David Gikungu

Kenya Meteorological Department

As geographical and temporal ranges expand with
global warming, it is expected that the prevalence
of climate sensitive diseases may also increase,
owing to their dependence on climate, especially
temperature, of the respective vectors—mosquito-
es, flies and snails (Kelly-Hope et al, 2008). The
vector-borne diseases include:
 malaria,
 dengue,
 leishmaniasis and
 schistosomiasis
 It is expected that the incidence and
magnitude of infectious disease effects will
increase as global temperatures rise. For
example, it has been observed since 1980,
that a new disease has emerged, on average,
every seven to eight months (Emerging
Infectious Diseases, 2005).
 60% of these emerging diseases are zoonotic,
that is, transmissible between animals and
man.
 The primary purpose of early warning is to enable
earlier intervention and effective prevention and
control of epidemics. A working framework for the
development of systems that enable epidemic
forecasting, prevention, early detection and control
has been developed and its various components and
processes tested in a number of countries.
 There indeed exist models of malaria incidence that
incorporate monitored or predicted climate, and
which can provide early warnings of epidemics one
to five months in advance in semi-arid areas.
 Access to frequently-updated climate information is
an important requirement for the development of
integrated early warning systems for climate
sensitive diseases.
 The routine use of such information within African
disease control programmes is, however, limited
mainly because of poor inter-sectoral collaborations
between health and other sectors (including
meteorology and agriculture) and the lack of
systematic evidence concerning the cost-
effectiveness of the early warning system.
 Fortunately, this is one of the key areas
addressed by the Libreville Declaration 11
Action points (2008) and Implementation
 Another major challenge facing Africa is the relative
weakness in disease surveillance and reporting
systems, which hamper the detection and control of
epidemics, making it difficult to obtain the long-
term linked datasets on climate and disease that are
necessary to develop early warning systems. During
malaria epidemics, for example, health facilities are
often overwhelmed and have to treat the whole
population in order to reduce the reservoir of the
parasite within the population.
 While the key factors in the epidemiology of various
diseases may differ from disease to disease, the
basis of any epidemic early warning and response
system is anchored on a framework of five
integrated components: (1) vulnerability
assessment and monitoring; (2) seasonal climate
forecasting; (3) environmental monitoring; (4)
sentinel case surveillance; and (5) planning,
preparedness and response.
 In the case of malaria models, it is clear that
technical and practical hurdles still need to be
overcome before some of the models can be
widely integrated into routine malaria-
control strategies.
 [Key steps on Local activity on malaria and
diarrhoeal diseases cited here]
 Alterations in rainfall, surface water
availability and water quality as a result of
climate change could affect the burden of
water-related diseases.
 Water-related diseases can be classified by
route of transmission, thus distinguishing
between water-borne (ingested) and water-
washed diseases (that is those caused by lack
of hygiene).
 The IPCC (AR4) states four main
considerations for evaluating the relationship
between health outcomes and exposure to
changes in rainfall, water availability and
quality. These are
 (i) linkages between water availability,
household access to improved water, and the
health burden due to diarrhoeal diseases;
 (ii) the role of extreme rainfall in facilitating
water-borne outbreaks of diseases through
piped water supplies or surface water;
 (iii) effects of temperature and runoff on
microbiological and chemical contamination
of coastal, recreational and surface waters;
and
 (iv) direct effects of temperature on the
incidence of diarrhoeal disease.
Floods
 Floods, a natural weather disaster and one of the
manifestations of climate change, are expected to
rise in intensity and frequency.
 Besides the immediate impacts of this natural
disaster, populations with poor sanitation
infrastructure and high burdens of infectious
disease often experience increased rates of
diarrhoeal diseases after flood events.
 Vector organisms that do not regulate their
internal temperatures and are therefore
sensitive to external temperature and
humidity transmit many important infectious
diseases.
 Climate change may alter the distribution of
vector species (increasing or decreasing)
depending on whether conditions are
favourable or unfavourable for their breeding
places. 
 Changes in climate that can affect the
potential transmission of vector-borne
infectious diseases include temperature,
humidity, altered rainfall, soil moisture and
rising sea level.
 In malaria dynamics, both parasite and vector are affected
by rainfall and temperature. Rainfall is widely documented
as a limiting factor for mosquito populations.
 Decadal decreases in rainfall have indeed been associated
with reductions in transmission, while inter-annual malaria
variability is climate-related in specific eco-
epidemiological zones (AR4) associations between inter-
annual variability in temperature and malaria transmission
in the African highlands. Malaria admissions in the
highland areas of Kenya have been associated with rainfall
and unusually high maximum temperatures 3-4 months to
the outbreak (Githeko and Ndegwa, 2001).
 There are clear associations between inter-
annual variability in temperature and malaria
transmission in the African highlands.
 Malaria admissions in the highland areas of
Kenya have been associated with rainfall and
unusually high maximum temperatures 3-4
months to the outbreak (Githeko and
Ndegwa, 2001).
 The best known way to reduce vulnerability is to
build infrastructure to remove solid waste and
waste water, and to supply potable water.
 No sanitation technology is “safe” when covered by
flood waters, as faecal matter mixes with flood
waters and is spread wherever the flood waters run
(Kovats et al, 2009).
 Health ministries are advised to ensure sustained
routine surveillance so as to provide data on
episodes of infectious disease both before and after
a flood.
 Epidemic malaria is a public-health problem
in most areas in Africa, with programmes in
place to reduce the morbidity and mortality
associated with these epidemics.
 Some projections suggest that climate
change may facilitate the spread of malaria
further up some highland areas.
 Therefore, programmes should not only
continue their current focus, but should also
consider where and when to implement
additional surveillance to identify and
prevent epidemics if the Anopheles vector
changes its range.
Thank you all