future scenarios: human health and the...

Future Scenarios: Human Health and the Environment

Tanja WolfWHO Regional Office for EuropeContributing Author of the health chapter of the A4 Intergovernmental Panel of Climate Change(IPCC)

Past lessons- future challenges

• Current trends• Health in IPCC scenarios• Conclusions

What I will talk about

Demographic transition

• birth rate• death rate • population

Source: OMRAN, A. R. (2005) The Epidemiologic Transition: A Theory of the Epidemiology of Population Change. The Milbank Quarterly, 83, 731-757.

Epidemiologic transition

• The age of pestilence and famine

• The age of receding pandemics

• The age of degenerative and man-made diseases

Source: OMRAN, A. R. (2005) The Epidemiologic Transition: A Theory of the Epidemiology of Population Change. The Milbank Quarterly, 83, 731-757.

Life expectancy 1950

0

10

20

30

40

50

60

70

80

90

0 2500 5000 7500 10000 12500 15000 17500 20000 22500 25000

PCI

LE

Per capita income

Life expectancy at birth

Source: Pitcher - Boulder University


0

10

20

30

40

50

60

70

80

90

0 2500 5000 7500 10000 12500 15000 17500 20000 22500 25000

PCI

LE

Per capita incomeSource: Pitcher - Boulder University


Energy boosts human development-but only to a certain extent

(HDI 1991 / 1992 per 100 countries)

Source: Reddy A K N, 2002 Energy technologies and policies for rural development

8 Tep1 Tep

Source: Energy as an Instrument for Socio-Economic Development – UNDP 1995 http://www.undp.org/energy/publications/1995/overview.htm#N-1

Energy boosts development-but only to a certain extent

Scenarios don’t always consider health

Only health determinants included

Health included

Global Scenario Group Global environmental outlook 3 (GEO-3)

Millennium project World water scenarios (WWS)

World Business Council on Sustainable Development Global scenariosWhich World

Global Trends

EPA's Environmental ScenariosProject

IPCC standardized reference emissionscenarios (SRES)

Climate change drivers

Greenhouse gases and Aerosols



Climate Change

Climate Change

Direct ExposuresTemperature and Precipitation changes

Sea level rise

Extreme events


Sea level rise

Extreme events

Indirect Exposures:Changes in ecosystems, water resources, food security, biodiversity, settlements,

Air quality


Air quality

Socio – economic developmentGovernance, literacy, education, equity, technology, consumer behaviour, etc


Health impacts

Mortality and disease from extreme temperatures

Mortality and morbidity from windstorms, floods, droughts

Malnutrition

Food, water, rodent and vector borne diseases

Cardio respiratory diseases

Allergic disordersOccupational health

Mental health

Health impacts



Malnutrition




Mental health

Adapted from Confalonieri et al, 2007; Patz et al, 2000; McMichael et al, 2003

Climate change is affecting human health

Last Ice Age

CO2 increases due to fossil fuel burning are the dominant cause of global warming

Last interglacial

350

300

250

200

Car

bon

Dio

xide

Am

ount

(ppm

v)

600 500 400 300 200 100 0Thousands of Years Before Present

[Adapted from Figure 6.3, ©IPCC 2007: WG1-AR4]

CO2 concentration breaks record

Warming is observed everywhere

IPCC (2007) Summary for Policymakers. IN SOLOMON, S., D. QIN, M. MANNING, Z. CHEN, M. MARQUIS, K.B. AVERYT, M.TIGNOR AND H.L. MILLER (Ed.) Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, United Kingdom and New York, NY, USA., Cambridge University Press.

Higher tree line

Retreat of glaciers Ice melting

Climate change is happening now

Extreme events more frequent

Adapted from IPCC (2007) Summary for Policymakers. IN SOLOMON, S., D. QIN, M. MANNING, Z. CHEN, M. MARQUIS, K.B. AVERYT, M.TIGNOR AND H.L. MILLER (Ed.) Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, United Kingdom and New York, NY, USA., Cambridge University Press.

PercentageMortality exceedance

0.00 - 0.120.12 - 0.180.18 - 0.270.27 - 0.410.41 - 0.620.62 - 0.780.78 - 0.850.85 - 0.910.91 - 0.970.97 - 1.041.04 - 1.101.10 - 1.161.16 - 1.231.23 - 1.271.27 - 1.311.31 - 1.351.35 - 1.391.39 - 1.591.59 - 1.881.88 - 2.322.32 - 2.992.99 - 3.983.98 - 5.475.47 - 7.707.70 - 11.05

August, 12th 2003

Source: Inserm, 2007

Climate change is affecting human health

… through extreme events such as heatwaves

Deaths During Summer Heatwave. INVS (2003)

Confalonieri, Menne et al, IPCC, 2007

Past lessons – future challenges!!??

Ticks in higheraltitudes

Health effects of climate change observed

Allergies

… gradually trough indirect impacts: infectious diseases, allergies, food, water,….

