Climate change and human health

COP15 United Nations Climate Change Conference 2009

7 - 18 December 2009
Copenhagen, Denmark

WHO side event

During the high level segment on Thursday 17 December, WHO held a side event on Protecting Health from Climate Change. The WHO side event at COP15 involved Senior Ministers and representatives of the health community from Parties, NGOs and civil society in a well-attended debate. Although the UNFCCC Secretariat decided to limit the entrance of NGO representatives, they have shown a committed interest in the issue and the lively session which ensued, is testimony to how WHO is actively involving the health sector in responding to the climate change challenge.

The robust dialogue heard country examples to enhance adaptation, opportunities for health protection and promotion from 'healthy' mitigation policies, in areas like transport and energy production, and the mutual benefits of a more coordinated agenda between the health and climate communities. WHO stressed that cutting carbon can bring direct health benefits. The Organization also highlighted the importance of considering the health argument being taken into account when decisions of mitigation are taken.

The audience responded to the dialogue by stressing the importance of WHO partnering with national focal points on climate change to strengthen at a country and regional level, as well as to work collectively on different policies that will highlight the work that is being done.


Hon (Mr) Abdul Bari Abdullah, State Minister of Health & Family, Ministry of Health & Family, Republic of Maldives
"The President of the Maldives is very much involved in greening the health sector. For example, we have been promoting ocean water cooling, a possible solution for air pollution. In addition to that there are other things we are looking at, for example, waste management which is another component to greening the health sector. It is not only the environment or transport sector that can reduce GHGs. The health sector needs to do its part."

Dr. Guilherme Franco Netto, Director, Environmental Health, Ministry of Health, Brazil
"Brazil is a country which is committed to the UNFCCC negotiations since the beginning, in 1992. This year, Brazil installed the national policy on climate change and this is linked with our working plan in general. One of the components of the plan, is to reduce social vulnerabilities related to climate change. Within this objective, we developed a health sector working plan. There are several components to this plan. We have some priorities including vector-borne disease issues, the disease related to pollution and injuries related to disasters. We have been doing a lot of work since 2007, including running workshops and seminars for the country and for regions. We are trying to have a plan that is able to communicate with the countries that we have important agreements and negotiations with."

Sir Andy Haines, Dean, London School of Hygiene and Tropical Medicine, London, UK
"Recently, an international team of researchers, led by the London School of Hygiene and Tropical Medicine, modelled the health effects of different policies to reduce greenhouse gas emissions in high and low income countries. Case studies focused on four key sectors: power generation, transport, household energy, and food and agriculture.
Many measures to reduce greenhouse gas emissions will have positive impacts for health in both high- and low-income settings. These co-benefits will offset some of the costs of mitigating climate change, and should be taken into account in international negotiations.
For example, in low-income countries, inefficient traditional solid fuel stoves create very high levels of indoor air pollutants. National programmes to introduce low-emission stove technology could avert millions of premature deaths, and constitute one of the strongest and most cost-effective climate-health linkages.
Cutting emissions through more walking and cycling, and reducing motor vehicle use, will bring substantial health benefits, including reduced cardiovascular disease, depression, diabetes and dementia."

Hon. Gatoloaifaana Amataga Alesana-Gidlow, Minister of Health, Samoa
"I will speak on behalf of the Pacific Islands. We already have negative effects of climate change in Samoa. Samoa is amongst the most vulnerable. Flooding is now more common than ever before. Whole families, villages and districts have been affected socially, physically and mentally.
We have invested heavily in promoting local production and using renewable energy. There should be a National Adaptation Action Plan, with health as one of the main actions.
Good early warning systems are essential for us. We don't have enough doctors and nurses to answer during catastrophes' like tsunamis. We realize the need for having a good early warning systems, to mitigate and adapt to climate change."

Dr. Olavi Elo, Representative from UNAIDS
"20 years ago, getting an HIV infection was practically a death sentence. The treatment today is still lifelong, and there is no cure. Prevention is still the only practical way to go. Brazil tackled the AIDS epidemic early on and it never took off the way it did in Sub-Saharan Africa. Early action on climate change is the same thing. Civil society empowerment is critical. In virtually all countries today, civil society is playing a positive role."

