WHO: Health effects of climate change already tangible

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As the health effects of climate change are already being observed, the EU should quickly boost its response capacity by improving early warning and surveillance of infectious diseases and establishing a sound communication system with the population, argues the World Health Organisation’s Dr. Nata Menabde in an interview with EURACTIV. 

Dr. Nata Menabde is the deputy regional director of the World Health Organisation (WHO) at its Regional Office for Europe.

To read a shortened version of this interview, please click here

What are the potential health effects of climate change in the EU? 

The health effects of climate change in the EU will not be different from health effects in other parts of the world. It is just that, fortunately, the EU member states are better prepared than many other countries in the world. Therefore, the health consequences of climate change on health may be less visible if compared to Africa or other locations, for example. 

In the EU, it has an important effect on the air pollution and all related diseases, such as respiratory diseases and allergic disease, especially in children. Obviously, floods are going to continue to affect EU states substantially, at least according to predictions. In that sense it will bear major costs for society, due to damaged infrastructure in big cities and the impact on living conditions of people in big cities. 

Infectious diseases will be also very much linked to this, because of outbreaks due to heat waves for example. An example of this could be increased incidence of salmonella because microbes grow faster when it is warm and contaminate food. If there is not a sufficiently vigilant system of food safety, it may actually reach the people. Compared to low temperatures, the risk is simply too high compared to heat waves. 

Also, in the EU, explicit effects of climate change will be on elderly people, because people live longer in the EU than in the other parts of the world, with chronic conditions, such as cardiovascular diseases and metabolic disorders. And those people will be explicitly vulnerable to any changes in the rise of temperatures. 

Heat affects people with cardiovascular conditions through dehydration, for example. Also people with hypertension have problems coping with heat. Basically, all chronic conditions will go into a more acute stage and through that you’ll have increased morbidity and mortality in the ageing population. 

There is a lot to do to reach out to these people to alert them of a coming heat wave for example, and prepare health systems to face increased demand. Heat waves will continue to affect these people disproportionately in Europe, because not all have good protection from heat in their apartments and not all health services have good conditioning everywhere. A number of health conditions will be exacerbated through climate change. 

How will climate change affect Europeans’ food security? 

With droughts and floods obviously you are changing the whole agricultural setting for growing crops, for example. According to our estimates crop yields will decrease by 30% by the end of this century in certain parts of Europe, such as the Mediterranean area, where the risk is certainly higher than in other parts of the EU. 

This naturally means that harvests will be smaller, affecting rural populations dependent on them and poor or otherwise vulnerable people dependent on the availability of traditionally cheap food. 

We think that in the South, it may have a significant impact on the people living [there]. Some things can be done to prevent this and to plan how to cope with these shortages in the long term. We need to elaborate an action plan on how to substitute the reduction of natural yield of certain food products. 

How could Europe prepare itself for food security threats?

Because it will affect the whole of Europe and because Europe is not dependent on European products only, you have to find out where you can import the necessary products from and what you will export, as climate change may actually change what you are growing. You need to have a long-term agricultural view to see what changes need to be introduced to business models. 

Forward-looking thinking is particularly needed regarding areas that are strongly dependent on production of a specific crop. Alternative replacement solutions need to be thought for them.

What could the EU or individual member states do to reduce the health effects of climate change?

There are two ways of doing it. One of them is the mitigation, thus dealing with the root causes of climate change and changing the way people are living. We need to achieve at least 35% reduction in CO2 emissions to stabilise the current levels by the end of the century. 

So, there is a lot to do in reducing the emissions. But that is not enough as we already observe health effects of climate change. We can only try to better respond to these challenges by: better equipped health systems, better trained doctors, better available technologies, better housing, living and socio-ecological conditions, better construction and shielding from environmental conditions. 

More importantly, you need to know when things are going to happen. You need to be able to reach as many people you can, when you know that a heat wave is coming. You need simple measures for people to be able to help themselves and protect their housing. It is a lot of early warning, surveillance of infectious diseases, the ability of health services to cope with outbreaks and provide proper treatment to help people out when they are already sick. It is a lot of primary and secondary prevention and cure measures and a lot has to do with communications, with media involvement. A lot of crises and failures happen because of poor communication and communication is not necessarily the health sector’s core strength. Authorities therefore need to put in place all measures to be able to connect with the population. 

WHO international health regulation, legally compulsory for those who have adopted it and introduced in 2007, requires member states to prepare their surveillance systems to the level that they can detect and cope with these kinds of event. 

Unfortunately there has been an assessment of the preparedness of the member states and this is not a very encouraging picture. Therefore, regulations cannot be fully implemented until two years from now. Two years were given to member states to upgrade their systems to be able to become reliable in detecting and informing others about such events or anything that could be internationally spreading. It is not as rosy a picture as one may think. 

It is one thing to have a Commission surveillance system, but you have to nationally collect this data, you have to catch every patient that may have symptoms and that is not done from Brussels but by local surveillance systems. 

What does health security stand for and how can climate change pose a threat to it?

A typical example of health security is SARS, because it has very serious, global, pandemic implications. Those issues that are putting at threat the whole existence of certain countries and economies, and which is not an individual case of one patient but a global, population-based threat. And usually these issues are considered under a national security plan – not national health plan – for these types of events there is almost a military type of response. 

WHO international health regulation partially serves to prevent anything from going undetected or if it has to be combated, then everybody should put their efforts into killing the thing in the cradle before it spreads and affects everyone. 

What should the European Commission do to help counter the health effects of climate change?

Exchange of best practice is not enough. But as the Commission is a very strong instrument and as it is cross-sectoral by nature, the work happening in other sectors can be influenced through it. 

The WHO’s strong message on the health effects of climate change is that it will be the oldest, the poorest, the sickest, the youngest and the less protected who will be hit the hardest by climate change, even in Europe. And we, as a society, have to make sure that it is not unfairly hitting on those who are the poorest and less protected. Thus, it is about putting the removal inequalities and inequities on the top of the agenda.

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