For over 20 years, WHO has provided technical information on the links between climate change and health. For over 10 years, the Organization has worked directly with countries to raise awareness of these links, and their implications for health policy, and is now coordinating health vulnerability and adaptation assessments in over 20 countries. At the end of July, 16 countries covering all regions of the world were brought together for the first time, to share their experience of evaluating health risks in different parts of the world, in a meeting organized by the Pan-American Health Organization/WHO, and hosted by the Government of Costa Rica.
The meeting was centred on draft guidance for health vulnerability and adaptation assessment, produced by PAHO, building on earlier work by the WHO European Regional Office. Representatives from each country presented on their experience in carrying out national assessments and in using the draft guidance, and made proposals for improving the final version.
A series of common themes emerged from the discussions.
1) Health leadership is critical. It is sometimes assumed, even by the health sector itself, that climate change is an environment or development issue, and several countries shared their experience of initial hesitancy for health actors to engage in this area. However, most also shared positive experiences: in Costa Rica for example, high-level engagement of the Ministry of Health helped to ensure that the assessment considered not only vulnerabilities and adaptations within the formal health sector, but in other “health-determining” sectors, such as water and agriculture.
2) Climate change does not affect health in isolation. All of the participants come from countries that suffer a range of stresses on health and health systems. They were therefore clear on the need to ensure that efforts to address climate change are integrated with programmes underlying health issues, such as building on existing programmes to protect health from extreme weather events, control vector borne diseases, and provide drinking water. None, however, argued that the existence of other problems was a reason to postpone action on climate change.
3) This is not a one-off intervention, but a long-term process. Health has a long and successful tradition vertical interventions to deal with specific diseases. Climate change presents a very different challenge, requiring the assessment of wide-ranging, complex and uncertain risks, and gradually strengthen and adapt health systems (in the widest sense) to manage them better.
Overall, the feedback on the guidance was positive, and a new version incorporating comments and examples from the countries will be published late in 2010 . Probably the most encouraging result of the meeting, however, was the emergence of a “community of practice”, of health professionals from around the world, who are working to assess and respond to the health risks of climate change.