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Climate change is 'biggest health threat'

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Widespread media coverage has been given to a warning from doctors that climate change is the biggest global health threat of the 21st-century.
Brought to you by NHS Choices

Many newspapers covered the report produced by The Lancet and University College London (UCL) on managing the health effects of climate change, including food shortages, heat waves and increased threat of tropical diseases such as malaria.

The conclusions of this report are valid and should raise debate on some of the challenging and increasingly urgent questions regarding health and climate change. The report took a multidisciplinary approach with input from doctors, engineers, scientists and philosophers, among others. The hope is that the movement will lead to co-ordinated thinking and action across governments, international agencies, non-governmental organisations and academic institutions. A framework is suggested for this, along with an action plan. The authors say that these actions must also sit alongside a reduction in greenhouse gas emissions.

The lead author, Professor Anthony Costello said, “The big message of this report is that climate change is a health issue affecting billions of people, not just an environmental issue about polar bears and deforestation.”

Where did the story come from?

This is the final report of a year-long project carried out by The Lancet and the University College London (UCL) Institute for Global Health. The UCL team was led by Professor Anthony Costello and included contributions from many disciplines including engineers, political scientists, lawyers, geographers, anthropologists, economists and philosophers. The report was published in The Lancet and is described as the first in a series of articles aimed at addressing neglected areas in health that demand a complex interdisciplinary analysis and response.

What is the report about?

The report is about the broad effects of climate change on health. The team that produced it concentrated on six areas: patterns of disease and mortality, food security, water and sanitation, shelter and human settlements, extreme events and population migration.

The authors looked at how the patterns of disease and variations in basic human needs are spread unequally and how any current inequities between rich and poor countries or people might get worse with climate change.

The introduction describes the science behind climate change. It explains that the temperature of the earth is determined by the balance between energy input from the sun and its loss back into space. It describes the effect of human industrial activity, saying that, of about 900 billion tonnes of CO2 released into the atmosphere, about 450 billion tonnes has stayed in the atmosphere. It mentions findings by the Intergovernmental Panel on Climate Change (IPCC), which looked at 23 atmosphere–ocean general circulation models to predict future temperature rises. The IPCC reported that the average global surface temperature could rise between 1•1°C and 6•4°C by 2100, with best estimates between 1•8°C and 4•0°C.

The authors call for a public health movement that frames the threat of climate change for humankind as a health issue, saying that health concerns are crucial because they attract political attention.

Three levels of action are proposed. First, that policies must be adopted to reduce carbon emissions and to increase carbon biosequestration (absorption) through reforestation and improved agricultural practices. Second, that action should be taken on the events linking climate change to disease. Third, appropriate public health systems should be put into place to deal with adverse outcomes.

What does the report say about the effects of climate change on health?

The report says that if steps are not taken to counteract climate change, it will have its greatest effect on the poorest people in the world; those who have least access to the world’s resources and who have contributed least to its cause. The authors say that, at present, despite global health improvements, 10 million children continue to die each year. Also, over 200 million children under five do not develop fully, 800 million people go to bed each night hungry and 1,500 million people do not have access to clean drinking water. They quote the World Health Organization (WHO) Commission on Social Determinants of Health, which in 2008 reported that a girl born today can expect to live up to 80 years if she is born in some countries but less than 45 years if she is born in others.

The authors also highlight the most serious threats to human health: economic crises, pandemics, poverty, and violence and conflict.

The report points out that raising health status and reducing health inequity will only be achieved by lifting billions of people out of poverty. They caution that, initially, this may make climate change worse as carbon emissions are increased in the poorest countries. They say that rich countries, the major contributors to global carbon production, also need to reduce their output massively.

What are the key challenges?

The researchers looked at six aspects that connect climate change with adverse health outcomes:

  • the changing patterns of disease and mortality,
  • food,
  • water and sanitation,
  • shelter and human settlements,
  • extreme events, and
  • population and migration.

They then considered each of these in relation to providing better information, addressing poverty and inequity, using and providing incentives for technology and starting socio-political or institutional change. One key challenge they mention for many countries is that more investment and resources are required to strengthen existing health systems.

What does the report conclude?

The report points out that policy responses to the public health implications of climate change will have to be formulated in conditions of uncertainty for different countries, and that this will require the collection of essential data. The authors say there is a particularly urgent need to generate evidence on health effects and adaptation for a more severe (3–4°C) rise in temperature.

They call for a public health movement that frames the threat of climate change as a health issue. They say that apart from a dedicated few, health professionals have come late to the climate change debate, but health concerns are crucial because they attract political attention.

The lead author, Professor Anthony Costello has said, “We believe that all the main players — health, political, scientific, technological and civil society must come together. We’ve laid out a framework for action and we have called for a collation of information on the health effects of climate change leading up to a major international conference in the next two years. We especially want representation from poorer nations. This conference would set out some clear indicators, targets and accountability mechanisms. We need a new 21st-century public health movement to deal with climate change.”

Links to the headlines

Climate change is biggest health threat of 21st century, claims report into global warming. Daily Mail, May 14 2009

Major report warns of climate change risk to world health. The Independent, May 14 2009

Professor Anthony Costello: climate change biggest threat to humans. The Times, May 14 2009

Docs’ climate alert. Daily Mirror, May 14 2009

Doctors warn of risks of climate change for the first time. The Daily Telegraph, May 14 2009

Links to the science

Lancet and University College London Institute for Global Health Commission. Managing the health effects of climate change. The Lancet 2009; 373: 1693-1733

A Commission on climate change. The Lancet 2009; 373:1659

Health and climate change: a roadmap for applied research. The Lancet 2009; 373

This article was originally published by NHS Choices

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