1. Carlos Corvalan PAHO / WHO Brasilia Climate change and human health: Public health threats and opportunities

2. Environment and health Climate change and health Action where is needed An agenda for Action

4. Health Proximal causes Air pollution Water, sanitation Chemicals Vector breeding sites Radiation etc. Causes of the causes Trade Degraded ecosystems Migration Desertification Climate change Social factors not related to environment Genetic factors Transport Environment-society-individual interaction on health Energy Water scarcity

5. Health Proximal causes Air pollution Water, sanitation Chemicals Vector breeding sites Radiation etc. Causes of the causes Trade Degraded ecosystems Migration Desertification Climate change Social factors not related to environment Genetic factors Transport Physical inactivity Injuries Respiratory diseases Cardiovasc. diseases Diabetes Breast cancer Malaria Dengue Leishmaniasis etc. Malaria Cardiovasc. diseases Injuries etc. Malnutrition Diarrhoea Malnutrition Drownings Intestinal parasites etc. Environment-society-individual interaction on health Lung cancer Respiratory infections COPD Cardiovasc. diseases

6. Health Proximal causes Air pollution Water, sanitation Chemicals Vector breeding sites Radiation etc. Distal causes Trade Degraded ecosystems Migration Desertification Climate change Social factors not related to environment Genetic factors Transport Physical inactivity Injuries Respiratory diseases Cardiovasc. diseases Diabetes Breast cancer Malaria Dengue Leishmaniasis etc. Malaria Cardiovasc. diseases Injuries etc. Malnutrition Diarrhoea Malnutrition Drownings Intestinal parasites etc. Environment-society-individual interaction on health Lung cancer Respiratory infections COPD Cardiovasc. diseases Malnutrition

7. Environment and health Climate change and health Action where is needed An agenda for Action

8. Increase in atmospheric temperature Increase in sea level Snow reduction in northern hemisphere The warming is real 19002000

9. proximal causes Causes of the causes Degraded ecossistems Migration Desertification Climate change Water scarcity Energy Transport Air pollution Water, sanitation Chemicals Radiation Vector breeding grounds Health Emerging threats: Climate change

10. Health effects Temperature-related illness and death Extreme weather- related health effects Air pollution-related health effects Water and food-borne diseases Vector-borne and rodent- borne diseases Effects of food and water shortages Effects of population displacement CLIMATE CHANGE Based on Patz et al, 2000 The health effects of climate change The health effects of climate change Some expected impacts will be beneficial but most will be adverse. Expectations are mainly for changes in frequency or severity of familiar health risks

11. Health effects Temperature-related illness and death Extreme weather- related health effects Air pollution-related health effects Water and food-borne diseases Vector-borne and rodent- borne diseases Effects of food and water shortages Effects of population displacement CLIMATE CHANGE Based on Patz et al, 2000 The health effects of climate change The health effects of climate change Some expected impacts will be beneficial but most will be adverse. Expectations are mainly for changes in frequency or severity of familiar health risks Nutrition, food safety

12. Africa region South-East Asia region Eastern Mediterranean region Latin America and Caribbean region Western Pacific region Developed countries Burden of disease by region: Climate change and urban air pollution Disability Adjusted Life Year per million. World Health report 2002. Climate change Air pollution Cardio- pulmonary diseases Respiratory infections Trachea/ bronchus/ lung cancers Protein-energy malnutrition Diarrhoeal diseases Malaria Unintentional injuries Climate change impact on health > 150 thousand deaths per year

13. Environment and health Climate change and health Action where is needed An agenda for Action

14. Global inequalities: Emissions of greenhouse gases Density equalling cartogram. Countries scaled according to cumulative emissions in billion tonnes carbon equivalent in 2002. Gibbs et al

15. Global inequities: Health impacts of climate change Density equalling cartogram. WHO regions scaled according to estimated mortality (per million people) in the year 2000, attributable to the climate change that occurred from 1970s to 2000. Gibbs et al

16. The most important public health problems: Food security; Communicable diseases; Disaster risks Water quality and access Disease vectors Climate change begins with…

17. Many of the major killers are climate sensitive -Each year: - Undernutrition kills 3.5 million - Diarrhoea kills 2.2 million - Malaria kills over 900 thousand Each of these is highly sensitive to temperature and precipitation

18. The most vulnerable groups: Children under 5; Marginalized rural, urban and indigenous Pregnant women; Elderly people; populations; Displaced persons Climate change begins with…

19. Climate change: children are the worst affected 88% of the burden of disease attributable to climate change affects children under 5 The most vulnerable to environmental changes are the least responsible for their cause

20. The most vulnerable regions: Low food production; High transmission of climate sensitive diseases; Water scarcity; Island and coastal cities Mountain communities Climate change begins with…

21. Environment and health Climate change and health Action where is needed An agenda for Action

22. World Health Assembly: Resolution on Climate Change and Health, May 2008 PAHO Directing Council: Action Plan to protect health from climate change (Review September 2008) Policies and Plans of Action, WHO and PAHO

23. A strategic approach protect health from climate change Strengthen health systems locally and nationally to protect human health from risks related to climate change. Sensitization Action areas: Adaptation Resouces Evidence Partnerships

24. Evidence: Promote and support the generation of knowledge on health risks associated with climate change and on the response of the public health sector to this phenomenon. Actions: Observatory of climate and health Strengthen surveillance systems Support the generation of information on CC

25. Sensitization: Create awareness of the effects of climate change on health among both the general public and in different sectors including health sector personnel, by promoting communication and dissemination of information in a multidisciplinary approach. Actions: Sensitize decision makers Promote education, information and communication strategies Guides on education and capacity building

26. Resources: Promote the strengthening and development of human resources, financial resources, institutional development, and policy development. Actions: Include CC in health sector policies Strengthen support to countries in environmental health capacity building Mobilize resources for research, adaptation, mitigation, etc)

27. Partnerships: Promote, articulate and establish cross- disciplinary, interagency and intersectoral partnerships to ensure that health protection and promotion is central to climate change policies. Actions: Mitigation policies in the health sector Networks of experts Evaluation of the actions in other sectors Cooperation between countries Collaborating centres

28. Adaptation: Strengthen and develop the capacity of health systems to design, implement, monitor, and evaluate adaptation measures with the aim of improving response capacity to prepare for and effectively respond to the risks of climate change. Actions: Evaluation of vulnerability and adaptation National action plans Response to emergencies: include climate change issues

29. Accions, from the local to the global level At micro level Remove the vicious circle of daily survival: Destroy the local environment, cut down, burn, pollute, risking today to eat tomorrow. At macro level Protect the ability of the planet to support life: water sources, ecosystems, climate. Remove the pattern of consuming today as if there was no tomorrow.

30. Climate Change: The biggest global health threat of the 21 st century?