The nature of various manifestations of climate change in the form of frequent extreme weather
events — heavy and prolonged rains, cloudbursts, flash floods, heatwaves, wildfires, catastrophic
TODAY'S PAPER | FLOOD DONATIONS | NOVEMBER 08, 2022
Climate change and health
Zafar Mirza | Published
November 4, 2022 greenhouse effects, global warming, melting glaciers and rising waters.
The writer is a former SAPM on health, professor of health systems at Shifa Tameer-i-Millat University and WHO
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THE devastating floods in Pakistan are a manifestation of climate change. Whatever
development gains had been made over the decades in the flood-affected districts
were washed away within a few days. Pakistan will take years to recover from this
deluge.
adapted to surviving in humans”.
Environmental factors alone take the lives
of around 13m people annually around the
globe.
Apart from the heat factor, there are also a number of direct effects of climate change depending
upon its manifestation at a given time and space.
Read more: Pakistan to take up climate financing issue at COP27, says minister
In these pages, I have written, for example, on the five groups of medical and healthcare problems
during the floods and the need for and challenges of corresponding healthcare provision — ie
injuries, waterborne diseases, exacerbation of existing chronic conditions, mental health issues
and special needs of vulnerable groups like women and young children, old people, the disabled,
etc.
Addressing these problems in emergency settings on a large scale and over a period of time puts
huge stress on healthcare systems which themselves are badly affected. Pakistan is passing
through such a situation, which the WHO has characterised as “public health crises”. Climate
change effects such as rising sea levels, collapsing ice shelves, and greater volcanic activity are
linked to the increased threat of tsunamis. The 2004 tsunami alone caused 227,000 deaths and
unfathomable misery.
The indirect and insidious health effects of climate change work through raising the level of risks
to health by negatively affecting the determinants of health. The discourse on the determinants of
health is vast and there are many ways of looking at these.
One way of understanding the determinants of health is to see them as social, economic and
political determinants. Another lens shows them as distal and proximal determinants in terms of
their effect on health, and yet another dichotomy groups them into environmental and
behavioural determinants. Whichever way we appreciate these factors, the fact remains that
improvement or decline in them affects human health in a positive or negative way.
Another important feature of this discourse, from a policy perspective, is that these are factors
which are not typically in the control of health ministries and hence necessitate inter-sectoral
collaboration.
storms, tsunamis, cyclones, droughts — make the future highly unpredictable. So, we don’t know
when and where the next climate change disaster will hit. Obviously, this makes preparations to
respond to these events extremely difficult, and never enough.
A lot has been written about the causes of climate change and how those who pollute the least are
affected the most, environmental injustice and ways to deal with unabated fossil fuel extraction,
For almost three decades, the United Nations has been bringing together member states for global
climate change summits. During this period, climate change has taken centre stage, globally. In
2015, the historic Paris Agreement was adopted by 196 world leaders with the aim of containing
the increase in the average global temperature to below two degrees Celsius, above pre-industrial
levels, and to pursue efforts to limit the temperature increase to 1.5°C above pre-industrial levels,
recognising that this would significantly reduce the risks and impacts of climate change (Article
2).
The 27th Conference of Parties is going to start this Sunday in Sharm El Sheikh, Egypt, where
45,000 participants have registered to discuss climate change issues. In the words of the
president-designate of COP27, “… climate crisis is existential, overriding and ever present, adverse
climate impacts are increasing in frequency, intensity and impacts”.
Climate change affects human health in many direct and indirect ways. Primarily, climate change
and its various manifestations occur due to the rise in global temperatures. As a result, the
frequency and intensity of heatwaves are increasing.
Prolonged exposure to high day and nighttime temperatures produce cumulative physiological
stress on the human body which exacerbates the top causes of distress and death globally,
including respiratory and cardiovascular diseases, diabetes mellitus and renal disease. And every
physical stress also results in mental distress and emotional disorder.
Rising temperatures are changing ecosystems which are favourable to the survival of many insects
and pathogens. Mosquitos and ticks, for example, thrive in warmer environments. Climate change
pushes animals to new habitats as natural habitats disappear, which leads to new interactions
between animals and humans, giving rise to the spread of zoonotic diseases, for example, rabies.
Ebola, Lassa fever, Rift Valley fever and monkeypox are examples which are known to spread
more and widely under the effect of rising temperatures.
America’s CDC speculates that “as the difference between environmental temperatures and
human body temperatures narrows, new fungal diseases may emerge as fungi become more
Take the example of education. Pradhan and others (2017) have concluded that the approximately
14 per cent and 30pc decline in under-five and adult mortality between 1970 and 2010 resulted
from improvements in education levels, and that female education is far more important than
male education for reducing both adult and child mortality.
Water is another critical determinant of health. The WHO estimates that almost one-tenth of the
global burden of disease could be prevented by improving water, sanitation and hygiene. The list
of health determinants is long and varied.
Climate change and a plethora of its manifestations influence most determinants of health.
Displacements, families sliding into poverty, lack of proper nutrition due to wiped-out crops and
seeds, lack of access to safe drinking water, disruption in schooling, air pollution, disrupted access
to healthcare, unattended and prolonged mental stress are all determinants which are negatively
affected by climate change.
Their combined and cumulative impact seriously affects human health and contributes heavily to
morbidity and mortality. Environmental factors alone take the lives of around 13 million people
annually around the globe while morbidity is uncountable.
The WHO rightly calls climate change the single biggest health threat facing humanity. Like
always, the most vulnerable are the most affected.
The writer is a former SAPM on health, professor of health systems at Shifa Tameer-i-Millat
University and WHO adviser on UHC.
zedefar@gmail.com
Published in Dawn, November 4th, 2022