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Preventing health impacts from heat in a changing climate Gerardo Sanchez Martinez WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR EUROPE Bonn, Germany
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Preventing health impacts from heat in a changing climate
Gerardo Sanchez Martinez
WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR EUROPE
Bonn, Germany
WHO Regional Office for Europe
Slide courtesy of Dr Diarmid Campbell-Lendrum
WHO Regional Office for Europe
Slide courtesy of Dr Diarmid Campbell-Lendrum
WHO Regional Office for Europe
Source: Confalonieri et al. 2007
Impacts of climate change on health
WHO Regional Office for Europe
A specific example: Heat and health (I)
Individual exposure and risk factors
Complex causal network including social and environmental determinants of health
WHO Regional Office for Europe
15 20 25 30
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0.0
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tmean.lag03
s(tm
ean.
lag0
3,5)
Heat and health (II)
Population exposure-response function
WHO Regional Office for Europe
15 20 25 30
-0.1
0.0
0.1
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0.5
tmean.lag03
s(tm
ean.
lag0
3,5)
2000 2020 2040 2060 2080 2100
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65
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Year
Po
pu
latio
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Exponential model
Logistic model (K=1000000)
Logistic model (K=900000)
Logistic model (K=800000)
Logistic model (K=700000)
2000 2020 2040 2060 2080 2100
0200
400
600
year
Attributa
ble
Death
s
Median scenario
2000 2020 2040 2060 2080 2100
0200
400
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year
Attributa
ble
Death
s
Minimal scenario
2000 2020 2040 2060 2080 2100
0200
400
600
year
Attributa
ble
Death
s
Maximal scenario
Population projection
Temperature-response relationship at baseline Climate
change scenarios
Adaptation scenarios
Example from case study in Skopje, Macedonia. Source: Sanchez, Baccini et al. (2016)
WHO Regional Office for Europe
Estimated 250,000 additional deaths/ year by 2030
WHO Regional Office for Europe
1. Agreement on a lead body;
2. Accurate and timely alert systems;
3. Heat-related health information plan;
4. Reduction in indoor heat exposure;
5. Particular care for vulnerable population groups;
6. Preparedness of the health and social care system;
7. Long-term urban planning;
8. Real-time surveillance and evaluation.
KEY ELEMENTS OF A HEAT-HEALTH ACTION PLAN
WHO Regional Office for Europe
ARE COUNTRIES PREPARED? (EUROPEAN PERSPECTIVE)
Countries / Indicators Lead body Alert system Information
plan
Indoor heat
reduction
Vulnerable
groups
Health care
preparedness
Urban
planning
Real-time
surveillance
Evaluation
Austria* **
Belgium **
Croatia
France **
Germany* **
Hungary
Italy
Luxembourg ** **
Macedonia
Moldova
Monaco **
Netherlands **
Portugal **
Romania
Serbia **
Spain ** **
Switzerland* **
UK
Total: 18 Source: Bittner et al. 2013 * regional level plans ** in other documents
WHO Regional Office for Europe
What is the situation like in the WHO EURO region?
• HHAP Adoption rate is low; only 18 member states have nominally taken action, but many more are at risk of heat-related mortality and morbidity
• Implementation is patchy particularly regarding long-term measures, timeliness of surveillance and notification, as well as monitoring and evaluation
• Heat and health treated as a static phenomenon!
– Climate change poorly or not incorporated
– Within season variations not taken into account
– Provisions for revising the HHAP not clearly established
– New or improved climate services not well taken advantage of
WHO Regional Office for Europe
Operational Framework to strengthen health resilience to climate change
WHO Regional Office for Europe
Health in the National Adaptation Programmes of Action (NAPAs) – WHO assessment (2010)
• 95% of the NAPAs identified health as a priority sector.
• 73% of the NAPAs identified health interventions within their list of adaptation needs and proposed actions.
• 11% of the priority projects focused on health
• 4% of the portfolio of the LDC Fund supporting the NAPA process targeted health adaptation.
• Potential explanations for this lack of support for health sector adaptation:
• health community largely absent from the NAPA process;
• health sector did not submit proposals to the LDCF; and
• limited technical guidance made available failed to ensure minimum technical requirements of health adaptation proposals.
WHO Regional Office for Europe
…opportunity for the health sector to get involved into the NAP process …
Ebi et al, WHO Guidance for health in national adaptation plans
Leadership and governance: Health component of NAPs (H-NAP)
WHO Regional Office for Europe
WHO’s support to national adaptation planning
• Awareness raising and guidance to support greater health sector engagement in climate-change adaptation programming.
• Technical and policy support for vulnerability and adaptation assessment based on newly revised WHO guidance.
• Integration of adaptation measures within approaches to health systems strengthening.
• Sharing of lessons learned and technical resources from WHO pilot projects on health adaption to climate change (e.g. through the Nairobi Work Programme).
• Technical and policy support for new projects and programmes on health adaptation to climate change.
• Technical support in developing national strategies and action plans.
WHO Regional Office for Europe
In conclusion
• Health needs to feature more prominently in Adaptation planning, at all levels;
• High temperatures are a clear example of exposure exacerbated by climate change; Heat-health action plans are a prime example of health adaptation to climate change;
• Implementation is low, particularly outside Europe and North America;
• Many new tools and climate services can help in planning, adoption, implementation and reevaluations;
• We need to involve all stakeholders that can help, particularly local authorities, which have effective outreach, fluid interaction with stakeholders, and clear competencies over urban planning.
WHO Regional Office for Europe
THANKSWrite to us at:
Visit us at:
http://www.euro.who.int/climatechange
