Category Archives: Climate & Health

What does “Climategate” mean for health?

The unauthorized release of climate researchers emails, and both accepted and alleged errors in the IPCC reports, have led to widespread negative reporting of climate science, just as the public health community has begun to engage with the issue. So, are we wasting our time in looking at climate change?

At the most basic level, the answer is clearly no. The conclusion that climate change is happening, and is due mainly to human activities, is based on well-established physics, supported by a large body of observations, and endorsed by almost all experts publishing on the issue. This is equivalent to the expert consensus that HIV causes AIDS, or that smoking is an important risk factor for lung cancer. Extraordinary evidence would now be needed to overturn any of these positions.

Nonetheless, the new criticisms may well affect public opinion – which in several countries is now very much at odds with the expert assessment.  While many commentators attribute this to the actions of the scientists concerned, the nature of modern communication of scientific issues is also likely to be at least as important.  This includes the media practice of providing balance only by giving equal coverage to extreme opposing positions, the actions of large commercial and ideological lobbies that seek to amplify evidence and viewpoints that support their own vested interests and attack those that do not, and a strong tendency for people to ignore information that suggests that they should make unwelcome behavioural changes.

While the media debate continues, the real question for the public health community is not “is climate science perfect?”, but “are we proposing the most responsible actions, in the light of the best available evidence?”

The balance of evidence indicates that climate change will mainly have negative effects, but the uncertainty is large in both directions, ranging from the potential for some positive effects in some populations, to diverse, widespread and severe impacts on health and health equity.  Fortunately, there is much more certainty about the best responses.  Actions such as controlling vector-borne diseases and providing clean water and sanitation, would both save lives now, and increase resilience to gradual climate change.

The same approach applies to cutting greenhouse gas emissions to reduce climate change.  Many of the necessary actions bring cost savings, while many others would bring enough public health benefit (for example through reduced air pollution) to repay the cost of investment. Policies such as cleaner and more equitable energy provision and more sustainable transport systems, are therefore good both for public health and for the environment.

Although we are confident in the measures that we are promoting, we need to remain absolutely open to any serious new findings that have a direct bearing on policy. The recent furore does not seem to have brought forward any such evidence. We continue to work with countries that have a  range of health stresses and are now at increasing risk of being flooded by rising sea-levels and more severe weather, or suffering prolonged drought, or are struggling to provide clean energy to increasing populations. Unfortunately, nothing in the recent coverage suggests that we will be able to give up this work anytime soon.

A longer version of this article, with supporting references, was published as “Science, media and public perception: implications for climate and health policies” in the Bulletin of the World Health Organization.  http://www.who.int/bulletin/volumes/88/4/10-077362/en/index.html

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Taking the heat out of the population and climate debate

Climate change and population, taken individually, are among the most contentious issues in public policy; bringing the two issues together is a recipe for controversy.  The issues are linked, however, so we do need to find a constructive approach to talk about the connections.

For all of its complexities, the basic challenge of climate-change policy is the apparent conflict between maximizing short-term individual or national gains (increasing per capita GDP through use of cheap fossil fuel energy) and the long-term protection of shared benefits (minimizing global damages from climate change).  The other dimension is fairness, as those populations that have contributed least to past emissions of greenhouse gases are most vulnerable to health and other impacts of climate change. Developing countries are therefore reluctant to limit their greenhouse gas emissions to help solve a problem that has, so far, been created elsewhere. For their part, richer countries hesitate to implement policies that they consider may harm their economic growth and competitiveness.

In some ways this is analogous to discussion of population policy. Again, there is a potential tension between the immediate rights of individuals (to control their own fertility) and a longer-term, population-level concern (that rapid population growth could potentially overstretch resources, hamper development and lay conditions for conflict).

These two issues are also closely linked. Although the major driver of greenhouse gas emissions remains the consumption patterns of richer populations, human population is also a fundamental long-term driver. However, discussing these links has often generated more heat than light.  Even stating the fairly obvious fact that having more children will tend to increase an individual’s “legacy” of greenhouse gas emissions has sparked outraged reactions against perceived threats to individual freedom or faith.  These tensions also play out at national level, as some have suggested that curbing population growth in developing counties would help to reduce climate change. In response, developing countries point out that per capita emissions of children born in poor countries are much lower than that in richer countries, and claim that they are being stigmatized for “profligate reproductive behaviour” as a negotiating position over greenhouse gas commitments.

Can these issues be discussed constructively? The best approach is probably to choose the least controversial entry point – identifying where human rights, health, environmental and equity objectives converge, rather than conflict. This can be framed around the fact that, in developing countries, approximately 200 million women express an unmet need for family planning services. Meeting this need is supported by the following arguments.

First, control over reproduction is an individual right, supported through international declarations, and embodied in the Millennium Development Goals. Second, it provides major public health benefits; increasing birth spacing from less than 18 to more than 36 months correlates with a two-thirds drop in childhood mortality. Third, avoiding local overpopulation increases resilience to near-term environmental and other stresses (a need identified by most of the poorest countries themselves). Fourth, over the long-term, it relieves climate change and other pressures on the global environment.

