When an extreme weather event like 2009’s Typhoon Ketsana, locally known in the Philippines as Typhoon Ondoy, kills hundreds of people, and causes billions of dollars of damage to infrastructure, the links between climate change and health are painfully apparent. But the longer-term health impacts may be obscured.
Anyone working in the field will know from experience that many disaster victims get sick and die long after the skies have cleared and the television crews gone home — often succumbing to common diseases that were previously under control. Poor hygiene and sanitation, scarcity of drinking water and disruption to health services inevitably lead to an increase in mortality and morbidity, particularly among vulnerable groups such as the very young and very old.
Productivity in the workforce declines as disability, disease and hunger take their toll, which can result in long-term economic depression.
This is the aftermath of climate change. As global leaders meet this week in Paris for COP21, the aim of preventing such scenarios from occurring more frequently is the most compelling and obvious motivation for urgent international efforts to reduce carbon emissions. However, there is another category of climate-related risk that impacts health in ways that may go unnoticed by the casual observer.
Health gains at risk of unraveling
The main causes of future climate change are already killing and disabling millions of people in the present. As a side product, they impact the economy by weakening the workforce. For example, 7 million people — 1 in 8 of all deaths — die every year from the effects of air pollution. Often the cause is largely unnoticed by the victims because it is part of their everyday environment, both outside and in the home.
Similarly, climate change greatly threatens the global health advances of the previous 50 years. For children’s health, one of the areas that I lead at the World Health Organization, progress over the last two decades has been remarkable. Since 1990, child deaths have been cut by more than half, with some 17,000 fewer children dying each day. These figures are global aggregates and represent hard-won progress in millions of homes, communities and medical facilities. But the advances can quickly regress.
By 2030, conservative estimates state that undernutrition, malaria, diarrhea and other easily preventable conditions could be causing an estimated 250,000 additional deaths annually due to the effects of unchecked climate change.
Local action benefits health and climate
Fortunately, there is a flip side to the equation that increased climate change equals more illness and death. Effective measures to tackle the problem almost always result in better health, particularly in those countries most vulnerable to extreme weather. Cleaner forms of energy and industrial production not only counter climate change in the long term, they also save lives and prevent illness locally in the short and medium terms.
Look at household energy. WHO estimates that nearly 2.8 billion people worldwide cook and heat their homes primarily with solid fuels such as wood and dung. These methods account for about 4.3 million premature deaths annually — mainly in low and middle-income countries — because they expose people to high concentrations of black carbon in an enclosed space.
Most of these deaths (82 percent) are caused by strokes, heart disease and chronic obstructive pulmonary disease; many could be averted simply by switching to cleaner energy sources such as low-emission stoves. The challenge is to make these available and affordable, in sufficient quantities and with sustainable supplies of clean fuel, so that families can switch easily. But it is clear — action by countries to reduce harmful sources of household energy can have significant and immediate benefits for health.
Of course, the idea that clean air greatly benefits public health is not new. In 2011, researchers estimated that reductions in fine particle and ozone pollution since the introduction of clean-air legislation in 1970 and 1990 in the United States prevented 160,000 cases of premature mortality, 130,000 heart attacks, 13 million lost work days and 1.7 million asthma attacks in 2010 alone.
The benefits outweighed the costs by a factor of 14-to-1 almost entirely due to the health gains.
The impact of spectacular results such as these, and their implications for economic productivity, have not gone unnoticed in low- and middle-income countries, which are also recognizing and responding to the health and economic benefits of local action on climate change.
Heads of state and government have a central role to play — both in reaching a global agreement in Paris at COP21 that takes health into account, as well as making good on their promises through actions at the national level. For delegates in Paris, they will know that health was central to the original U.N. climate change convention, and it is heartening to see that it is an important part of the rationale in the draft for the Paris agreement. However, we know that in order to really support implementation of health resilience to climate change, and to gain the health benefits of mitigation policy, it should be clearly spelled out in the operative sections — on adaptation, mitigation, and on finance. This would help ensure that health plays its full role in a truly comprehensive approach to sustainable development.
But the burden of reducing illness and death caused by climate change does not rest with government alone.
Development professionals and leaders can also play a role by finding new ways to mitigate the impact of climate change through their programmes — for example, through switching to low-carbon and renewable forms of energy and looking for greener procurement and delivery processes. They can contribute to improved health outcomes simply by helping people in vulnerable areas understand and adapt to the growing threat.
Look at Senegal, a country identified by the United Nations as increasingly vulnerable to climate change. Local action by development partners has helped mitigate impact, with extremely positive benefits for public health. As a by-product of the multisector Senegal River Basin Project, 83 percent of children aged under five in the region now sleep under insecticide-treated mosquito nets. This has dramatically reduced deaths from malaria — one of the world’s biggest killers and a disease known to spread geographically as temperatures rise.
This is an important new reality for everyone involved in health and development. Whatever our specialization, we are all in some way also concerned with climate change, because it threatens to undermine everything we are trying to achieve. In the era of the Sustainable Development Goals, with its focus on integrated, multi-sector action, work on climate change does not happen in “someone else’s sector.” It affects all development work, and is therefore everyone’s business.
Local action on climate change — whether by the communities or the people that work in them — and global action on health and climate change can never be guaranteed to prevent another Typhoon Ketsana. But it is a certain way to reduce the burden of ill health, and that alone is a tremendous incentive for action.
Planet Worth is a global conversation in partnership with Abt Associates, Chemonics, HELVETAS, Tetra Tech, the U.N. Development Program and Zurich, exploring leading solutions in the fight against climate change, while highlighting the champions of climate adaptation amid emerging global challenges. Visit the campaign site and join the conversation using #PlanetWorth.