Time to build climate-resilient health systems
Climate change is happening. In recent years average temperatures across the globe have increased, with significant impact on humanity’s most precious resource, the environment. Water systems are being stressed. Food sources are being imperiled. And areas once safe for settlement are being threatened and erased.
The implications for human health are concerning. Climate change increases the frequency and severity of extreme weather events such as cyclones and floods, exacerbating almost all public health risks, from food-borne disease to malnutrition and heatstroke. It impacts the spread and abundance of disease-carrying vectors such as mosquitoes, threatening the re-emergence of once-prevalent illnesses, from scrub typhus to dengue. And it can create a range of outcomes that compromise public health in one way or another: Rising sea levels or prolonged drought can displace communities; scarce resources can trigger instability and conflict; and a decline in agricultural output can aggravate and entrench poverty. Southeast Asia is particularly vulnerable. In recent years 11 countries in the region — all of them low- or middle-income — have faced public health challenges from diverse climat-eassociated events and processes, including glacial lake outburst floods, cyclones and rapidly eroding coastlines. These and other phenomena are likely to be exacerbated as global temperatures rise.
Economic losses associated with climate change, meanwhile, are already affecting the development aspirations of millions of people region-wide, and with it their ability to secure health and well-being. As the United Nations Sustainable Development Goals emphasise, health both determines and is determined by poverty and its attendant conditions.
Though the problem of halting and reversing climate change is bigger than any one country, mitigating its health-related impact is both possible and necessary for all. Across the region, health systems should be able to anticipate, respond to, cope with, recover from and adapt to climate-related shocks and stress, and do so in a way that advances health equity and ensures no one is left behind. There are several ways to do this.
Most critical is obtaining high-level awareness and resolve to take action. In each of the countries in the region, health authorities should be fully cognisant of the specific climate-associated health risks they face and draft national plans accordingly. At the same time, cross-sectoral collaboration should be established with a range of key ministries, ensuring climate-associated health concerns are addressed across diverse policy areas.
Health systems’ service delivery should likewise be evaluated and augmented. This could include integrating meteorological information with climate-sensitive health programmes to better anticipate shifting disease burdens. It could include enhancing disaster risk reduction and emergency preparedness to better manage the threat of extreme weather events. And it could also include scaling up the technical and professional capacity of health workers to better prepare for and deal with climate change’s health-related outcomes.
Climate-resilient infrastructure and technology has much to offer. All health facilities, for example, should have contingency plans to ensure essential services such as water, sanitation and electricity are maintained during extreme weather events. Similarly, new facilities should be planned, sited and built as per projected climate risks such as storm surges or cyclones. Technologies that provide early warning of extreme weather events should be integrated into emergency preparedness systems, while mobile communications that can reach appropriate audiences should be obtained and utilised.
To facilitate these investments, climate and health financing should be adequately assessed, mobilised and secured. This means looking for opportunities to integrate the principles of climate resilience into everyday health system strengthening, whether related to health personnel or basic infrastructure. It also means identifying and accessing funding that can build resilience through more targeted initiatives such as expanding surveillance or retrofitting health facilities.
Countries across the Southeast Asia region are working to make this happen. In recent years a range of innovative measures have been implemented region-wide to protect and improve health as climate change takes effect. This must continue. It must also be scaled up. The World Health Organisation (WHO) South-East Asia Region is committed to facilitating this process, and ensuring member countries across the region are able to cope with one of humanity’s greatest challenges.
There is, after all, no other option. Climate change is already transforming life as we know it, and will continue to do so as global warming advances. Though the risks to human health are many, the means to take action are available to all. By building climate-resilient health systems, countries across the Southeast Asia region can stay on track to achieve the SDG goal of health and well-being for all, and also safeguard their many public health gains. Adapting to change can be difficult; the need to do so is clear. Climate resilience is a principle all health systems must embrace.