Global change and biodiversity future challenges of healthcare

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In sub-Saharan Africa over million people currently live in regions prone to malaria epidemics. Climate change could add million to this figure by the s assuming no population increase, and including forecast malaria reductions in West Africa from drying.

Africa is very vulnerable to climate change because of other environmental and social stresses. The economy depends critically on agriculture, which accounts for two thirds of the workforce and up to half of household incomes and food. Some links between climate change and human health are complex. For example, the predicted drying in sub-Saharan Africa could increase the incidence of HIV infection, as impoverished rural farming families move to cities where conditions foster sex work and unsafe sex.

The recent report of the Global Environmental Change and Human Health project gives a good summary of the major categories of current and predicted health effects of global environmental changes other than climate change. The spectrum of potential strategies to reduce health risks is wide, commensurate with the diversity of threats to health posed by climate change and other global environmental changes.

Local policies and actions, both to mitigate environmental change at source and to adapt to existing and unavoidable risks to health, will often need support from health attuned policies at provincial, national, and international levels. For example, community programmes to mosquito-proof houses will need to be reinforced by improvements in the national surveillance of infectious diseases and in outbreak warning systems.

Doctors and other health professionals have particular knowledge, opportunity, and, often, political leverage that can help ensure—through advocacy or direct participation—that preventive actions are taken. Actions include promoting public understanding, monitoring and reporting the health effects of environmental change, and proposing and advocating local adaptive responses box 2.

Various websites list and discuss actions for doctors to take, both individually and collectively box 3. For example, the US Centers for Disease Control and Prevention lists 11 functions for the public health system and practitioners for responding to climate change.

Many local actions can be taken to reduce the vulnerability of communities and populations. These will vary considerably between different regions of the world, and in relation to prevailing socioeconomic conditions and available resources. Climate change and other large scale environmental changes are unlikely to cause entirely new diseases although they may contribute to the emergence of new strains of viruses and other microbes that can infect humans.

Rather, they will alter the incidence, range, and seasonality of many existing health disorders. Hence, existing healthcare and public health systems should provide an appropriate starting point for adaptive strategies to lessen health effects.

Although adaptive strategies will minimise the effects of climate change, the greater public health preventive challenge lies in stopping the process of climate change. This requires bold and far sighted policy decisions at national and international levels, entailing much greater emissions cuts than were being proposed a decade ago.

Scientists have concluded that we need to prevent atmospheric carbon dioxide concentrations exceeding ppm to avoid the serious, perhaps irreversible, damage to many natural systems and ecological processes that a global average temperature increase of o C would cause. Improving awareness of the problem is the first step.

We should also add this topic, including its relevance to health professional activity, to the medical curriculum. The health sector, meanwhile, must minimise greenhouse gas emissions from its own infrastructure, especially hospitals. Health researchers should act to minimise greenhouse gas emissions from their own studies.

The health professions have a crucial role in promoting public understanding of this fundamental association and health protecting responses to it. He co-chairs the International Council of Science research project on global environmental change and human health.

SF has worked in public health nutrition and health promotion research at national and international level for 15 years. She has worked closely with ministries of health, education, agriculture, and social affairs in healthy public policy development.

AN is an environmental scientist and has contributed widely to global environmental change research in Africa and to the Africa chapter for the fourth assessment report of the Intergovernmental Panel on Climate Change He is a senior programme specialist on climate change with the International Development Research Centre.

CC is a senior environmental epidemiologist at WHO. He has contributed substantially to recent scientific reviews and policy development work on climate change and global environmental change and their health effects. Provenance and peer review: Commissioned; externally peer reviewed. Author information Copyright and License information Disclaimer.

Correspondence to: A J McMichael ua. Who will be affected The health effects of global environmental change will vary between countries. Role of social conditions The relation of environmental impoverishment to health risks and inequalities is complex. Open in a separate window. Climate change and health Human induced global climate change is now an acknowledged reality. The main risks are: Effects of heat waves and other extreme events cyclones, floods, storms, wildfires.

Impaired functioning of ecosystems for example, wetlands as water filters. Displacement of vulnerable populations for example, low lying island and coastal populations. Box 1 Africa and climate change Africa is very vulnerable to climate change because of other environmental and social stresses. Livestock viral diseases such as east coast fever, foot and mouth disease, blue tongue virus, Rift valley fever are climate sensitive.

Climate change and agricultural downturn in Africa may force populations to move, generating conflicts over territory. Roles for doctors and other health professionals The spectrum of potential strategies to reduce health risks is wide, commensurate with the diversity of threats to health posed by climate change and other global environmental changes.

Preventive programmes—eg, vaccines, mosquito control, food hygiene and inspection, nutritional supplementation. Health care especially mental health and primary care for communities affected by environmental adversity.

Surveillance of disease especially infectious disease and key risk factors. Forecasting future health risks and gains from mitigation and adaptation strategies. Strategies that extend beyond health sector: Early warning systems for impending extreme weather eg, heat waves, storms. Neighbourhood support schemes to protect the most vulnerable people. Climate-proofed housing design, urban planning, water catchment, and farming practices.

Doctors for the Environment Australia www. Global environmental change and human health project www. Intergovernmental Panel on Climate Change www. International Society of Doctors for the Environment www. Medact UK www. Adaptive strategies to lessen health risks Many local actions can be taken to reduce the vulnerability of communities and populations.

