Secretary-General Professor
Obasi,
Excellencies,
Ladies and Gentlemen,It gives me great pleasure on behalf of WHO to share the platform
with Professor Obasi, Secretary-General of the World Meteorological Organization, on World
Meteorological Day.
In WHO we have put a new emphasis on reaching out to our external partners - to other
agencies in the UN family, to the research community, to partners in civil society and to
the private sector. We do so because we believe we can achieve more by pulling together
and looking for solutions to health and development across traditional borders.
Working closely with WMO has been ongoing for many years. For good reason. We are
brought together on the broad agenda of sustainable development.
Our area of common interest can be described sharply and briefly:
We have evidence to state that climate change - by altering weather patterns and by
disturbing life-supporting natural systems and processes - affects the health of human
populations.
There are many effects of these changes. And there is still discussion on the exact
causality between human behaviour and climate change. But we know enough to take this very
seriously and we have every reason to be concerned about adverse consequences for human
health. The world's climate is warming and we know that human behaviour has a role in that
phenomenon through the sharply increasing emission of greenhouse gases. We must expect
that this trend, if continued, will have profound consequences for life on Earth and for
the health of human beings.
The purpose of my address here today is to focus on the health implications and to
reiterate WHO's commitment to continue its work on environment and health, and in
doing so to work closely with WMO.
We need to bring our findings together. Sustainable development cuts across sectors and
calls for action by all parts of society. This was the message of the World Commission on
Environment and Development. Environment is where we all live. Development is what we all
do to improve our lot within that abode. The two are inseparable.
It takes little effort to point to some obvious health consequences of recent climatic
drama. Disasters like Hurricane Mitch and Hurricane George are ruining entire health
systems and the economies needed to support them. Honduras and neighbouring Nicaragua are
now rife with cholera, malaria, dengue fever, respiratory diseases and rodent-borne
leptospirosis.
Floods in China and Bangladesh have had devastating effects on the health of millions
and millions. I saw with my own eyes the extensive burden put on China in protecting
against emerging diseases and epidemics following the floods - weeks after the water had
receded.
Such dramatic events place a particular burden on the poor. Some question that -
clinging on to the belief that the weather is the only thing that treats all people
equally. As the saying goes: no matter whether you are rich or poor, everybody gets wet
when it rains.
But that gives a false picture. Even when it comes to weather, the poor are worse off.
Much worse.
When a storm hits, the poor are most likely to live near the waterfront and in
low-lying areas. Their sheds are made of flimsy material which easily get smashed to bits
by wind and water. And when the storm has passed, leaving destruction and disease in its
path, the poor have no insurance to pay for damage and treatment. Their water supply is
more likely to be contaminated, and the risks of them falling victim to epidemics is much
greater than for the better off.
This we all know. But what is becoming increasingly clear is that the poor are also
bearing the main burden of the long-term climatic changes to our environment.
Recent assessments by health scientists working within the Intergovernmental Panel on
Climate Change have confirmed that poor populations tend to be the most vulnerable to the
health impacts of climatic variation and climate change.
This is a serious cause for concern. Social inequality and environmental issues are
intimately connected.
Just as it is the poor who bear the brunt of the HIV/AIDS epidemic, malaria and
tuberculosis, it is they who would be the most vulnerable to heatwaves, floods,
temperature extremes, sea-level rise and, of course, El Niño.
About 60% of today's carbon dioxide emissions come from industrialized countries -
and even more have done so historically. Yet the anticipated impact of climate change will
fall largely on developing countries, where nearly 80% of the world's population live.
Global models project a 1 to 3.5 degrees Celsius rise in global temperatures by the end
of the next century. This would be the fastest rate of warming over the past 10,000 years.
Health scientists estimate that it would increase the relative size of the population at
risk of malaria, dengue, yellow fever, cholera, Rift Valley Fever, and various other
infectious diseases.
Let us talk for a minute about malaria - a special concern for WHO.
