Those interested on Climate change

1. Ravi K Mishra
MPH, 3rd Batch
Department of Community Medicine, NMC, Birgunj
Recent Advanced
on
Climate Change and Human Health
1

2. Outline of Recent Advanced
• Introduction
• Observed Climate Change
• Climate change in Nepal Context
• Impacts of Climate Change
• Health Impacts of Climate Change
• Recent Activities on climate change and Public Health
• Vulnerability
• References
Total No of Slide:66
Estimated Time Period : 50 Minutes
2

3. Climate Change
Climate change refers to the variation in the Earth's global
climate or in regional climates over time.
It describes changes in the variability or average state of the
atmosphere over time scales ranging from decades to
millions of years.
These changes can be caused by processes internal to the
earth, external forces or, more recently, human activities.
Source (IPCC 2007)
3

4. The impact of climate change is not experienced
equally through out the world.
Developing Countries are considered to be
particularly susceptible to climate change due to
their limited capacity to cope with hazards
associated with changes in climate change.
Nepal is no exception in being a country
vulnerable to the impact of climate change due to
its fragile mountain ecosystem, weak geological
condition and diverse nature of climate.
4

5. Observed Climate Change
 Global average surface air temperature has increased, especially since
about 1950.
 The average temperature of the world has increased by 0.74 degree
Celsius over the last 100 years (1906-2005).
 2005 and 1998 were the warmest two years in the instrumental global
surface air temperature record since 1850. Eleven of the last 12 years
(1995 to 2006)-1996 exception-rank among the 12 warmest years on
record since 1850.
 Climate models calculate that the global mean surface temperature could
rise by about 1 to 4.5 centigrade by 2100.
 Average global precipitation has also increased by 0.5-1% annually. It is
decreasing in equatorial region and increasing in higher latitude.
Precipitation has increased over land at high latitudes of the Northern
Hemisphere, especially during the cold season. Decrease in precipitation
occurred in steps after the 1960s over the subtropics and the tropics from
Africa to Indonesia.
5

6. Observed Climate Change
Temperature
 Days and nights are both becoming warmer.
 Warm spell duration (Long hot days) is increasing
 Cool nights and cool days are becoming less frequent.
Extreme weather ahead
Rainfall
Total rainfall and heavy rainfall events are
increasing
Maximum 24 hour rainfall is also increasing
6

7. Climate change may result from:
 Natural factors, such as changes in the Sun’s energy or slow
changes in the Earth’s orbit around the Sun; changes in ocean
circulation.
 Anthropogenic factors that change the atmosphere’s make-
up (e.g., burning fossil fuels) and the land surface (e.g.,
cutting down forests, building developments in cities and
suburbs, etc.).
7

8. Global warming
 Global Warming is an average increase in temperatures near
the Earth’s surface and in the lowest layer of the atmosphere.
 Increases in temperatures in our Earth’s atmosphere can
contribute to changes in global climate patterns.
 It can be considered part of climate change along with
changes in precipitation, sea level, etc.
8

9. Greenhouse Effect
 The greenhouse effect is a natural process in which the Earth's atmosphere
insulate the Earth.
 Incoming solar radiation (short-wave radiation) is absorbed at the Earth's
surface. Energy is then radiated back from the Earth's surface into the
atmosphere as long-wave radiation.
 Over time there is an approximate balance in this incoming and outgoing
radiation.
 Changes to this balance, such as changes in the amount of radiation received or
lost by the system(due to GHGs), or changes to the distribution cycles within
the system, can affect climate.
9

10. IPCC 2007a
Greenhouse gases’ effect
10

11. IPCC (2007):- Most of the observed increase in global
averaged temperature ... is very likely due to ... increase in
GHG concentrations.
Source :- Intergovernmental Panel on Climate Change(IPCC)
11

12. IPCC (2007)
Warming in
the
climate system
is unequivocal.
Source :- Intergovernmental Panel on Climate Change(IPCC)
12

13. 13

14. 14

15. Environmental health risks in different scale
Regional air pollution
Acid rain,
Asian brown cloud
Global change
Direct, toxic, hazard
Extremes of
exposures;
disruption of
life/health-support
systems
Environmental
tobacco smoke
Indoor air
Local air pollution
15