Preventive action Although adaptive strategies will minimise the effects of climate change, the greater public health preventive challenge lies in stopping the process of climate change.

Summary points The biophysical and ecological systems of the natural environment are fundamental to human health. Mounting human pressures on the environment are disrupting and depleting these systems. The resulting health risks will particularly affect vulnerable and poorly resourced populations. Health professionals are well placed to contribute to adaptive and preventive strategies. Competing interests: None. References 1.

McMichael AJ. Eur J Public Health ; 16 Millennium development goals New York: UN, Environmental health. In: Levy B, Sidel V, eds. Social injustice and public health Oxford: Oxford University Press, Fuel for life: household energy and health Geneva: WHO, Zhang J, Smith K. Household air pollution from coal and biomass fuels in China: measurements, health impacts, and interventions. Environ Health Perspect ; For instance, the loss of forests means the loss of carbon sinks, further accelerating climate change.

The Amazon used to sink 5 percent of annual carbon emissions, but that is no longer the case. In the first six months of alone, 1, square miles of Amazon forest — an area more than twice the size of Beijing - was destroyed. Further, 40 percent of all conflict is caused, made worse, or financed by natural resources.

Biodiversity blunts the impact of other crises, like climate change and conflict, on development; it is also the wealth of poor nations and poor communities within nations as a producer of jobs and GDP. Take the fisheries sector, where 60 million jobs globally are tied directly to fishing and fish farming.

For every one of those jobs, 2. That is million jobs, 60 percent of which are in the developing world. The same can be said for industries such as forestry and nature-based tourism. We cannot ignore that nature and biodiversity loss is a material risk to our economies, our financial sector and therefore to development.

Malaysia is a good example. A recent World Bank report found that in the case of a partial ecosystem collapse, Malaysia — one of the most biodiverse countries in the world — could suffer 6 percent annual loss of its GDP by A recent study we carried out along with the Bank Negara, Malaysia's central bank, found that more than half the commercial loans made by the banking sector are to sectors which are highly dependent on ecosystem services, and almost 90 percent are to sectors which themselves have a high impact on ecosystems.

Source: World Bank. Around the world, nature -- the biodiversity of living organisms and accompanying ecosystem services they provide -- are vanishing at an unprecedented rate and scale with already catastrophic implications for economies and livelihoods. This loss and degradation of biodiversity affects the poorest economies most. Natural capital -- assets like forests, water, fish stocks, minerals, biodiversity, and land — is undervalued and unaccounted for.

As a result, its loss is not properly recognized. And yet, the country's wealth is depleted and its future jeopardized. We do, however, have a way to understand the losses from overexploitation and the opportunities from preservation. Natural capital accounting is a systematic way to measure and report on stocks and flows of natural capital. It helps decision makers understand how the environment interacts with the economy.

Consider what is at stake: more than half of global GDP is generated in industries that are highly or moderately dependent on ecosystem services, such as pollination, water filtration, and raw materials. Renewable natural capital, including land assets like agricultural soil and forests, and blue assets like fisheries and mangroves, account for 23 percent of the wealth in low-income and 10 percent in lower-middle income countries. Across countries and markets, nature is an economic linchpin but one that is undervalued, underpriced and underinvested in.

It should not be seen as charitable, rather it is crucial in order preserve the economic well-being on which our lives and livelihoods depend. As we convene at the United Nations Biodiversity Conference COP , we have the tools to actualize the economic contributions of nature and biodiversity in order to influence economic decision making so that investors and policymakers can eliminate the blind spots that are trading away our future prosperity. After almost a decade of conflict, the fishery value chain in Yemen has been devastated.

Fish are a valued part of the local diet in a country where two thirds of the population are food insecure. It is also an important export and source of employment. To this end, the project works with local partners, fishery communities, and associations to make fishery management more sustainable, to increase production, and create jobs while protecting fish and their ecosystem.

By helping diversify the economy, the grant enhances economic opportunities in Yemen and improves food security. Reestablishing a sustainable fishery value chain makes these livelihoods more secure for the future. Biodiversity and climate crises are critical challenges. They are intertwined, with declines in each accelerating us toward an irreversible tipping point.

Rather than tackling them as separate problems, we can address them together. Mangroves are powerful natural infrastructure. They are an important habitat for fish and sequester four times more carbon than rainforests. When they become degraded, there are severe climate, social, and economic consequences. These revitalized forests sequester 1. Now, during cyclones, the tidal wave forces are reduced by increased mangrove coverage.

India has focused on nature-based solutions to protect against disaster and climate challenges while increasing biodiversity. This triple win means increased productivity for marine ecosystems and the protection of coastal communities for Nature lies at the core of climate solutions.

Aligning biodiversity and climate goals leads to sustainable societies and inclusive development. Since , it is estimated that million hectares of forest have been lost through conversion to other land uses. Between and , the rate of deforestation was estimated at 10 million hectares per year — an area the size of Iceland.

To endure, the global response to the biodiversity crisis must take a whole-of-economy approach. This means integrating nature considerations across sectors and policies, at all levels. This is where the Bank stands out: bringing together a variety of stakeholders to test and scale up transformative solutions.

They also store large amounts of carbon that mitigate climate change. The Indonesia Sustainable Landscapes Management Program SLMP takes an integrated approach to protecting and enhancing these assets by promoting cooperation between the national and provincial government, the private sector, civil society, and communities.

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