Other relevant meetings and side events in 2009

United Nations (UN), "Advancing work on adaptation to climate change: A United Nations system perspective"

Monday, 14 Dec (13: 00 - 14:30) -- The UN system is committed to assisting countries in adapting to the impacts of climate change, while tackling poverty and achieving growth. The event will showcase good practices and resources developed by the system in key adaptation areas.

Presentation at the iSeeT kiosk on Monday

14 December (15: 15 - 15:45) -- iSeeT was the 2009 exhibition of the secretariat of the United Nations Framework Convention on Climate Change (UNFCC) which focused on how information and communication technologies (ICTs) are helping to increase awareness and to support concrete action on climate change in both developing and developed countries. Dr Roberto Bertollini gave a 45-minute presentation on Protecting Health from Climate Change: The Global Response.

Health briefing on Monday

14 December (16: 00 - 17:00) -- The WHO delegation at COP15 organized an informal round table discussion in order to have a mutually beneficial interactions among the key health stakeholders, exchange information, raising awareness and actively involving the health sector/people in responding to the climate change challenge.

International Labour Organization (ILO), “Addressing social consequences of climate change: impacts on development, employment, Health and gender”.

Tuesday, 15 Dec (13:00—14:30) -- The event organized by ILO, with the participation of WHO, UNIFEM, UNDP, UNICEF, explored the climate change impacts affecting the daily lives of people everywhere in terms of employment and livelihoods, health, gender equity, increasing vulnerabilities and sustainable development.


Tuesday, 15 Dec (all day/various locations) -- The event explored the human impact of climate change/humanitarian concerns including water scarcity, youth, food insecurity, DRR, public health, migration/displacement. The events were attended by WHO (ADG HAC, Dr. Eric Laroche) and by the WHO Goodwill Ambassador Mr. Jet Li who called for urgent action on the adaptation and reduction of risk of disasters to protect the world's most vulnerable communities. The events that took place in the framework of the “Humanitarian Day” at COP 15 stressed the urgency with which the world community needs to act to address the very real challenges already affecting the poorest and most vulnerable countries, especially children and youth.

United Nations Environment Programme (UNEP), "First steps towards a low-carbon United Nations"

Tuesday, 15 Dec (20:00- 21:30) -- Following the call by the Secretary-General to safeguard our planet and climate, first steps have been taken to manage the greenhouse gas impact arising from the United Nations' operations. This event reviewed progress made in a selection of the diverse array of institutions that make up the UN system. The study made by WHO about our own carbon footprint has been included in the final UNEP report on a Carbon Neutral UN.

United Nations (UN), "The United Nations system delivering as one on climate change"

Wednesday, 16 Dec (2009 18:15—19:45) -- This event will provide an overview of United Nations system capacities and confirm the system's commitment at the highest level to further assist Parties to UNFCCC in planning and implementing measures to address climate change in adaptation, capacity building, technology transfer, REDD and other areas.

Media monitoring - WHO at COP15

Events convened on Thursday, 17 December 2009.1

ENB on the Side - A Special Report on Selected Side Events at the Fifteenth Conference of the Parties to the UN Framework Convention on Climate Change (UNFCCC) and Fifth Meeting of the Parties to the Kyoto Protocol (COP 15 and COP/MOP 5).

Franklin Apfel, World Health Communication Associates, opened the session, noting that it would discuss the human health dimensions of climate change.

Maria Neira, WHO, stated that despite some climate change-related “inconvenient truths” for human health, including the large numbers of deaths from malaria, malnutrition and extreme weather events, there are also “convenient opportunities,” namely that: linking climate change and health solutions can be simple; we have cost-effective interventions against all climate-sensitive health impacts; and cutting carbon can bring direct health benefits.

Stating that the health sector can take a leadership role on climate change issues, Abdul Bari Abdulla, Maldives, discussed potential GHG emission reductions in the health sector. Guilherme Franco Netto, Brazil, highlighted a national working plan in his country that focuses on, among others, how to reduce: social vulnerabilities; vector-borne disease; disease from pollution; and injuries related to disasters.

