Addressing Health Adaptation Gaps: Synergies between ...Vector-borne diseases Estimated or reported...
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Addressing Health Adaptation Gaps: Synergies between Sustainable Development Goals Keynote, BSF 2019, Basel, Switzerland Guéladio Cissé 1, 2 Head, Ecosystem Health Sciences Unit Department of Epidemiology and Public Health 1 Swiss Tropical and Public Health Institute (Swiss TPH) 2 University of Basel, Switzerland
Transcript of Addressing Health Adaptation Gaps: Synergies between ...Vector-borne diseases Estimated or reported...
Addressing Health Adaptation Gaps: Synergies between Sustainable Development Goals
Keynote, BSF 2019, Basel, Switzerland
Guéladio Cissé 1, 2
Head, Ecosystem Health Sciences Unit Department of Epidemiology and Public Health 1 Swiss Tropical and Public Health Institute (Swiss TPH) 2 University of Basel, Switzerland
Overview • Insights from the UNEP
Adaptation Gap Reports • UNEP Gap Report 2018: focus on
health (Infectious diseases, Heat, Nutrition)
• How to address health adaptation gaps
• Highlights of synergies needed from SDGs
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Framework for Adaptation Gaps
Source: UNEP GAR 2014
Inappropriate, Ineffective Practice
Appropriate, Effective Practice
Adaptation Gap Knowledge Gap
Implementation Gap
Residual Impacts Gap
AdaptationGapTypology
Source: Peter Berry 2018
Appropriate, Effective Practice
Inappropriate, Ineffective Practice
Implementation Gap
Knowledge Gap Residual Impacts Gap
Adaptation Gap Over Time
Time 2050 2030
Impa
cts
Source: Peter Berry 2018
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Estimatingtheadaptationgap:morechallengingthancalculatingtheemissionsgap- Nogloballyagreedgoalormetricsforadaptation- Adaptationisaresponsetospecificclimaterisksandimpactsoftenlocalinnatureandvariableovertime-Needfindingwaysofmeasuringtheadaptationgapsothatprogresstowardsreducingitcanbemonitored
Defining Adaptation Gap: a challenge
Funding Technology Knowledge
Source: UNEP GAR 2014
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Adaptation Funding Gap
Source: UNEP GAR 2014
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Adaptation Technology Gap
Source: UNEP GAR 2014
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Adaptation Knowledge Gap
Source: UNEP GAR 2014
Adaptation gap in health
Thedifferencebetweentheclimate-relatedhealthoutcomesunderactualadaptationeffortsandtheclimate-relatedhealthoutcomesthatwouldoccurunderdesirablelevelsofhealthadaptationefforts,consistentwithasocietallysetgoalforadaptation.
Source: UNEP GAR 2018
Adaptation GAR 2018: Focus on Health
Chap 6- Heat & EEs Chap 7- Inf. Disease Chap 8- Nutrition
• Baseline situation: a significant, largely preventable, current burden of climate-related illness and mortality
• Projections
• Addressing gaps
Heat and Extreme Events
CurrentimpactsalreadythreatenhealthofvulnerablepopulationsinmanyregionsProjectedincreasesinheatandextremeweathereventsandchangingsocio-demographictrendswillfurtherincreaseexposureandrisks
Disasters,manyofwhichareexacerbatedbyclimatechangeandwhichareincreasinginfrequencyandintensity,significantlyimpedeprogresstowards
sustainabledevelopment.
SendaiFrameworkforDisasterRiskReduction2015-2030
HeatandExtremeEvents
Heat and Extreme Events Vulnerable Groups
• Theelderlyfromdysfunctionalthermoregulatorymechanisms,chronicdehydration,medicationandpre-existingdiseases
• Pregnantwomenandfoetuses;extremeheatisariskfactorforadversebirthoutcomessuchaslowbirthweightandprematurebirth
• Patientswithchronicdiseases;forexample,peoplewithdiabetes,whoareobeseandthosewithcognitiveimpairments
• Outdoorseasonalworkers
• TravellersSociallydisadvantagedorisolatedgroups
• Migrants,refugeesandinternallydisplacedpeople
Infectious diseases
Cissé et al. 2018; UNEP AGR, 2018
Infectious diseases : #20 percent of the global burden of disease (Murray et al., 2012). Three important categories of infectious diseases sensitive to climate change: (i) water-borne diseases (WBDs); (ii) food-borne diseases (FBDs); and (iii) vector-borne diseases (VBDs) Adaptation gap associated with infectious diseases, focus on WFDs and VBDs.
Infectious diseases CurrentbudenandprojectionsforWFBDsandVBDs
Exposure/outcome Currentimpacts ProjectedimpactsW a t e r -a n df o o d -b o r n edisease
• In2016,diarrheacausedaround1.7milliondeaths,includingalmost450,000inchildrenyoungerthanfiveyears(Troegeretal.,2017).
