world weather open science climate conference 2014 montrÉal users, application, & social...

WORLD WEATHER OPEN SCIENCE CLIMATE CONFERENCE

2014 MONTRÉAL

USERS, APPLICATION, & SOCIAL SCIENCE

Joint Plenary Session

21 August 2014

RESEARCH NEEDS for BETTER HEALTH RESILIENCE

to WEATHER HAZARDS

MICHEL JANCLOES

MD, MPH, DPH

Assisted by: NICHOLAS CHONG

Joint Plenary: User, Applications, and Science Program

WWOSC Montreal

21 August 2014

A Story: Malaria in Pikine

• Early acute malaria cases

• Longitudinal prospective study

• Findings: Humidity changes = transmission shift

New warning messages and interventions against malaria

M. JancloesWWOSC Montreal

21 August 2014

A new health proverb

“When baobabs blossom, use your mosquito bed nets”


21 August 2014

Science is beautiful when open to community knowledge and action

Our agenda today

This plenary:

Health Issues and Research Perspectives

Later, a special panel!

Climatic information data to improve public health


21 August 2014

Plenary presentation outline

1. Need for Operational Research

2. Experience sharing

3. Current trends

4. Strategic Research tracks


21 August 2014

Need for Operational Research

In the future: more frequent, longer and more severe weather hazards.

Predicted health impact due to:• Water/food/shelter conditions• Spread of diseases• Access to Health infrastructure and services


21 August 2014

Potential use of new Climate IC Technologies

Demand for informed decision making on: • Response preparedness• Early warning• Alert

Request of scientific evidence for investment pre appraisal and capacity building

Need for Operational Research


21 August 2014




3. Current trends



21 August 2014

Experience 1: MERIT

Meningitis

Environment

Risk

Information

Technologies


21 August 2014

Meningitis belt

What shape today?

Tomorrow?

•Thomson et al., 2013


21 August 2014

MERIT purposes

A network of public health and climate/environment scientists to:

Improve response timeliness to meningococcal meningitis outbreaks

AND

Influence decisions related the introduction a new preventive vaccine.


21 August 2014

Cyclic outbreaks due to conjunction of risks factors:• Root cause still not fully understood• Meningitis belt in Africa is extending• Urgent need to better capture the influence of

environmental factors on epidemics• Attention is given to

Climate changesNew climate technologies

• Services are available

Rationale for a Research Network


21 August 2014

Epidemiological pattern

Season: Dry season

December to June

Biological factors: Damaged mucosaCo-infections

Climate factors:

Humidity, dust, winds, temperature

Person to person transmissionCarriers

Social & behavioural factorsCrowded housingDisplacementsSocial gathering

Seasonal annual epidemic pattern Major cyclic outbreaks every 5-12 Y

Causal pathogen

Preventive vaccine Reactive vaccination

Thresholds for saving lives

Alert threshold (5/100 000/wk)

Alinical samples + lab confirmation

Epidemic threshold (10/100 000/wk)

Immediate mass vaccination

Strengthen case management


21 August 2014

From coordinated research works ( more than 30 institutions):

• Retrospective review of existing data (epidemiological, environmental and climatic)

Several models developed and validated during two years in five countries.

Predictive value of models in countries with and without vaccines.


21 August 2014

MERIT 7 years work

MERIT’s merits


21 August 2014

Working with a Network of research institutions and country officers.

Strengthening epidemiological surveillance.

Validating strategies between several countries.

FIND OUT MORE: WWW.HC-FOUNDATION.ORG




3. Current trends



21 August 2014

Experience 2: GLEAN

Global

Leptospirosis

Environmental

Action

Network


21 August 2014

GLEAN Participants


21 August 2014

Leptospirosis: a neglected disease

Endemic & epidemic disease

Increasing severity post-disaster

Adjusted due to potential underreporting:

>1,500,000 cases>100,000 deaths

A serious global zoonosis


21 August 2014

Rationale for a Research network

Major human and animal disease• YET neglected, non-detected, and under-reported

Absence of control strategy due to• Non-specific symptoms• Complex transmission• Complex pathogen agent with multiple variants

>250 sero-variants

Economic impact

Probable impact of climate change

Increasing concerns at country level and request for technical support


21 August 2014


21 August 2014

A complex epidemiology

GLEAN network components

PREDICT

Baseline Incidence?

Main drivers and predictive value?

• Climate

• Environment

• Vector demography

Predictive models and risk stratification

(to be validated at risk sites)

INTERVENE

Informing public health decision

Outbreak investigation guidelines

Operational Guidance for outbreak control

PREVENT

Evaluation of:• Rodent controls?• Chemoprophylaxi

s in humans?

Impact of animal vaccination ?

DETECT

Case definition?

Outbreak threshold?

Early diagnosis tests and case confirmation

(specificity-sensitivity)

Algorithms for outbreak detection ?