Sir Andrew Haines, London School of Hygiene and Tropical Medicine, UK, highlighted recent research that identifies opportunities for improving public health across various sectors, including in food and agriculture, electricity generation and urban transport. He stressed that public health benefits can help to offset the costs of GHG mitigation.

Gatoloaifaana Amataga Alesana-Gidlow, Minister of Health, Samoa, discussed various climate change impacts specific to Samoa and other small island states. She highlighted that incidences of vector-borne diseases, such as dengue fever, are likely to increase with climate change and that new diseases, such as malaria, are expected to affect Samoa.

Jochen Flasbarth, Federal Ministry of the Environment, Germany, stressed the need to raise awareness about health-climate linkages, not only in the general public but also among politicians. He highlighted that adaptation and health must be addressed through a systematic approach and noted the importance of cooperation among various ministries on this issue.

Amb. Cristina Barrios, Spain, underscored that there are many dramatic interactions between climate change and human health. She referenced the results of a recent meeting in her country that adopted a research plan to study, among other things: the long-term impacts of climate change, such as declines in freshwater, on health; how to improve the effectiveness of short-term interventions; and the health impacts of policies in non-health sectors, such as the impact of biofuel production on food security.

Olavi Elo, UNAIDS, reflected some lessons learned from his organization’s work on addressing the AIDS epidemic, which he said could be useful to the current the health-climate discussions. He stressed the importance of: early action; joint programming across agencies; and the “empowerment” of civil society in finding solutions.

Participants asked questions throughout the event on topics including: the role of health in the UNFCCC negotiations; next steps for implementing health-related climate policies; how civil society can participate in negotiations and access data; and the types of WHO and government activities that participants would like to see to address the issues discussed by the presenters.

Jochen Flasbarth, Federal Ministry of the Environment, Germany, stressed that the largest health benefits can be realized by promoting “active transport,” such as walking and biking.

Gatoloaifaana Amataga Alesana-Gidlow, Minister of Health, Samoa, emphasized that health is identified as a priority area in her country’s NAPA.

Maria Neira, WHO, highlighted various examples of synergies between health and climate change policies, providing the example that providing sustainable urban transport could cut heart disease by 10-25% in developing countries.

COP15 delegates encourage WHO to press home the health message.2

Make more noise! This was the message to WHO at their side event at the climate change conference on 17 December 2009. Climate change threatens human health, but as the audience pointed out, the wide-ranging health impacts have not been adequately emphasized and more importantly, neither have the considerable co-benefits to health that would be achieved by climate change mitigation and adaptation measures.

How many lives do we want to save? Maria Neira, Director of Public Health and Environment at WHO, listed some inconvenient truths. Globally, under-nutrition killed 3.5 million people a year, diarrhoea killed 2.2 million, malaria killed 900,000 and extreme weather events killed 60,000. All these global killers were highly sensitive to changing climate. Climate change was likely to be the biggest global threat to health of the 21st century.

It had been happening for some time. A WHO comparative risk assessment had estimated that by 2000, climate change that had occurred since the 1970s was already causing over 150,000 additional deaths per year.3

However a convenient truth was that linking climate change to health solutions could be simple. Lisa Jackson, the Administrator of the US Environmental Protection Agency had told the Conference that the instrument that the Agency was about to use to regulate greenhouse gas emissions was based on showing that they endanger public health, and the same regulations could be used to address other health-threatening pollutants.

Lives could be saved now, by what Lisa Jackson had called “common-sense measures”: proven, cost-effective interventions against every climate-sensitive health impact. They included clean water and sanitation, bed-nets for vector control, disaster risk reduction, early warnings, and humanitarian aid. All these deaths were preventable if health protection was prioritized, and if adaptation aid was additional to official development assistance.

Cutting carbon would bring direct health benefits, for example, the health benefits that would ensue from reduced air pollution as a result of reducing greenhouse gas emissions could offset a substantial fraction of mitigation costs.4 In both developed and developing countries, sustainable urban transport could cut heart disease by 10-25%. Clean household energy would reduce indoor air pollution: improved stoves in India could save 2 million lives in India over 10 years. If health promotion measures were prioritized, mitigation was much more cost-effective.