17. Land Areas Warm More than the Oceans with the
Greatest Warming at High Latitudes
Annual mean temperature change, 2071 to 2100 relative to 1990.
Global average in 2085 = 3.1°C.
IPCC 2007b 17

18. Nepal Context
 Nepal is the fourth most vulnerable country in terms of
climate risks and 30th in terms of water-induced disaster.
Climate change is posing additional threat to Nepal.
 Nepal's average annual mean temperature has increased by
0.060C between 1977 and 2000 and these increases are more
pronounced at higher altitudes and in winter.
 There is a general increase in temperature extremes with
warmer days and nights becoming more frequent and cooler
days and nights less frequent.
 A study conducted by Nepal Country Vulnerability Study Team
in 2009 has projected that Nepal’s mean annual temperature
may rise by 1.4 degree Celsius by 2030, 2.8 degree Celsius by
2060 and by 4.7 degree Celsius by 2090.
18

19. 19

20. Annual Mean Temperature Increase by Ecological
Region in Nepal (1977-2000)
Ecological Regions Temperature (°C)
Mountain
0.08
Hill
0.06
Terai
0.04
Nepal
0.06
20

21. 21
(DHM, Nepal)

22. Climate Change: Temperature Distribution Shift to
More Heat
IPCC, 2007b 22

23. Impacts of Climate Change
23

24. Impacts on Water Resources
 Water is the most impacted sector by climate change.
Water impacts are key for all sectors.
 IPCC predicts that by 2050, freshwater availability in
central, south, east and south east Asia, particularly in
large river basins, is projected to decrease.
 Effects of climate change on water resources could yield
manifold implications either due to too much and/or too
little water (NAPA 2010).
 Due to rise in temperature, Himalayan region is noticeably
impacted by climate change. The reported impact is rapid
reduction in glaciers.
 Climate change will increase the frequency and intensity of
water induced disasters.
24

25. Cont…
 Nepal’s high altitude glaciers are thinning (30 cm-1 m) and
retreating at an alarming rate (10-20m annually), faster
than the world average, resulting in an increase in the
number and size of glacial lakes and the threat of
catastrophic Glacial Lake Outburst Floods (GLOFs). Lake
Imja Tsho is an example of a glacier lake which was non-
existent in 1960 and now covers nearly one square
kilometre. The Imja glacier that feeds the lake has
retreated 75 m between 2001 and 2006.
 The new inventory identified 3,808 glaciers with a total
area of 4212 sq.km and 1,466 glacial lakes in Nepal
(ICIMOD 2011). The rapid reduction in glaciers has
profound future implication for downstream water
resources.
 There are about 21 potentially dangerous glacial lakes
identified by ICIMOD, among which 6 are most critical
25

26. Impacts on Agriculture
 Nepal’s agriculture is facing risks due to
changes in the reliability of stream flow,
a more intense and potentially erratic
monsoon rainfall and flooding. About
64% of cultivated areas are fully
dependent on monsoon rainfall.
 Decline in rainfall from November to
April adversely affects the winter and
spring crops.
 Rice yields are sensitive to climatic
conditions and may fall in western region
and it may threaten overall food security.
A study carried out by B.R.Regmi and A.
Adhikary in 2007 reveals that climate
change is posing threat to food security
due to loss of some local land races and
crops. 26

27. Cont…
 Initial National Communication,2004 states that with the increase of
temperature beyond 4 degree Celsius, the yield of Terai rice is
projected to decrease. The effect of temperature on rice crops in the
hills is little more severe than in the Terai. But in mountain region it is
better, but rice is grown negligibly there.
 The yield of wheat is projected to fall down with the rise in temperature
in Terai. The effect of temperature on wheat yield in the hills is less
than in Terai. There is insignificant decline of wheat yield in mountain
environment with rise in temperature.
 The rise in temperature will affect yield of maize crops in Terai more
than wheat and rice crops. It affects less in the hills than in Terai but
increases production of maize in mountain areas.
27

