1. Climate Change and Health: International Perspective

2. Learning Objectives Players on the world stage
Initiatives to tackle emissions
Political challenges
Why the health sector?
What can the health sector do?
Learning objectives for this pack. 2

3. Players on the World Stage
United Nations: Global association of governments facilitating cooperation in international law, security, economic development, and social equity
World Meteorological Organisation: United Nations' authoritative voice on weather, climate and water
Intergovernmental Panel on Climate Change: assesses the scientific, technical and socio-economic information relevant for the understanding of the risk of human-induced climate change
World Health Organisation: United Nations public health arm. Monitors disease outbreaks, assesses the performance of health systems around the globe.

4. International Initiatives to Reduce Emissions
UN Framework Convention on Climate Change: sets an overall framework for intergovernmental efforts to tackle the challenge posed by climate change
Kyoto Protocol: an agreement linked to UNFCC - sets binding targets for reducing greenhouse gas emissions. National cuts in emissions can be supplemented by:
Emissions Trading: allows countries to sell any unused permits to other countries that are over their targets
Clean Development Mechanism: allows a country with a commitment to reduce emissions to implement an emission- reduction project in a developing country
Joint Implementation: allows a country with a commitment to reduce emissions to implement an emission-reduction project in another country which also has a commitment to reduce emissions

5. We are running out of time!
The Kyoto Protocol expires in
Climate Change Conference in Copenhagen Dec 2009: the parties of the UNFCCC meet for the last time on government level before the climate agreement needs to be renewed.

6. Climate Negotiations Environment v Politics
There is an urgent need to reverse the trend of rising CO2 emissions
Despite this need there is no certainty that the Copenhagen Conference will result in an binding commitment to reduce emissions
In particular some developing countries are reluctant to agree to caps on emissions

7. Climate Negotiations Political challenges
Credit Crunch
Energy needs / economic development model of Developing World
Voter engagement – climate policies seldom determine election success
Business engagement
Complexity of issues
Long term v short term
Climate change not a vote swinger…

8. Climate Negotiations Political opportunities
‘Obama Effect’
Green New Deal
Green Jobs
Investment in low/zero carbon technology

9. Carbon reduction Options…
Massive reduction in consumption of energy
Massive behavioural change
Massive switch to renewable energy
Massive investment in new low/zero carbon technology

10. Climate Negotiations Why the health sector?
Climate change is a threat to health:
Heatwaves/Floods/Droughts
Vector borne disease eg Malaria, Dengue
Malnutrition/Diarrhoea
Injury and death through conflicts over scarce resources
Stress/lack of food/lack of water/disease caused by migration

11. Climate Negotiations Why the health sector? (2)
Can take the long view
Understands the science
Other health initiatives will be overtaken by the effects of climate change
Action on climate change has health effects itself
Positive (“health co-benefits”)
Negative

12. Health effects of action on climate change
CAN YOU
SUGGEST SOME
Positive effects?
Negative effects?

13. Health effects of action on climate change
More physical activity: improved quality of life, reduction in obesity, heart disease, stroke, diabetes, road deaths – plus reduced travel emissions
Reduced meat/dairy consumption and increased consumption of local seasonal vegetables: reduction in cancer, obesity, heart disease – plus reduction in CO2 and methane emissions
Improved insulation: reduced winter mortality, asthma and other respiratory complaints – plus less energy used for heating

14. Health effects of action on climate change
Carbon Taxes: exacerbate health inequalities?
Carbon Quotas/Trading: redistributive of wealth (but could they provide an incentive for population growth?)

15. What is the health sector doing internationally on climate change?
IPCC working group (summarises impacts on human health – feeds into Assessment Reports)
World Health Organisation
Climate and Health Council

16. Climate Change and Health Professionals: The Global Perspective
Climate Connection Launch December 2008
Climate Change and Health Professionals: The Global Perspective
Maria Neira, Director, Public Health and Environment Department World Health Organization, Geneva

17. Why the response needs to be global
Cumulative emissions of greenhouse gases, to 2002
WHO estimates of per capita mortality from climate change, 2000
Map projections from Patz et al, Ecohealth 2007.
WHO Comparative Risk Assessment estimated that by 2000, climate change that had occurred since the 1970s was causing over 150,000 additional deaths per year (WHO, 2002, McMichael et al 2004)

18. Sixty-First World Health Assembly
May 2008
New resolution on climate change and health adopted unanimously by 193 Nations
The resolution draws attention to the further strengthening of the evidence for human-induced climate change, and consequent risks to global health.
It calls on WHO to strengthen its work in raising awareness of the health implications of climate change, collaborating with other agencies within and outside the UN, supporting capacity building and research in health protection from climate change.
The resolution also calls on Member States themselves to further strengthen the engagement of the national health sector. It urges them to develop health measures and integrate them into adaptation plans; to build the capacity of public health leaders to be proactive and take rapid and comprehensive action; strengthen the capacity of health systems to prepare for and respond to natural disasters; promote health sector engagement with other sectors to reduce risks; and commit to meeting the health challenges of climate change.