21 August 2014

Linking extreme events and outbreaks


21 August 2014

Compounding impacts of floods (AR4, IPCC):• Proving more than just a correlation to increase and/or shifts in

disease epidemiology.

Identifying the specific link will be crucial for targeting the most appropriate health determinant:

• Role of animal hosts (esp. rodents) in disease spread.

Need for understanding different patterns of outbreaks:

• Local transmission dynamics• Important for intervention program focused on control

Especially since post-outbreak management is costly


21 August 2014

Linking extreme events and outbreaks

680 cases of leptospirosis /yr with seasonal peak during the rainy season

Typhoon Pepeng: 3 October

Typhoon Ondoy: 26 September

Thousands of people displaced and housed in emergency evacuation centers

In the 2 following weeks, 505 suspect cases and 15 deaths in Manila alone!

Philippines, 2009

GLEAN: Way forward

New partnerships and new working areasPublic Health-Veterinarians-Biotechnology Industry

• Economic analysis of outbreaks• Detection strategies• Vaccine development

Public health and Research Institutions• Prediction and Early case detection

surveillance and public health intelligence• Improved coordination with meteo/climate services


21 August 2014

Lessons learnt

1. Prerequisite: Understand the knowledge and capacity gaps

2. Move from impact assessment towards risk management with a focus on vulnerability understanding.

3. Time and space downscale for developing adaptation strategies and involve the local communities

4. Enhance quality of data sets , in particular epidemiological surveillance .

5. Develop interaction between Health and MET/Climate services on a need based approach

6. Validate the relevance of new knowledge and identify backup required for implementation


21 August 2014

Still some Research traps

a) Weather/Climate kills?

b) Impact assessment leads to risk management?

c) Research meets user needs when findings are shared?


21 August 2014




3. Current trends



21 August 2014

Current Research trends

Policy background and recommendations from the international community:

• WMO/GFCS, WHO, the UN Summit,• Several world conferences such as ICCS, One Health…

Advocacy for health at the center of adaptation strategies.

Research needs for backing up short and long term policy decisions.


21 August 2014

Current Research trends

Using new technologies, in particular tele-information and communication.

Scaling down to local contexts with participative process.

Integrating research into Resilience development including awareness on solution gaps, vulnerability risk analysis and incremental capacity building towards anticipative interventions awareness.


21 August 2014




3. Current trends



21 August 2014

Strategic Research tracks

Patterns of health resilience challenges due to extreme events ( as amplified by climate change and vulnerability shift)

Synergy of observations, experiments and modeling for policy guidance

Water Safety, Food security Risks linked with extreme events and vulnerability predictions

Specificity and sensitivity Early Warning, Alert thresholds linked with vulnerability

Space Downscaling (new modeling methods)


21 August 2014

Some institutional issues

• Considering other determinants of health, should it be a priority to link meteorology and climatology for better health resilience against future weather hazards?

• Who should be involved in the design of research proposals? Who should be the key actors?

• How can we develop a sustained cooperation between met/climate offices, research institutes and public health related services?


21 August 2014

Conclusion


21 August 2014

Science is beautiful when open to community knowledge and action

A political MUST

An Applied Research Opportunity

FIND OUT MORE: WWW.HC-FOUNDATION.ORG

References


21 August 2014

• Bertherat E. 2007. Meningococcal Meningitis in Africa Overview: Response Strategies and Current Challenges. WHO

• Global Frame Work for Climate Services. Available online: http://www.gfcs-climate.org (accessed on 31 July 2014)

• Jancloes M, et al. 2014. Climate services to improve public health. Int. J. Environ. Res. Public Health. 11, p. 4555-4559.

• Jancloes M. 2013. Climate Services for Health (Presentation). WMO GFCS• MERIT Report of the 4th MERIT technical meeting (2010).• Rogers, D.P.; Tsirkunov, V. 2013. Weather and Climate Resilience Effective Preparedness through National

Meteorological and Hydrological Services; The World Bank: Washington, DC, USA. • Thomson MC, et al. 2013. A climate and health partnership to inform the prevention and control of

meningoccocal meningitis in sub-Saharan Africa: the MERIT initiative. Climate Science for Serving Society: Research, Modeling and Prediction Priorities. Geneva (Switzerland): World Health Organization; p.459–484.

• 3rd Global Leptospirosis Environmental Action Network (GLEAN) Meeting (2013).• One Health Summit. Available online: http://glean-lepto.org/component/k2/item/95-one-health-summit-17-20-

november-2013-in-davos-switzerland (accessed on 31 July 2014). • Committee on Climate, Ecosystems, Infectious Diseases, and Human Health. Under the Weather: Climate,

Ecosystems, and Infectious Disease. 2001:National Academies Press.

world weather open science climate conference 2014 montrÉal users, application, & social...

Documents

jancloeswwosc montreal21

health issues

research needs

health infrastructure

research perspectiveslater

research networkm

operational researchin

operational researchm