Malaria is on the increase in the world at large, but particularly in Africa. More than
300 million new cases of malaria - perhaps as many as 500 million - occur every year, and
one million people die annually. Children are, as always, the most vulnerable, with most
of these deaths occurring in sub-Saharan Africa.
WHO has launched Roll Back Malaria to rally forces against a disease which not only
causes serious human suffering but also represents a real roadblock to social and economic
development. Roll Back Malaria is driven by WHO in partnership with UNICEF, UNDP and the
World Bank and a broad alliance of public and private partners.
The link to the environment is striking. We need only to follow the breeding
environment for mosquitoes. They enjoy floods, unsafe water and a warming climate. A
mosquito can happily breed in a footprint.
During periods of extreme temperature or altered rainfall, many areas of the world have
been shown to experience a marked increase in malaria cases. Quantitative leaps in malaria
incidence have been recorded in recent decades in Colombia, Ecuador and Venezuela in South
America, in Rwanda in Africa, and in Pakistan and Sri Lanka in South Asia.
In several locations around the world, malaria is now reported at higher altitudes than
in preceding decades, such as on the mountain plateaus in Kenya. We cannot yet be sure of
the reason - and there are probably several. One possibility that we have to take
seriously, if the trends continue, is that climate change is contributing to the spread of
this major disease. Health scientists, including some at the Copenhagen and Rome offices
of WHO, are beginning to address this as a serious research issue.
The impact of climatic variation goes beyond malaria. The drought-related forest fires
in Indonesia, parched by an El Niño event, resulted in a dramatic increase in cases of
respiratory diseases in cities in Malaysia. There is circumstantial evidence of a close
connection between El Niño-caused changes in coastal water temperature, weather and
outbreaks of cholera. More generally, cholera can be linked to floods which contaminate
water supply, or to droughts which make hygiene more difficult and also contaminate the
water that remains.
Let me give you a specific example. In Tanzania in September and October 1997, heavy
rainfall and flooding led to 40,000 cases of cholera, a huge increase beyond the 1,460
cases the previous year. About 2,200 people died in 1997, compared to 35 deaths in 1996.
An unforeseen consequence of the East African cholera epidemic was its economic cost.
Europe refused to accept fish imports from the region because of the marine reservoir for
the cholera bacteria. It is a vicious circle. Extreme weather and outbreaks of diseases
cause human suffering and retard economic development.
Beyond the diseases there are other health consequences of climatic variations. There
will be increased impact, particularly on urban populations, of hotter summers and
especially heatwaves.
It can be argued that a warming climate may open up new areas for agricultural
production. That may gradually become true, but it is hard to believe that this will
outweigh the negative implications of an increasingly unstable climate. Let me take but
one example: climate change may impair agricultural production in some regions -
particularly in various poorer countries where food insecurity already exists. Food and
water shortages, due to a combination of increasing demand and climate-induced downturns
in supply, may heighten tensions between populations and countries in some of those
regions. The implications for public health are as sad as they are obvious.
Let us also include the consequences of rising sea-levels. If coastal protection
systems are not strengthened, a 50 centimetre rise in sea-level by 2100 would place 80
million people in danger of being flooded more than once a year, compared to 46 million
people under present climate and sea-level conditions.
The displacement of so many people to already densely-populated delta areas and on
populous island states would be bound to result in outbreaks of diseases like diphtheria
and diarrhoea, just to mention the most obvious ones. The rising water table along the
coast could also encourage the release of pathogens into septic systems and waterways.
There would also be nutritional, physical and psychological health impacts.
Again - and as always - the poor, the elderly and children will be the most vulnerable.
It also goes without saying that the consequences of sea-level rise will be much more
serious for developing countries and their people than for industrialized societies and
their peoples. Developing nations are less able to respond to food and water shortages and
to deal with epidemics.
Closely associated with climate change is ultraviolet radiation due to depletion of the
stratospheric ozone. This environmental change, now well documented, results from an
essentially separate process from that of greenhouse gas accumulation in the lower
atmosphere. Nevertheless, the two processes influence one another.