Health is sensitive to climate

Source: Checkley et al, Lancet, 2000

The example Diarrhea

Source: Yang, Vounatsou, et al. 2005

Freezing zone 1960-90

Freezing zone 1970-2000

The example of Schistosoma japonicum

Health is sensitive to climate

Many of the major killers are climate sensitive

- Each year:

- Undernutrition kills 3.7 million

- Diarrhoea kills 1.8 million

- Malaria kills 1.1 million

Each of these is highly sensitive to temperature and precipitation

Es timate s by WH O sub -reg ion for th e year 2 000(WHO , 2 002 ; McMich ael, Ca mpbe ll-Lend ru m e t al , 200 4)

CC Deaths /mi llion0 - 2

2 - 4

40 - 80

80 - 120

0.3-0.4% of the global burden of disease and premature deaths in 2000 can be attributed to climate change

150.000 deaths and more than 5 million DALYs

IPCC scenarios

Source: NAKICENOVIC, N. & SWART, R. (Eds.) (2000) Emissions scenarios. A special report of working group III of the Intergovernmental Panel on Climate Change., New York, Cambridge University Press.

http://www.grida.no/climate/ipcc/emission/005.htm

IPCC emission scenarios

IPCC (2007) Summary for Policymakers. IN SOLOMON, S., D. QIN, M. MANNING, Z. CHEN, M. MARQUIS, K.B. AVERYT, M.TIGNOR AND H.L. MILLER (Ed.) Climate Change 2007: The Physical Science Basis. Contribution ofWorking Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, United Kingdom and New York, NY, USA., Cambridge University Press.

Scenarios on health determinants

• Water: By 2050, water availability is projected to decrease by 10-30% over some dry regions at mid-latitudes and in the dry tropics.

• Food: At lower latitudes, especially seasonally dry and tropical regions, crop productivity is projected to decrease for even small local temperature increases (1-2°C), which would increase risk of hunger.

• Air quality: Future climate change may cause significant air quality degradation by changing the dispersion rate of pollutants, the chemical environment for ozone and aerosol generation and the strength of emissions from the biosphere, fires and dust.

IPCC, wg II SPM, 2007

Climate change is expected to increase the proportion of the global population exposed to dengue from about 35% (upper figure), to 50-60% (lower figure), by 2085.Hales et al, Lancet 2002

Future climate change and dengue

Many millions more people could be flooded

Source: Adapted from IPCC (2007) Chapter 6 Contribution of Working Group

Few studies estimate future effects

Health Impact Available studies of climate change effectsThermal extremes Donaldson eet al 2001, Dessai 2003, Hayhoe 2004,

McMichael et al 2003

Extreme weather events

No complete analysis of linkage from climate change – extreme events- health impacts

Food- & water-borne disease

Hijioka et al 2002, McMichael at al 2003, Dep. Of Health and Expert Group 2001

Malaria Van Lieshout et al 2004, Tanser et al 2003, Thomaset al 2004, Ebi et al 2005, Kuhn et al 2002, Casimiro and Calheiros 2002, McMichael et al 2003, Bhattacharya et al 2006

Dengue Hales et al 2002, deWet et al 2001, Woodruff et al 2005

Other VBD Ogden et al 2006 (Lyme disease), Randoph and Rogers 2000 (TBE)

Malnutrition One global model of climate change to regional food availability

Millions of people will be at additional risk

Adapted from Confalonieri et al, 2007

Negative Impact Positive Impact

Very High Confidence Malaria: Contraction and expansion, changes in transmission season

High ConfidenceIncrease in malnutrition

Increase in the number of people suffering from deaths, disease and injuries from extreme weather events

Increase in the frequency of cardio-respiratory diseases from changes in air quality

Change in the range of infectious disease vectorsReduction of cold-related deaths

Medium ConfidenceIncrease in the burden of diarrheal diseases





Climate Change

Climate Change


Sea level rise

Extreme events


Sea level rise

Extreme events


Air quality


Air quality



Health impacts



Malnutrition




Mental health

Health impacts



Malnutrition




Mental health

MitigationMitigation AdaptationAdaptation

Mitigation and Adaptation are crucial

Protect health while reducing emissions

BuildingsIndoor air pollution

Heat and coldprotection

Energy supply & conversionOccupational risks;

Construction and transport

AgricultureNutrition,Water /

vector-borne disease

TransportAir pollution

Traffic injuriesPhysical inactivity

IndustryOccupational risks,

mining and transport

WasteOccupational,

chemical

Greenhouse GasEmissions

Components of the WHO strategic response1. Public Health Actions Based on Sound Evidence

monitoring climate in Africa

working with communities to select locally appropriate interventions in SE Asia spraying for

mosquito control in India

2. Revitalizing the Preventive Approach to Public Health

climate change "adaptation“ = public health action

• household water treatment, • disease surveillance and response, • health action in emergencies.

3. Guiding Healthier Development

Healthier energy and transport choices could not only reduce CO2 emissions, but

• help reduce the 800,000 annual deaths from urban air pollution,

• the 1.5 million from indoor air pollution,

• the 1.2 million from road traffic accidents,

• the 1.9 million from physical inactivity.

4. Advocating for Healthy Development –From Individuals, to Communities, to Governments

Past lessons – future challenge: support changes in behaviour to promote health at the same time as working to reduce climate change

Health actions as defence against climate change impacts

Healthy development

Environmentalhealth capacitybuilding

Integrated vectormanagement

Health actionin emergencies

Infectious diseasesurveillance

Safe drinkingwater

Diseases affected by

climate

Key messages

• Health models and scenarios show: the Age of diseases from man made climate change has arrived

• Besides sustainable mitigation, adaptation is necessary everywhere; – education– health system development, access to health services,

water and sanitation– information, surveillance, early warning– new partnerships

Contact us:

WHO Regional Office for Europe

European Centre for Environment and Health, Global change and health

http://www.euro.who.int/globalchange

[email protected]

Our action:

Providing leadership on matters critical to health and engaging in partnershipsTwo Ministerial Environment and Health Conference DeclarationsRC resolutionShaping the research agenda Articulating ethical and evidence-based policy optionsProviding technical supportMonitoring the health situation

THANKS FOR YOUR ATTENTION

http://www.euro.who.int/globalchange

future scenarios: human health and the...

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