The agreement on greenhouse gas (GHG) emissions in Copenhagen this December will be a pivotal decision determining global public health in the 21st century. Let us not forget that the ultimate impact of all climate change threats to environment, economy and security will be on human health.
Dr Margaret Chan, Director-General of World Health Organization (WHO)02/04/2009 15:00
I am concerned, however, that policy makers in all sectors are not giving enough attention to these health impacts in their current discussions to curb climate change. Let me be very clear. Business-as-usual decisions would result in far reaching and devastating health consequences, particularly for the poor. Equally important is the fact that placing a strong and equitably distributed cap on GHG emissions will bring major and lasting global health improvements.
The scientific evidence is overwhelming. The warming of the planet will be gradual, but the increasing frequency and severity of extreme weather events – intense storms, heat waves, droughts, and floods – will be abrupt and the consequences are being felt already. Climate scientists once again emphasized at a recent meeting in Copenhagen that the longer we delay in addressing climate change, the greater the risks become. If we delay too long, we risk progressive and unstoppable climate instability that would blight humanity for millennia.
Feasible improvements in environmental conditions could reduce the global disease burden by more than 25%. Reducing GHG from energy consumption and transport systems, for example, would have the added benefit of addressing some major public health issues, including outdoor air pollution (800 000 annual global deaths); traffic accidents (1.2 million annual deaths); physical inactivity (1.9 million deaths); and indoor air pollution (1.5 million annual deaths).
In countries where cars are the predominant means of transport, shifting to more walking and cycling will lower carbon emissions, increase physical activity (which will reduce obesity, heart disease and cancer), reduce traffic-related injuries and deaths and result in less pollution and noise. In countries where solid fuels are the predominant form of household heating and cooking energy, changing to cleaner fuels and getting more efficient stoves will lead to fewer illnesses and deaths related to indoor air pollution.
WHO's Member States highlighted the importance of action to protect health from climate change and realise the benefits to health from reduced emissions in WHA resolution 61.19 2008 and again at the Executive Board meeting in January this year. Countries are seeking greater WHO support in their efforts to assess and address the implications of climate change for health and health systems.
Based on WHO estimates around 150,000 additional deaths now occur in low-income countries each year due to climate change from four climate-sensitive health outcomes – crop failure and malnutrition, diarrhoeal disease, malaria and flooding. Almost 85% of these excess deaths are in young children
WHO and Intergovernmental Panel on Climate Change (IPCC) projections indicate that business-as-usual scenarios will affect, in profoundly adverse ways, some of the most fundamental determinants of health: food, air, water. This is what concerns me the most. The earliest and most severe threats from these impacts are to developing countries, where undernutrition is already widespread and health system infrastructures are weak. Climate-sensitive risk factors and illnesses are currently among the most important contributors to the global burden of disease; these include 3.5 million deaths from undernutrition, 2.2 million from diarrhoea, 0.9 million from malaria.
Of major concern to us is the fact that climate change threatens to reverse progress made towards the Millennium Development Goals (MDGs). Poverty cannot be eliminated while climate change exacerbates malnutrition, disease and injury.
The Stern Review (2006) and other economic projections estimate that the costs of unconstrained business-as-usual paths for emissions will be 5% of GDP per year by 2050. Current estimates indicate that, when the costs of the direct and indirect health impacts of climate change are added, costs rise to 11-20% GDP.
Effective measures to reduce greenhouse gas emissions need not prevent substantial economic growth. Importantly, they can save money from not having to cover the health-care costs of climate change related environmental health risks (e.g. respiratory problems caused by air pollution) and lost work time. These savings often match or exceed the costs of tackling the hazard itself.
As we debate these issues let us not forget that, even if greenhouse gas emissions were to stop today, the consequences will be felt throughout this century and beyond. To adapt to these threats health systems will need to be strengthened. All the major studies reach the same conclusion. Countries with robust and inclusive health systems will be best able to withstand the added shocks and stresses of climate change.
Activities that strengthen health capacities in fundamental ways become especially important at a time of global financial crisis and economic downturn. They signal the need to step up health protection, rather than cut it back, as the smartest possible response.
I strongly urge you to use these health arguments as you make policy and investment decisions in the run-up to COP15. The post-Kyoto agreement must ensure that all can share in the health and economic benefits of clean energy, poverty reduction and equitable human development.Dr Margaret Chan is Director-General, World Health Organization (WHO).
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