Exposure to ultraviolet radiation would result in an increase of non-melanoma skin
cancer, particularly in light-skinned people. It is also a near-certain cause of
cataracts. Less certain, but potentially important, is the suppressive effect of
ultraviolet radiation on the human immune system.
We recognise the possibility - and that is all there is at this stage - that this
effect could reduce the effectiveness of vaccine programmes. One of WHO's most successful
programmes over recent decades has been the massive immunization of children. We therefore
must remain alert to this possible consequence of ozone depletion.
What can be done to meet these profound challenges?
At the outset we need to revert to the broader agenda of sustainable development. The
message of Our Common Future - reiterated at Rio - was the link between environment and
development. We called for a new era of economic growth - growth that is forceful and at
the same time socially and environmentally sustainable.
In that process the developed countries must show their share of solidarity. Poverty is
in itself the prime polluter. Populations have a right to lift themselves out of poverty.
The developed world cannot pull up the ladder and say: sorry - we filled the waste baskets
- there is no room left for you. We need to continue the work to take the Climate
convention further - step by step - based on evidence, and new mechanisms of burden
sharing.
Health is a yardstick for how we succeed. In the health field, concerted action over
the past 50 years has led to significant progress. Half a century ago, the majority of the
world's population died before the age of 50. Today average life expectancy in developing
countries is 64 years and is projected to reach 71 years by 2020.
But as we pride ourselves on the positive trends in the traditional macro-indicators of
health status - life expectancy and infant and child mortality - poverty has been eating
away at many of the health gains. Reversing this trend - in fact aiming at halving the
number of people living in poverty by 2015 - will call for commitment and action. The work
may be even harder if the changing climate creates new obstacles for us.
But we can also apply another perspective and look at health policy in itself as a
means to reduce the impact of extreme weather patterns. Equitable, cost-effective health
systems that improve the health conditions among poor, that assist in reducing poverty,
free resources that can be used to improve preparedness.
Health systems which reach and treat all people will ensure that those who are most
exposed to the vagaries of weather will, at the least, not have to suffer unduly in the
aftermath. Working to raise the living standards of all people will ensure that everyone
is less likely to be, literally, swept up or aside by the next extreme weather event.
Increased living standards will mean better health systems, better living conditions, more
resources to prepare for the next extreme weather event - and as a bottom line - new
opportunities to foster human, social and economic development.
There are a number of specific actions that can be taken to increase preparedness for
extreme weather patterns and improve the assistance in the wake of these events. As a
member of the "climate agenda" inter-agency programme, WHO's task is to help
link the monitoring of health impacts with the monitoring of climate and associated
impacts. For example: improvements in predicting and monitoring unusual weather
occurrences, such as El Niño, will allow us to take pre-emptive measures to reduce the
public health impact of such events.
We have recently compiled a comprehensive report on the health impacts of El Niño
events. We need to develop our ability to respond to an increasingly diverse set of
humanitarian crises - particularly in the disaster preparedness phase, but also in
follow-up support to populations after the event.
This brings me back to where I started - to much needed partnerships. We in the health
sector are very dependent on working with WMO. We are grateful to you, Professor Obasi,
for your Organization's data inputs to our work.
There are numerous current health impacts of climatic variation in today's world and
many potential impacts of the anticipated future changes in world climate. These health
impacts weaken our ability to counter various disease problems - from rolling back
malaria, to maintaining good nutrition, to sustaining our highly effective immunization
programme.
The task is complex; the scale is often unfamiliar; and there is a clear need to take
coordinated intersectoral action.
But that is what we intend to do. At WHO we will set up a Task Force on the health
dimension of the global climate agenda, including climate change. This Task Force will
ensure that issues related to climate variation and climate change are adequately
addressed, future health impacts are anticipated, and our preparedness for disasters is
enhanced.
WHO is ready to work with WMO and other partners to undertake this major task.
Thank you. |
