Sandy Dechert :”Recent decades have witnessed dramatic progress in global health,” says the US Agency for International Development. Smallpox has been eradicated within the past half century. In all but three countries (Afghanistan, Nigeria, and Pakistan), polio has been wiped out. Use of modern methods of contraception has increased from 10% in 1965 to more than 50% in 2013. Child deaths from diarrhea have been cut in half since 1990. Malaria deaths have fallen by more than a quarter globally since 2000. Only half as many mothers died in live childbirth in 2010, compared to 20 years earlier. Unheard of 50 years ago, HIV/AIDS has now transited from certain death to a chronic ailment.But climate change could quickly wipe out the past 50 years of world health progress.Thanks to the power of the internet and the tenacity of a commission formed years ago under the auspices of The Lancet (one of several world-recognized medical journals), however, the world has just gained a comprehensive and forward-looking, reliable perspective on the subject of human health and climate change-a force that could impact our lifestyles more than any individual actions (exercise, diet, purchasing an umbrella, etc.) that we might pursue. This new report from leading world experts on environmental health begins:”Climate change is one of the defining challenges of the century, and increasingly recognised as a public health priority. Research in this field is increasing, but is comparatively undeveloped in view of the complexity of the issue and the potential magnitude and range of health consequences. For example, the average annual number of articles published in PubMed-indexed journals that referred to ‘health’ and either ‘climate change’ or ‘global warming’ more than doubled between the early 1990s and the middle of the current decade.”The report compares in scope and ambition to the Fifth Assessment Report from the United Nations Intergovernmental Panel on Climate Change, which will form the scientific basis for the proposed international agreement at COP21 in Paris this December, or the US National Climate Assessment. The difference: the 2015 medical study from The Lancet holds a current snapshot of all human knowledge about how changes in climate-especially the anthropogenic changes of the past two centuries around energy use-may play out for the health of the entire human race on Earth.The Lancet initially formed an initial multidisciplinary international Commission on Health and Climate Change, with strong collaboration among academic centers in Europe and China. Its purpose: “to map out the impacts of climate change, and the necessary policy responses, in order to ensure the highest attainable standards of health for populations worldwide.” The Lancet and University College London, UK, produced the first Lancet Commission report (Costello et al.) in London in May 2009.It sets out how climate change over the coming decades will be the biggest global health threat of the 21st century. In fact, it could have a disastrous effect on health across the globe.Potential tipping points in climate systems from Costello et al, 2009 (thelancet.com/journals/lancet/)Potential tipping points in climate systems from Costello et al, 2009 (thelancet.com/journals/lancet/)”Effects on health of climate change will be felt by most populations in the next decades and put the lives and wellbeing of billions of people at increased risk. During this century, the earth’s average surface temperature rises are likely to exceed the safe threshold of 2°C above pre-industrial average temperature.”The first report outlines all the major threats-both direct and indirect-to global health from climate change. These derive from changing patterns of disease, water and food insecurity, vulnerable shelter and human settlements, extreme climatic events, and population migration. The report presents these results in four sections:The physical basis.Health impacts of climate change.Non-linearities, interactions, and unknown unknowns.Health co-benefits of emissions reduction.To emphasize the multiple health co-benefits, the authors have created a magnificent graph (see pdf) showing which major mitigation techniques are allied with them. It also charts dozens of interrelationships.The report concludes from 175 references that a new advocacy and public health movement is needed urgently to bring together governments, international agencies, nongovernmental organizations, communities, and academics from all disciplines to adapt to the effects of climate change on health.The World Health Organization has also worked proactively on the subject. WHO held the first-ever global conference on health and climate in Geneva last August. It brought together over 300 participants-government ministers, heads of UN agencies, urban leaders, civil society leaders, and leading health, climate, and sustainable development experts-and paved the way toward the UN Climate Summit organized by Secretary-General Ban Ki-moon in September. WHO concluded then that measures to adapt to climate change would ensure that communities are better prepared to deal with the impacts of heat, extreme weather, infectious disease, and food insecurity. Through careful planning, these efforts could save lives around the world.In the US, the point agency for state and city health departments to prepare for specific health impacts of climate change is the Climate and Health Program of the Centers for Disease Control and Prevention. Its missions:Ensure that systems are in place to detect and respond to current and emerging health threats.Fast forward to Monday, June 22, 2015-the day the Lancet Commission publishes its long-awaited second major report: Health and climate change: policy responses to protect public health, from Nick Watts et al. In it, the internationally respected team lays out the policy responses necessary to ensure the highest attainable standards of health for populations worldwide in the face of projected climate alterations.Naturally, many will find the unknowns and some of the science terrifying. However, the central finding from the Commission’s work is that tackling climate change could present the greatest global health opportunity of the 21st century.The text is also informed by a section on generic barriers. Opposing national (and vested) interests, clashing views of what constitutes fair distribution of effort, and a model of economic growth that is tied to current fossil fuel use can all impede progress. The decades-old UNFCCC process has been stymied at one time or another, and is still held up, by all of these. The Commission cites Hulme, 2009, on a few specific barriers:Uncertainty and complexity.Psychological distance along four dimensions-temporal, social, geographical, and degree of uncertainty. (People tend to connect more easily with issues that are close in time, space and social group, and about which there is little uncertainty. All these dimensions interact with each other and tend to dampen concern and willingness to act.)Enormous lock-in to current economic patterns, e.g., addiction to fossil fuels and/or the services they provide.Active promotion of misinformation, motivated by either ideology or vested economic interests. A major study of the Climate Change Counter Movement in the US identifies funding of around $900 million annually.The Commission also offers a useful look at the influence of public opinion. “Ultimately, effective actions by local and national governments, and by businesses, are unsustainable without supportive public opinion.” Public support for stronger action on climate change is a necessary, albeit far from sufficient, factor that is essential for behavioral change to contribute to solving the problem.Cross-national studies suggest that most people view climate change as a threat, although its degree can vary significantly among regions. As of 2013, over 60% of people in parts of Europe (Greece, Spain, Italy), Lebanon, Tunisia, Uganda, South Korea, Japan, the Philippines, and most of South America see climate change as a major threat. Belief in climate change as a major threat is only held by 40% of US citizens in this tabulation, about the same as in China, although fewer Chinese consider it not a threat than Americans. Canada, Australia, the UK, and Russia all think climate change is a worse threat than US citizens do. Only Egypt, Jordan, Israel, Pakistan, and the Czech Republic (torn by dissension for centuries) view it as less of a major threat, and they have more immediate problems.The Commission’s writers go on to state that public understanding of climate change is shaped by broader knowledge, religious convictions, and political belief systems. They make the point that effective communication about climate change requires trust. (Sandy Dechert covers environmental, health, renewable and conventional energy, and climate change news.)…….to be continued