When developing this case, the order of the arguments is critically important. Individual rights come first, with the population health, local and global environmental benefits as welcome and important co-benefits. In contrast, using the need to reduce climate change as a justification for curbing the fertility of individual women at best provokes controversy and, at worst, provides a mandate to suppress individual freedoms.

Although the case for family planning services should be self-evident, it needs to be carefully constructed, and sensitively handled.

(A longer version of this article, with supporting references, was published in the Bulletin of the World Health Organization: http://www.who.int/bulletin/volumes/87/11/09-072652/en/index.html)

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The implications of COP15

As we take stock of the implications of COP15, one lesson is clear. If we are to maintain and expand public and political support to act on climate change, we need the headlines to be more about what we are aiming to achieve, and less about the process. We need to be clear that this is about a better future for humanity.

In Copenhagen, WHO outlined an additional proposal; to move from talking about “inconvenient” to “convenient” truths. WHO has also assembled and reported on the evidence that climate change endangers health. The 1992 UNFCCC itself is based on such warnings, to avoid “adverse effects”; on human health and wellbeing, on the natural environment, and on economies.

But the time has come for more positive messages and for climate change to be seen as a valuable investment in a more sustainable, fairer and healthier future than a painful cost.

From the health perspective, we see a range of good news stories. In April the US Environment Protection Agency decided that carbon dioxide and five other greenhouse gas emissions could endanger human health and well-being.

The well-attended WHO side event at COP15 showed a committed interest in the issue and WHO is actively involving the health sector in responding to the climate change challenge.

From COP15 we need to make clear that we support the most effective polices, informed by the best science, and, most importantly, guided by our values. In WHO’s view, the values that guide our response to climate change are the same as those that guide our work in public health; the drive to improve lives, protect the weakest, and enhance fairness. The health community is a willing partner in addressing this challenge.

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Humanitarian agencies call for urgent climate action

On the first day of the 15th United Nations Climate Change Conference (COP15) the Inter-Agency Standing Committee, a coalition of humanitarian agencies, including WHO and other United Nations organizations, Red Cross/Red Crescent and nongovernmental organizations, jointly emphasized the urgency of taking prompt adaptation action on climate change and called for a strong and binding global climate change agreement which protects the poorest and most vulnerable.

WHO, along with the other members of the Committee, is technically an observer of the climate change talks. WHO role is to support and encourage the negotiators from the Member States to ensure that health impacts of climate change are addressed in a strong climate change agreement. As with all such occasions, the inclusion of a word or a phrase in a sentence makes all the difference. In this case it could facilitate countries’ efforts to prioritize new health initiatives and health system reform in their plans to combat climate change and adopt mitigation measures.

At the talks, on the opening day, the IASC group made a joint statement at the Ad Hoc Working Group on Long Term Cooperative Action under the Convention, as follows:

Inter-Agency Standing Committee observer statement at the COP15 Opening Day on 7 December 2009

  • On behalf of the agencies of the Inter-Agency Standing Committee, including the United Nations, the Red Cross/Red Crescent movement and the nongovernmental organizations, I would like to thank you for the opportunity to speak at this Opening day of COP15
  • As a coalition of humanitarian actors we have joined forces to raise awareness of the humanitarian impacts of climate change and to call for urgent adaptation action to climate change
  • Climate change is already affecting millions of people worldwide every year through increasingly frequent, intense and non-seasonal floods, storms and droughts. Those that suffer the most are the poorest and most vulnerable in risk-prone countries. These people lack the resources to adapt to, or cope with, the rapidly changing climate patterns
  • Humanitarian agencies are already seeing increased food insecurity, public health threats, migration and displacement, and other related consequences. We are deeply concerned with how we can urgently help the most vulnerable adapt to their changing reality
  • Current national and international humanitarian systems do not have the capacity to respond to increased demand from climate related impacts and therefore require additional resources
  • We need a strong and binding global climate change agreement, which protects the poorest and most vulnerable. Such an agreement must help us avert or reduce the worst humanitarian consequences of climate change.
  • We must also look beyond Copenhagen to the critical early measures, commitments and resources needed now to help national governments help their people adapt
  • Disaster risk reduction, disaster preparedness and response are vital front-line defenses for vulnerable communities, especially in risk-prone parts of the world. While humanitarian organizations will continue to respond to weather and climate related crisis and disasters, we can also help to reduce the impacts of extreme weather and climate change through disaster risk reduction and disaster preparedness systems.
  • Immediate action is urgent and daunting. We call on you to come to an agreement in Copenhagen that will give better protection of those most vulnerable to the impacts of climate change.



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Public health impacts of strategies to reduce greenhouse gas emissions

Different mitigation strategies are likely to have different implications for health. For example, how much would a move to low carbon sources of power improve public health by reducing air pollution? What could be the health benefits of encouraging people to cycle and walk rather than take the car? Could improved biomass cook stoves in developing countries have impacts on child and maternal health as well as greenhouse gas emissions?

In the first major study of its kind, an international team of researchers in collaboration with WHO, have been modelling the health effects of different policies to reduce greenhouse gas emissions in high and low-income countries. Case studies focus on four key sectors: power generation, transport, household energy, and food and agriculture. The study findings will be published in a special issue in the Lancet in November 2009.

The results will be launched at events in London and Washington on 25 November 2009.

For further information, please consult our website.

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