19. Main objectives for international public health
Raising awareness: of the health implications of climate change
2) Strengthening partnerships: to place health at the centre of climate change policy
3) Generating evidence: on the health effects of adaptation and mitigation policies
4) Strengthening public health systems to cope with additional threats posed by climate change

20. 1. Raising awareness Climate change hurts
With impoverished populations in the developing world the first and hardest hit, climate change is very likely to increase the number of preventable deaths. The gaps in health outcomes we are trying so hard to address right now may grow even greater.
This is unacceptable.
Climate change and health: preparing for unprecedented challenges.
WHO Director General Margaret Chan.
December, 2007
Plus World Health Day 2008
Climate change hurts
World Health Day 2008: Protecting health from climate change.

21. 2. Partnerships to raise the profile of health in climate change policy
Why health should be central:
Main reasons for concern (e.g. disasters, food shortage, displacement, disease) are health and wellbeing issues
Most energy and environment decisions (e.g. choice, use of fuel sources) have major direct health implications
WHO speaks out on behalf of the health community in the international negotiations – and national health sectors are becoming more engaged.

22. 3. Providing Evidence Health Adaptation
Describing risks from national to global level
Measuring the effectiveness of interventions
Evaluating health effects from decisions in other sectors
Improving decision-support tools
Assessing the financial costs
WHA resolution defined the headlines for a very practical research agenda on climate change and health. WHO is coordinating the development of this agenda.
Figure: Effective interventions exist, but may be compromised by climate change. The figure shows the means and 95% confidence intervals for various studies of the protective effect of handwashing against diarrhoea. Studies highlighted in blue took place in situations of low water availability, and show less protection than the average (dotted line).
Protection of handwashing against diarrhoea, highlighting studies in water-stressed situations.
Adapted from Curtis V, Cairncross S. 2003; Lancet Inf Dis 3:

23. 3. Providing Evidence:
Improving health while reducing greenhouse gas emissions
"Health benefits from reduced air pollution as a result of actions to reduce greenhouse gas emissions… may offset a substantial fraction of mitigation costs" – IPCC, 2007
We have an opportunity to reduce:
- The 800,000 annual deaths from urban air pollution, and the 1.6 million from indoor air pollution
- The loss of 1.9 million lives, and 19 million years of healthy life, from physical inactivity
- The 1.2 million deaths and over 50 million injuries from road traffic accidents

24. 4. Strengthening public health systems
Much of "adaptation" is basic, preventive public health:
Improved surveillance and response: E.g. heatwave warnings, compliance with International Health Regulations to prevent international spread of disease.
Better management of environmental health determinants: Provision of safe water and sanitation, control of air pollution
Strengthened action on diseases of poverty: Including wider coverage with vector control and vaccination programmes.

25. What is the health sector doing internationally on climate change?
IPCC working group (summarises impacts on human health – feeds into Assessment Reports)
World Health Organisation
Climate and Health Council

26. The Climate and Health Council
“Our aim is to mobilise health professionals across the world to take action to limit climate change”
Pledge – aiming 10,000 signatures from health professionals by Copenhagen (Nov 2009)
Co-benefits report

27. What can the UK public health community do internationally?
Raising awareness
Partnerships: raising profile of health climate change
Generating evidence
Health adaptation
Improving health through mitigation (co-benefits)
Strengthening health systems

28. World Health Organisation www.who.int/globalchange/climate/en
Get informed

29. Climate and Health Council www.climateandhealth.org
Sign the declaration and contribute to the five actions

30. The Climate Connection www.theclimateconnection.org
Build partnerships, share evidence, experience and ideas

31. Summary
2009 is a crucial year for international negotiations on climate change with the Copenhagen post-Kyoto negotiations in December. Public health has an important contribution:
advocacy for radical action
communicate value of co-benefits
advise on health impacts of adaptation & mitigation policies

32. The Climate Connection is a partnership for public health action on climate change
The Climate Connection, c/o UKPHA, 94 White Lion St, London N1 9PF
UKPHA registered charity number