Authors: Joanes Atela (joanes.atela@gmail.com) and Brian Otieno (owuorbrian@ymail.com)

Background

Climate change and health issues co-exist within similar social contexts.  Climate change is linked to challenges faced in health systems.  The  challenges include disruption of lives, expansion of infectious diseases and worsening mental illness. According to the World Health Organization (WHO), the risk of death and diseases arising from climate change is likely to double in the next 20 years. The WHO estimates a loss of at least 150,000 lives every year due to climate change and changes in rainfall. Developing countries with relatively minimal contribution to Green House Gas emissions (GHGs) are the most vulnerable to health consequences owing to their weak health systems.  This blog outlines some linkages between climate change and health systems and identifies existing research gaps.

Links between climate change and health systems

Climate Change effects on health manifest in specific and relatively broad ways.  Direct linkage is manifested through climate variables e.g., increasing temperatures catalysing transmission of vector diseases especially the vector-borne diseases. The sixth IPCC report shows that climate change will increase Africa’s vulnerability to vector-borne diseases. Climate change could also alter the geographic distribution and epidemiology of vectors thus accelerating the spread of vector-borne diseases.  For instance, insects responsible for diseases such as malaria, yellow fever, dengue and encephalitis thrive in warmer climates and these diseases could be exacerbated by increasing temperatures. Other diseases like cholera are closely linked to the quality of potable water supplies, which can be seriously eroded by flood events and microorganism contaminants.

On the other hand, climate change also has broad effects on health systems.  The latest report by Wellcome Trust shows that health systems in developing countries are increasingly getting exposed to climatic impacts. In Africa for example, the capacity of health systems is often overstretched in times of shocks such as climatically driven starvation, malnutrition, and associated disasters such as floods. Climate change is likely to affect the affordability and access to health services especially for the poor who are worst hit by climate impacts.  For instance, impacts of climate change on agricultural productivity pushes poor households whose incomes are dependent on agriculture and nutrition, to become more vulnerable and malnourished, thus unable to afford health care.  For the poor, every time the climate crisis hits, their struggle to earn a living and feed their families exposes them to more health problems.  Even in cases where people’s health or socioeconomic status is improving, climate change posits the potential to reverse such gains or slow down progress.

Climate Change and health consequences also pose great threat to civil and political rights and economic, social, and cultural rights, including rights to life, access to safe food and water, health, security, shelter, and culture. Climate-related justices and inequalities exacerbate health challenges. Vulnerable groups such as women and children, people with chronic diseases and disabilities, those residing in areas with a high prevalence of climate-related diseases, and workers exposed to extreme heat or increased weather variability already suffer serious health challenges. The COVID – 19 pandemic experience in Africa shows that vulnerable populations suffer double exposure to health and climate challenges due to already constrained basic amenities such as poor access to water and sanitation facilities.

Limited support to these vulnerable groups would mean double exposure from climate change and health, and with adverse effects.  Voicing pro-poor health concerns within climate justice debates is critical. The Glasgow pact established during the just-concluded COP 26, gives attention to climate justice and is an opportunity to promote pro-poor health concerns within the wider climate justice debates.

Building climate proof and resilient health systems

Health systems therefore need to be made more resilient to climate change.  There are debates and suggestions around enhancing adaptation of health systems. The WHO has developed an operational framework for building climate resilient health systems. The framework advocates for enhancing ability of health care workers to adapt to the impacts of climate change. Additionally, strengthening the health care ecosystem to be able to withstand harsh climatic events e.g. flooding or heat waves, among others is key.  For instance, developing effective design and risk-proof clean water and sanitation systems that are not overrun by floods and sewerage is a key pathways to health care resilience.  The initiative also calls for integrated climate-health care policies that account for the link between health and climate change adaptation. More specifically, the development of a Health National Adaptation Plan and associated financing strategies is key – building on international financing options such as the Green Climate Fund and innovative instruments such as climate insurance, green bonds, etc.

On the other hand, decarbonizing health systems though low carbon health technologies is becoming an important part of the discussion.  Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. A low-carbon health system could be more efficient and could provide the best possible quality of health care in the future. It puts health systems on a climate-smart development path and aligns the delivery of health services with global climate goals. This approach saves money by reducing energy and resource costs. Most importantly, a low-carbon health system is likely to improve the quality of care, especially for the poor who are already suffering the impacts of climate change.

Some of the options for decarbonizing the health systems include using clean energy in health care machines and infrastructure e.g., application of 100% clean, renewable energy. Additionally, practices that reduce emissions from health systems could be considered. These include zero emissions buildings and infrastructure, sustainable travels, low-carbon drugs, and transport for attending appointments and greater provision of remote consultations, organic diets and sustainable health care waste management.

Gaps in climate change and health research

There have been attempts to address these questions but rather from an exploratory perspective and non-systematic manner to inform more resilient health systems. Additionally, while there are relatively well developed climate information systems on one hand and health information systems on the other hand, the interactions between these two bodies of information are currently weak. There are still some silos which need to be broken through better climate/health data systems that could inform resilient and equitable primary health care for all and in line with the Alma – Ata Declaration on provision of primary health care.