If under a new climate change treaty carbon was reduced, global temperature stabilized and health improved, the result would be a cut in the 2 million deaths globally every year from indoor air pollution, the 1.2 million deaths from outdoor air pollution, and the 3.2 million deaths from physical inactivity.

Some countries could already see the impacts on health from climate change: they were already happening. A speaker from the Maldives described some of the urgent measures that were under way to help the population survive despite the rising sea levels. The health sector was taking a lead, cooperating with other sectors such as energy and transport. Health Minister Alesana-Gidlow from Samoa described how vulnerable the Samoan population was, with three quarters of them living in low-lying areas. Many people had been killed by the tsunami, and their chief crop was entirely destroyed, which affected both food security and the economy. Groundwater supplies were under threat. Some diseases were now more virulent, and they feared the arrival of malaria. They were planning both mitigation and adaptation measures, and investing in low carbon energy. In Bangladesh, a third of the entire country would be underwater if climate change continued at the same rate. There was evidence of increased rate of infectious diseases. Their emissions were among the lowest in the world, but they would be one of the worse affected.

Brazil had a national policy on climate change, and one its objectives was to reduce social vulnerability due to climate change. A health sector plan was also being developed. Since 2007, workshops and seminars had been helping to raise awareness and come to important agreements with other countries in the Region, including the seven countries involved with the Amazon. They had a technical surveillance initiative that was going to link climate, environmental, and health surveillance and research data and prediction models, to try to understand the short, medium and long term impacts that needed to be addressed.

Professor Andy Haines described the international task force he chaired of 55 scientists doing the research for the recent series in the Lancet, which was examining the health co-benefits of addressing climate change. In the four sectors, health, energy, electricity generation, transport, scenarios had found substantial co-benefits. Urban transport was one example. Using low energy cars and promoting active transport were both effective measures. Promoting cycling and walking in cities reduced heart disease, dementia, depression, and obesity. These benefits offset the cost of the carbon reduction strategies.

Dr Joachim Flasbarth, President of Environment Protection Agency of Germany, stressed that people knew about disasters and rising sea levels, but did not understand the wider impact on health. Not only the public, but also politicians needed to know that this was a very urgent issue. Adaptation and health needed a systematic and strategic approach, it was planning for the future, and all ministries had to be involved, this was very important.

Germany had started to cooperate with even countries in the European Region, providing knowledge on adaptation and undertaking a climate change health assessment. Whatever the main problem for each individual country, whether it was increased diseases or lack of water supply, building capacity was key. Cutting noncommunicable diseases cut health costs and climate change policies offered huge areas of opportunity.

Spain had participated in various international initiatives and planned to increase their evidence base on health and climate change, planning research on five areas: the interaction with health determinants, direct and indirect effects of climate change in the long term, the effectiveness of policies against short term events such as heat-waves, the health impact of policies on the health sector such as food security and malnutrition, and strengthening the public health systems. Spain would be addressing climate change during the European Union Presidency.

The audience widened the discussion. Why would it not be possible for climate change to be declared a public health emergency, as had happened with the Montreal Protocol? In the talk about the health sector and health systems, what was the role for civil society? It was agreed that in the climate change debate there was an imbalance: more emphasis should be put on protection of human health, to much emphasis on production and not enough on distribution. Experience with HIV/AIDS showed that prevention had to be the way to go, and that involving civil society was empowering, they were part of the solution. It was important to join with other agencies, working with multiple institutions.

The audience recommended that WHO should raise a strong voice about putting climate change on the primary health care agenda. They suggested that WHO should work with national focal points of the Climate Change Convention: it was essential that ministries of health should designate an individual that would be part of each country’s negotiating team. They also suggested that in their climate change work, WHO should pay more attention to dietary issues and promote eating less meat.

WHO should work with other UN family members on adaptation programmes. Health professionals should speak out more and cut the health sector’s own emissions, which were sizeable. Climate change measures should be in the training curricula for health professionals. Young people should be involved.

Voices had to be raised, to reach the delegates in time to improve the international agreement. This was an opportunity for public health.

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