• 600millionfood-borneillnessesand420,000associateddeathsin2010(WHO,2015b).
• InEurope,themostprevalentwater-andfood-bornediseaseiscampylobacteriosis,whichishighlysensitivetoclimate(ECDC,2012).
• Global projections (WHO, 2014); 48,000additional deaths per year in childrenagedunder15yearsareprojectedduetodiarrheal disease for the year 2030 and33,000deathsfor2050.
• InEuropeinthe2080s,climatechangecouldinduceanadditional40,000casesofsalmonellaannually(Watkissetal.,2009).
Vector-bornediseases
Estimatedorreportedannualcasesofselectedvector-bornediseases(WHO,2017c):
• Malaria:212million.• Schistosomiasis:207million.
• Dengue:96million.
• Lymphaticfilariasis:38.5million.
• Onchocerciasis:15.5million.
• Globalprojections (WHO,2014):60,000additionaldeaths peryearfrommalariafortheyear2030and33,000deaths for2050.
• Climatechangewillcontinuetoincreasetheriskoftick-bornediseases(Stoneetal.,2017).
Infectious diseases Projectionsforfoodandwater-bornediseases(2)
WHO, 2014
Infectious diseases Current burden of vector-borne diseases (2)
WHO, 2014
InfectiousdiseasesProjectionsforvector-bornediseasesMostmodelsprojectanincreasedriskforVBDtransmissionathighlatitudesduringthenextcentury(Tjadenetal.,2017).
WHO, 2014
Infectious diseases
Addressbothimplementationgapsandknowledgegaps- IncreaseaccesstoWASH- InvestmoreinhealthresearchinareasthataremostaffectedbyWBDandFBD
- Moreeffortsforreducingthepopulationofparasites,microbesandvectors
- Improveintegratedvectormanagement- Reducehumanexposure- Reducetheburdenofdiseases
- MakeprogresstowardsSDGs.
Unequalexposuresandimpacts• Majorityoftheworld’shungrypeopleliveindevelopingcountries,
where12.9percentofthepopulationisundernourished.
• Poornutritioncausesnearlyhalf(45percent)ofdeathsinchildrenunderfive–3.1millionchildreneachyear.
• AsiaandAfricarepresentnearlyallofthecurrentstuntingburden.
• SouthAsiarepresentsmorethanhalfofthosewasted.• Missedtarget:reducethenumberofstuntedchildrenby40%as
comparedwith2012by2025.
FoodandNutritionalSecurity
Climatechangewillmakesitworse…• Mortality
• 95’176additionalundernourishmentrelateddeathsinchildrenunderfiveby2030and84’697by2050.
• Undernourished• [email protected]°C• 540-590millionundernourishedby2050@2°C
• Stunting• 570’000(underprosperity/lowclimatechangescenario)• >1million(underthepoverty/highclimatechangescenario)• 7.5millionmoderatelyandseverelystunted(2030)and10.1
m(2050)underbase-casesocio-economicscenario.
FoodandNutritionalSecurity
Multi-level governance: resources, sectors, and actors
FoodandNutritionalSecurity
Need Climate Resilient Health Systems
• The overall presence of health-sector activities in international climate adaptation finance stands at less than one percent.
• Additional resources are needed to build the capacities of health professionals to deal with climate-related impacts
• Accelerated action on basic climate-sensitive determinants of health within SDGs (WASH, evidence-based interventions to avoid malnutrition, etc.)
• Early warning, monitoring and DRR (including building evidence base and improving data coverage)
NEEDOFABROADERDEVELOPMENTPERSPECTIVE
HEALTH in the SDG ERA
WHO
Increase Synergies from SDGs
• Twopolicy-relatedclustersarehighlighted:WaterSupplyandSanitationandHealthandHealthcareofIndigenousPeoples.
• Water Supply and Sanitation: a central concern linking Environment and Health
• NEEDFORSUSTAINEDACTION
Nakamura et al. 2019 Web of Sc. Group
Increase Synergies from SDGs
• Africa,theArabStates,andLatinAmericaare,bycontrast,smallparticipantsdespitethefactthatSDGsarekeyconcernsintheseregions.
• EuropeannationsdominateSDGsresearch,withNorthAmericaandtheAsia&Pacificregioncontributingless,butroughlysimilar
Nakamura et al. 2019 Web of Sc. Group
EEA Report No 1/2018 National climate change vulnerability and risk assessments in Europe, 2018
Source: EEA Report 2018
Timelines of CCIV information and adaptation policy developments for Switzerland
Source: EEA Report 2018
Countries to do more for NAPs & SDGs
The Lancet 2018 391, 581-630DOI: (10.1016/S0140-6736(17)32464-9) Weneed:• Moreofthem• Betterones,insomecases• Fortheexistingonestobeimplemented
