Climate Change and Health

With special reference Anthony J McMichael to risksEpidemiology & Population Health facing small National Centre for The Australian National University island-states Canberra, ACT 0200

Climate Change: the debate

Skepticism is now receding. We know that: Greenhouse gas (GHG) concentrations are increasing GHGs affect the climate system (thankfully!) World average temperature has risen relatively fast over the past 30 years Sea-level rise is gradually accelerating Many temperature-sensitive systems/processes have changed over the past two decades

Kilimanjaro 1970

Ice on Kilimanjaro
Area (km2)
15 10 5 0

1900 1920 1940 1960 1980 2000 2020 Year

Kilimanjaro 2000

Climate Change: Basic Issues

Earths climate varies naturally because of a variety of cosmological and geological processes. Climate change refers to an additional, and relatively rapid, change induced by human actions. The additional change several degrees C within a century will disrupt the foundations of life on Earth. Ecosystems and life in general have evolved within a narrow band of climatic-environmental conditions.

1.4 1.2

Number of Earths used by humanity One Earth is available (The planets total biocapacity = 1.0)

Number of Earths

1.0 0.8 0.6 0.4 0.2 0.0

1960s

1970s

1980s

1990s

Based on Wackernagel et al, 2002

Changes in environmental indicators, 1750 - 2000

Atmos CO2 conc Atmos N2O conc Atmos CH4 conc

Atmos ozone loss

Av surface temp (NH)

Climate disasters

Fully exploited fisheries

Coastal shrimp farms

Coastal N2 flux

Loss of trop forest, woodland

Domesticated land Global biodiversity

From: Steffen et al. In press 2004

20

Average Global 19 Temperature (OC)

18 17 16 15 14 13

This presents a rate-of-change IPCC (2001) problem for many natural estimates systems/processes a 1.4-5.8 oC increase Central estimate = 2.5 oC (plus increased variability)

High

Low

Band of historical climatic variability

1860

1900

1950

Year

2000

2050

2100

Sea-level rise over coming centuries Sea-Level Rise, over the coming millennium
following 70 years of excess greenhouse gas emissions
1.5

Sea-level rise (m)

Total sea level rise

1.0

Ocean Expansion

0.5

Ice-melt

Greenhouse gas emissions (super-Kyoto action)

0.0

200

400

600

800

Peaking in 2050

Time from start (years)

IPCC, 2001 IPCC 2001

SLR Risks to Small Island-States

Coastal flooding Amplified storm surges Damaged coastal infrastructure (roads, etc.) Salination of island fresh-water (esp. subterranean cells) Impaired crop production Population displacement: diverse health risks (nutrition, infection, mental health)

Modulating influences

Health effects Health Effects

Temperature-related illness and death Extreme weatherExtreme weatherrelated (floods, storms, related health effects etc.) health effects Air pollution-related health effects

Human exposures

Climate Change

Regional weather changes Heat waves Extreme weather Temperature Precipitation Sea-level rise

Microbial changes: Contamination pathways Contamination paths Transmission Transmission dynamics dynamics

Water and food-borne Water and food-borne diseases diseases Vector-borne and Vector borne and rodent- borne diseases rodent borne diseases Effects of food and water shortages Mental, nutritional, infectious-disease and other effects

Changes in agroecosystems, hydrology Socioeconomic and demographic disruption

ENSO and climate change

The effect of global climate change on the future frequency and/or amplitude of El Nio is uncertain . Events may become more frequent or more intense. However, even with little change in amplitude, climate change is likely to lead to greater extremes of drying and heavy rainfall, and to increase the risk of droughts and floods that occur with El Nio [IPCC 2001].

VECTOR-BORNE DISEASE

Estimated population at risk of dengue fever under standard climate change scenario: 1990, 2085

1990

2085
.

Source. Hales S et al. Lancet (online) 6 August 2002.

Modelling Malaria Transmissibility in Zimbabwe. I

Baseline 2000

Courtesy: Kris Ebi

Modelling Malaria Transmissibility in Zimbabwe. II

Courtesy: Kris Ebi Baseline 2000 2025

Modelling Malaria Transmissibility in Zimbabwe. III

Baseline 2000 2025 2050

Courtesy: Kris Ebi

What Should Health Ministries Do?

Commission/conduct national assessments of risks to health from CC (and SLR) Participate in emergency management preparedness (communications, facilities, skills) Argue the centrality of population health as the real bottom line in the sustainability debate Make links with other ministries education, primary industry (agriculture), fisheries, development planning, etc. Highlight the sense and cost-savings of adaptation strategies, to lessen adverse impacts

That s All

Global average temperature (oC) over the past millennium

GHG: Coming Decades

The International Energy Agency predicts that the increase in greenhouse gas emissions from 2000 to 2030 in China alone will almost equal the increase from the entire industrialized world. China is the world's second largest emitter of such gases, after the United States even though China's per-person emissions are, for example, still only oneeighth of those in the United States.

Population

Total real GDP

Foreign direct investment

Damming of rivers

Water use

Fertiliser consumption

Urban population

MacDonalds Restaurants

Motor vehicles

International tourism

From: Steffen et al. 2003

Need to convert estimates of regional food yields into estimates of changes in numbers of malnourished people

Climate change impacts on rain-fed cereal production, 2080 (IIASA: Fischer et al, 2001)

Dengue Fever: Estimated geographic region suitable for maintenance of Ae. aegypti, alternative climate scenarios for 2050
Darwin

Darwin

Broome

Port Headland

Katherine

..

Broome

. .

Katherine

Port Headland

. .

Cairns Townsville

Cairns Townsville

Model Estimate: Current Dengue Risk Region

.
Brisbane

Mackay

Carnarvon

Rockhampton

Mackay

Scenario: A1B (mid) CSIROMK2

Rockhampton

Darwin

. .
NCEPH/CSIRO/BoM, 2003

Broome

. .

Katherine

Port Headland

. .

Cairns Townsville

Mackay

Carnarvon

Rockhampton

Scenario: A1F1 (high) CSIROMK2

Categories of climate extremes

Simple extremes based directly on climate statistics
Hot day = day with temperature > 95th centile

Complex, event-driven extremes

Droughts Floods Hurricanes/typhoons/tropical cyclones

Changes in climatic phenomenon

Confidence in observed changes (latter half of 1900s)

Probability of projected changes to 2100

Higher maximum temperatures - more hot days Higher minimum temperatures, - fewer cold days and frost days Increase of heat index over land areas More intense precipitation events

Likely Very likely Likely Likely, (N mid to high latitudes)

Very likely Very likely Very likely Very likely

Increased summer continental drying Likely, in a few areas and associated risk of drought

Likely, over most mid-latitude continental interiors. Likely, over some areas Likely, over some areas

Increase in tropical cyclone peak wind intensities Increase in tropical cyclone mean and peak precipitation intensities

Not observed in the few analysis available Insufficient data

IPCC WORKING GROUP I, Third Assessment Report, 2001