Jhabindra Bhandari

In an era of global health security, there are increasing concerns for urgent actions to keep humans and the planet healthy worldwide. This will require a global movement to create societies focused on health and wellbeing. This year’s world health day has particularly focused more on our planet and health. The climate crisis is a health crisis. Because climate change affects the social and environmental determinants of health such as clean air, safe drinking water, sufficient food and secure shelter. The World Health Organisation (WHO) estimates that more than 13 million deaths around the world each year are due to avoidable environmental causes. Between 2030 and 2050, climate change is expected to cause about 250, 000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.

In most developing countries, lack of adequate trained human resources for health and weak health infrastructure are the key barriers to cope with catastrophic consequences of climate change on human health. In this context, there are increasing priorities to reduce emissions of greenhouse gases and air pollutions through better transport, food security and energy use.

Extreme weather
There are increasing evidences that climate change largely affects human health through a range of pathways, including increasing the frequency and intensity of hazardous extreme weather events such as heatwaves, floods and droughts; water-borne and vector-borne infectious diseases. In this scenario, there is a particular need to strengthen systems to be able to respond to acute shocks associated with climate variability, including the health consequences of natural disasters, and more frequent, severe and wide-ranging epidemics.

The resilient health systems are critical to respond the pandemic such as COVID-19 and other health emergencies. As a matter of fact, climate change places enormous stress on the capacity of health systems to prevent, adapt and respond to increased health risks. Poor health infrastructure, limited health workforce, inadequate supply chain management of essential medicines and lack of transport facilities are key concerns during acute health emergencies.

Therefore, developing countries need to invest more in building climate resilient health systems to protect the health and well-being of populations from the profound effects of climate change and hence reduce health inequities at large. Sadly, climate change is still a low priority agenda in many developing countries.

No one is safe from climate-sensitive health risks. Extreme weather events, such as heatwaves, storms and floods, the disruption of food systems, increases in zoonoses and vector-borne diseases are causing increased morbidity and mortality among women, children, ethnic minorities, poor communities, migrants or displaced persons, older populations, and those with underlying health conditions.

Majority of the populations who are poor, socially disadvantaged and living in low-income countries are most vulnerable to climate crisis. Undoubtedly, this threatens to poverty reduction, global health, and sustainable development by further widening health inequalities between and within populations. That is why developing countries remain particularly vulnerable to climate related health risks with limited capacity to prepare for and respond to these challenges. Therefore, there are emerging needs to strengthen the capacity of health systems by considering climate risks in health policy and decision making, interventions, and surveillance and early warning systems.

Like many other developing countries, Nepal is one of the climate change prone countries. Therefore, there are significant challenges of climate-sensitive health risks and subsequent morbidity and mortality, particularly among poor and socially disadvantaged communities. Unfortunately, existing efforts of mitigating the effects of climate change on human health are not adequate. Furthermore, existing health systems are not adequately able to plan, prepare for, and respond to those challenges.

In this context, the Ministry of Health and Population (MoHP) has developed Health National Adaptation Plan (H-NAP), Climate Change Health Adaptation Strategies and Action Plan (2017-2022) with the support from development partners, civil society and communities. However, effective implementation of these strategic plans is a key challenge.

Disproportionate impacts
Climate change will eventually affect some of the most basic determinants of health such as food, air and water. The warming of the planet will be gradual, but the increasing frequency and severity of extreme weather events, such as intense storms, heat waves, droughts and floods will have profound effects on human health. More importantly, the health impacts will be disproportionately greater in poor and vulnerable populations. As a result, this is most likely to threaten public health security.

To sum up, more innovative efforts are needed to protect health from climate change. National health policies and strategies need to prioritise climate change as a new public health agenda.
It is high time to implement adaptive strategies at all levels in order to reduce the impacts of climate change on human health. Concerted efforts are still needed to enhance research on health protection from climate change. By strengthening cross-disciplinary partnerships, developing countries can ensure effective mitigation and adaption.

(PhD in global health, Bhandari writes on health and development issues.)