1. A.J. McMichael National Centre for Epidemiology and Population Health The Australian National University Canberra, Australia Climate Change and Human Health A wide-scope overview

2. Glacier loss, sea- level rise Nutrition: child devt, adult health Ecosystem damage Property loss Infra- structure damage Reduced food yields Tourism and recreation Altered surface water Loss of jobs, livelihoods Direct economic impacts Climate change Mean conditions and Variability Physical hazards Fresh- water availability Food prices, choices Community morale: mental health disorders temperature and rainfall Microbial ecology (host-animals, vectors, pathogens) Hygiene; local food yield River flows, dams Infectious disease risks Post-event depression, etc. ~ Other systemic environmental changes – acting in concert with climate change Direct impacts  risks of injury & death heatwaves, extreme weather events Displacement, Conflicts shortages, prices: competition Relocation, disruption Trauma, deaths …..

3. Deaths Attributable to Climate Change in Year 2000 14 WHO statistical regions are, here, scaled by estimated annual mortality (in 2000) due to change in climate since ~1970. Selected causes of death. (Patz, Gibbs et al, 2007: based on McMichael, Campbell-Lendrum, et al, 2004) Estimated annual deaths due to climate change from: malnutrition (~80K), diarrhoea (~50K), malaria (~20K), flooding (~3K)

4. 60 days: 56,000 extra deaths in Moscow and Western Russia (Munich Re estimate) Approx 8 o C above normal http://www.noaanews.noaa.gov/stories2011/20110309_russianheatwave.html Temp o C Extreme Heat (and Smoke) in Western Russia, Summer 2010: human (and crop) impacts

5. Baseline 2000 2025 2050 Ebi et al., 2005 Climate Change and Malaria Potential transmission in Zimbabwe Bulawayo Climate suitability:* red = high; blue/green = low High probability Medium probability Low probability Harare Highlands * Temperature + minimum seasonal rainfall

6. Ebi et al., 2005 Bulawayo Harare Baseline 2000 2025 2050 Climate Change and Malaria Potential transmission in Zimbabwe Climate suitability: red = high; blue/green = low

7. Ebi et al., 2005 Bulawayo Harare Baseline 2000 2025 2050 Climate Change and Malaria Potential transmission in Zimbabwe Climate suitability: red = high; blue/green = low

8. Schistosomiasis: Modelled future impact of warming on Schistosoma japonicum transmission in China Source: Zhou et al., Am J Trop Med Hyg 2008 Potential transmission zone now Zhou et al, 2008: “Recent data suggest that schistosomiasis is re- emerging in some settings [where previously good control]. …. “Along with other reasons, climate change and ecologic transformations have been suggested as the underlying causes.” 2030: + 0.9 o C 2050: + 1.6 o C Yang et al (2005): Northwards drift, over past 4 decades, of winter ‘freezing zone’ that limits water-snail survival – associated with a 1.0-1.5 o C temperature rise in SE China. This has put an extra 21 million people at risk.

9. 64 36 20 80 Percentage change in yields to 2050 -50 -20 0 +20 +50 +100 UN Devt Prog, 2009 Plus climate-related: Flood/storm/fire damage Droughts – range, severity Pests (climate-sensitive) Infectious diseases (ditto) CLIMATE CHANGE: Poor Countries Projected to Fare Worst MODELLED CHANGES IN CEREAL GRAIN YIELDS, TO 2050

10. Modelled and child nutrition/underweight No. of additional deaths (1000s) Sub-Saharan Africa South Asia Climate change: impact on crop yields and child under-nutrition (< 5 yrs) as cause of increased risk of infectious disease: Model-forecast additional child deaths from infection to 2060 (excluding HIV/AIDS) Year Hughes et al., Bull WHO, 2011

11. 1500 1550 1600 1650 1700 1750 1800 War Fatality Index, Europe Nth Hemi- sphere Temp Variation o C Rate of Migrations, Europe European Temp Variation standardised units Cold Period 1570-1660 Zhang et al., PNAS, 2011 Coldest period, 1570-1660, in Europe during Little Ice Age: Relation to War and Displacement – as Food Yields Plummeted and Prices Rose

12. Photo- synthetic activity 20 o C30 o C40 o C Food Yields: General Relationship of Temperature and Photosynthesis 0% 100% ∆ 2 o C

13. Hsiang et al., Nature 2011 Affected (n= 93) Weakly affected (n= 82) New civil conflicts twice as likely to break out in El Niño years as in cooler La Niña years Annual Conflict Rate (% of countries with conflict) El Niño Index (NINO 3 ), o C (May-Dec average SST) Civil Conflicts, 1950-2004, in Countries Affected and Little Affected by ENSO

14. And that’s All

15. Summary Points Climate change is a major part of today's 'planetary overload' syndrome, due to escalating human pressures. It will progressively weaken Earth's life-support capacity. Beyond the evident health risks from increases in heatwaves, weather disasters and some infectious diseases are potentially greater climate-related threats to food yields and nutrition, to freshwater supplies, and to community morale, mental health and stability. Climate-related food shortages, starvation, epidemic outbreaks and associated social unrest endangers health, safety and survival – via conflict, warfare and displacement.