to potential health risks from water and food scarcity –Coordinate and network with relevant sectors and actors, with particular focus on health

India The National Climate Change Action Plan considers eight missions, but no specific one focuses on health concerns  A Task Force has been set up to prioritize health action, inter alia by conducting multicentric studies to assess: –Respiratory diseases sensitive to climate change –Links between water quality and diarrhoeal disease and climate change (Bay of Bengal, Ganges – Brahmaputra river basin, a priority area) –The impact on ocular health –Vulnerability assessment of malaria, dengue, chikungunya, and Japanese encephalitis (JE), to provide evidence for taking proactive measures vis a vis climate change effects –How to develop infrastructure in primary health centres to handle psychiatry cases due to loss of property and life –Impact of climate change on major crops, to map adaptive capacity and improve supply food during droughts  Institutes/persons have been identified for undertaking studies on vulnerability assessment and adaptation needs Multicentric studies are required to assess: respiratory diseases sensitive to climate change, links between water quality and diarrhoeal disease and climate change (Bay of Bengal, Ganges - Brahmaputra river basin, a priority area) the impact of Global warming and Ultra Violet Radiation (UVR) exposure on ocular health vulnerability assessment and impact of climate change on Malaria,Dengue, Chikungunya and JE, to provide evidence for taking proactive measures. How to develop infrastructure at Primary Health centre level to handle the psychiatry cases due to loss of property and life. Indian Agricultural Research carrying out impact assessment of climate change on major crops to to map adaptive capacity by farmers. National authorities plan to improve supply food during drought. Institutes/persons have been identified for undertaking studies on vulnerability assessment and adaptation needs. Multicentric studies are required to assess: respiratory diseases sensitive to climate change, links between water quality and diarrhoeal disease and climate change (Bay of Bengal, Ganges - Brahmaputra river basin, a priority area) the impact of Global warming and Ultra Violet Radiation (UVR) exposure on ocular health vulnerability assessment and impact of climate change on Malaria,Dengue, Chikungunya and JE, to provide evidence for taking proactive measures. How to develop infrastructure at Primary Health centre level to handle the psychiatry cases due to loss of property and life. Indian Agricultural Research carrying out impact assessment of climate change on major crops to to map adaptive capacity by farmers. National authorities plan to improve supply food during drought. Institutes/persons have been identified for undertaking studies on vulnerability assessment and adaptation needs. Multicentric studies are required to assess: respiratory diseases sensitive to climate change, links between water quality and diarrhoeal disease and climate change (Bay of Bengal, Ganges - Brahmaputra river basin, a priority area) the impact of Global warming and Ultra Violet Radiation (UVR) exposure on ocular health vulnerability assessment and impact of climate change on Malaria,Dengue, Chikungunya and JE, to provide evidence for taking proactive measures. How to develop infrastructure at Primary Health centre level to handle the psychiatry cases due to loss of property and life. Indian Agricultural Research carrying out impact assessment of climate change on major crops to to map adaptive capacity by farmers. National authorities plan to improve supply food during drought. Institutes/persons have been identified for undertaking studies on vulnerability assessment and adaptation needs.

Nepal  Improve the understanding of public health authorities on the linkages between climate change/variability and health  Conduct research for evidence generation  Assess vulnerabilities and identify interventions for mitigation and for adaptation  Identify adaptation needs and options derived from the challenges posed by future sudden and/or large climate changes  Improve current public health programmes in intersectoral collaboration with the Ministries (water, agriculture, urban development, etc.)  Strengthen institutions and mechanisms that can systematically promote interactions among researchers, policymakers, and other stakeholders

Maldives  Maldives revised its NAPA in 2009  The main health components focus on: –Assessing health vulnerability and identify adaptation measures –Adapting to sea-level rise –Conserving water and harvesting rainwater –Implementing sanitation and sound waste management –Implementing an integrated approach to manage disease vectors –Preparing to respond better to health impacts from extreme weather events Source: earthobservatory.nasa

Thailand  Build capacity to adapt and reduce vulnerabilities to climate change  Promote greenhouse gas mitigation activities based on sustainable development  Support research and development to better understand climate change, its impacts, and adaptation and mitigation options  Raise awareness and promote public participation  Build capacity of relevant personnel and institutions, and establish a framework of coordination and integration  Support international cooperation to achieve the common goal of climate change mitigation and sustainable development

Conclusions  While the awareness that climate change is happening now has increased immensely in the last two years in most SEA countries, health professionals have not yet fully understood the implications for health and the urgency for action  National climate action plans have been prepared by most countries, yet the health dimensions are still neglected  At the same time, there are national experts in many countries who have gathered evidence on health impacts and prepared proposals for action

Conclusions (cont.)  Most actions focus on awareness building, capacity development, and research and policy development; few focus on supporting community resilience  Health sector does not yet fully participate in national, regional, or global debates on climate change  The actions plans developed with support from WHO need to be integrated into national plans and institutionalized to ensure their implementation  A positive step forward is this course!