CLIMATE CHANGE HEALTH IMPACTS IN THE PHILIPPINES: TUBERCULOSIS

The Philippines is located near the equator and experiences a tropical climate. With the rise of
global temperatures, the country is vulnerable to climate change. Climate change is the variation of the
mean temperature which causes the extreme conditions in the environment. This impacts human health as
it increases the prevalence of infectious diseases by the changing temperatures favorable for transmission
and breeding of causative agents. Air pollution, one of climate change’s key drivers, leads to severe
consequences to respiratory health. Last 2018, the Philippines was recorded to have the third-highest air
pollution-related deaths in the world. Tuberculosis (TB), an infectious disease mainly affecting the lungs,
is a major public health problem, and is the 6th leading cause of morbidity in 2010. Its incidence in the
country is 554 per 100,000 individuals. As stated by McIver et al. (2015), one of the occurrences that lead
to an increased possibility of transmission of tuberculosis is climate change. Moreover, climate change may
affect food and water security, which further hasten the socio-economic (poverty, overcrowding, population
growth) and individual factors (malnutrition, smoking and diabetes) that determine and identify as risk
factors of TB.
The Earth’s climate has undergone multiple changes throughout history. As the global average
temperature continues to rise, 2015-2019 may be the warmest five-year period recorded. This 1.1°C
increase from the late 19th century is greatly attributed to the rise in greenhouse gas (GHG) emissions, with
carbon dioxide (CO2) growth rates almost 20% higher than the past few years. This has resulted in the
occurrence of sea-level rise, ice loss, and extreme weather. In fact, the 2020 Climate Risk Index presented
last United Nations Conference on Climate Change (COP25 Chile) identified the Philippines to be the
second country most affected by climate change. Due to significant exposure to natural hazards and
dependence on climate-sensitive natural resources, the country has exhibited a continuous increase in
temperature. It has also experienced an increased incidence of cyclones during El Niño and a sea-level rise
of 0.15 meters. These changes are projected to worsen by 2050, with temperatures expected to increase by
1.8°–2.2°C along with a higher frequency of extreme weather events, increasing health risks from endemic
cardio-respiratory, vector-borne, and waterborne diseases.
Seasonality and climate factors play a secondary role in TB transmission. Overcrowding and poor
ventilation are the primary factors in the disease’s transmission. Researches have suggested that
environmental factors such as temperature, humidity, and sunlight exposure, contribute to TB seasonality.
Transmission could be enhanced in extremely high or low temperature climate as reported in a study
conducted in Japan. High temperature environments have a high airflow which makes a conducive
environment for TB transmission. The study also reported that exposure to extreme heat was associated
with a high number of TB cases. Furthermore, another study suggests that the causative agent of TB,
Myobacterium tuberculosis, favors a high temperature environment for replication. In addition to the
warming temperature, air pollutants and CO2 emissions (known causes of global warming and greenhouse
 CLIMATE CHANGE HEALTH IMPACTS IN THE PHILIPPINES: TUBERCULOSIS

effect) also affect TB transmission. Exposure to air pollution will have an effect on the immune process of
humans in inhibiting the disease. Undernutrition is another risk factor for TB, and climate change has
worsened the country’s food insecurity. As extreme weather conditions negatively impact the agricultural
sector, recent data showed that 26.2% of the population of the Philippines are malnourished. Climate change
therefore has direct and indirect effects on TB prevalence.

World Health Organization has built partnerships with United Nations Framework Convention
on Climate Change (UNFCCC) for the inclusion of human health in climate change agenda. The WHO
UNFCCC Health and Climate Change Country Profile Project is able to establish evidence-based
policies for member countries by strengthening climate resilient health systems. The Centers for Disease
Control and Prevention (CDC) also leads efforts to anticipate the effects of climate change on health,
advocating for climate surveillance, preparedness, management and respond strategies to be represented
well in health systems. Philippines have participated in these global policies for the country by signing
and ratifying to the Kyoto Protocol and the Paris Agreement. Among the country’s initiation for climate
change mitigation for human health are National Climate Change Action Plan, the Climate Change Act
of 2009, and the National Framework Strategy on Climate Change (NSFCC). The NSFCC spearheads
local government policies for climate resilient communities. It is highly advised for public health
authorities to collaborate with local government units (LGU) in public planning and policy-making.
Mitigation should start with sufficient data of infectious disease outbreaks in the locality, where climate
risk-factors are identified and assessed for pre- and post-policy implementations. Most attainable
solutions would be the reduction of GHG by provision of bike lines, intensified practicing of solid waste
management in households, creating yearly target of land areas for tree planting and maintenance,
protection of forest areas by reduced commercialization, establish an agreement with local business
owners to utilize sustainable packaging, implementing strict guidelines and penalties for industries’
waste management, imposing climate resilient practices in agriculture, and conduct education
campaigns of health and climate relations, especially in schools. These strategies would contribute to
TB prevention and control as these would decrease extreme heat temperatures, and assure air quality.
Additionally, a WHO review of the Philippine’s NCCAP suggests that climate information should be
included in an Integrated Disease Surveillance and Response system.

Philippines is highly vulnerable to climate change for its geographical setting. Subsequent direct
and indirect impacts increase the incidence of infectious diseases. TB, one of the country’s major public
health concerns, continues to emerge as secondarily influenced by the extreme warm temperatures of
the country. Existing local policies are established to improve climate resilient health systems, however
 CLIMATE CHANGE HEALTH IMPACTS IN THE PHILIPPINES: TUBERCULOSIS

would need further modifications for effectivity. Therefore, the worsening status of climate change puts
it as a salient factor in disease prevention and health promotion.

Total word count without references: 975

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