28. Impact on Livestock Livestock production is highly sensitive to climate
change.
Rising temperature increases lignifications of plant
tissues and reduces the digestibility (Minson, 1990),
reducing meat and milk production in range-based
livestock production system.
Increased heat stress is another pathway affecting the
livestock production. The increased heat alters heat
exchange between animal and environment affecting the
feed intake and metabolism (SCA, 1990; Mader and
Davis, 2004). Such stresses will affect growth and
productivity of the animals. But, effects vary from species
to species.
Water buffaloes need frequent bath for heat exchange.
Drying of ponds due to drought can deprive the buffaloes
for taking baths affecting adversely the productivity of the
buffaloes.
Similarly, the increased energy deficits may decrease
cow fertility, fitness, and longevity (King et al., 2006).
Increased temperature and humidity will increase the
risks of mortality and morbidity among the livestock and
poultry.
28

29. Impacts on Forests and Biodiversity
 IPCC predicts that approximately 20 to 30% of
plant and animal species assessed so far are
likely to be at increased risk of extinction if
increases in global average temperature exceed
1.5 to 2.5 degree Celsius.
 Increased temperature and rainfall variability
have resulted into shifts in agro-ecological zones,
prolonged dry spells, and higher incidences of
pests and diseases.
 New alien and invasive species are emerging
and their habitat is spreading at a fast rate.
 Migration of the forest towards the higher altitude,
change in their composition, and extinction of
species.
 Extreme climatic conditions have led to
increased incidence of fire in recent years
affecting more than 50,000 people and loss of
large areas of productive forest land. These
changes lead to species and habitat loss. 29

30. Cont…
30

31. Cont…
31

32. Health Impacts of Climate Change
McMichael et al. 2003a 32

33. Pathways: climate change human health
Source: adapted from Patz et al., 2000
33

34. Change in disease pattern
Food and nutrition
Water source depletion
Natural disaster
Health
Climate change
Health impact of climate change
Change in agent
Change in carrier
Change in host
Disease
Climate
change
Causal pathway
Health impact of
climate change: the
causal pathway
34

35. 1) Extreme weather related: cold waves and heat waves in the Tarai,
2) Water and food borne: diarrhoea, dysentery, typhoid, giardiasis,
amoebiasis, gastritis, jaundice and infectious hepatitis
3) Climate induced disaster: prolonged droughts and flash floods
4) Air pollution-related: respiratory diseases like acute respiratory
infection (ARI), bronchitis & asthma
5) Vector borne diseases: Japanese encephalitis, Malaria, Dengue and
Kala-azar (Visceral leishmaniasis)
6) Nutritional, Mental and Other: Malnutrition, Mental diseases and
non-communicable diseases including injuries and accidents
Climate Sensitive Diseases Identified by NAPA (2010)
35

36. Celsius Notes
27–32 °C
Caution — fatigue is possible with prolonged exposure and
activity. Continuing activity could result in heat cramps
32–41 °C
Extreme caution — heat cramps, and heat exhaustion are
possible. Continuing activity could result in heat stroke
41–54 °C
Danger — heat cramps, and heat exhaustion are likely; heat
stroke is probable with continued activity
≥54 °C Extreme danger — heat stroke is imminent
Classification of heat index
Source: Steadman (1979);
http://www.bom.gov.au/info/thermal_stress
36

37. Recent activities in climate change
and public health
37

38. Adaptation Initiatives
 The government of Nepal prepared the NAPA in 2010 to address its urgent
and immediate adaptation needs through a consultative and country-driven
process.
 NAPA is a strategic tool to access climatic vulnerability, and symmetrically
respond to climate change adaptation issues by developing appropriate
adaptation measures.
 Out of about 250 adaptation options proposed by the Thematic Working
Groups (TWG), nine integrated projects have been identified as the urgent
and immediate national adaptation priority.
38

39. Cont…
 The government of Nepal has approved the National Framework on
Local Adaptation Plans for Action (LAPA Framework) in 2011 that helps to
integrate climate adaptation and resilience aspects in local and national
plans.
 Agriculture, forestry, health, water and sanitation, watersheds and micro-
finance have been identified as the main entry points. But it states that
education, local infrastructure, disasters and other environment-related
areas may also be taken as entry points.
 Since 2013, the government is implementing 70 Local Adaptation Plan
for Actions in 69 village development committees and one municipality of 14
districts in the Mid and Far Western regions of Nepal with support from
Nepal Climate Support Programme: Building Climate Resilience in Nepal
Project funded by UNDP/DFID/EU
39

40. LAPA Process
The LAPA Framework consists of the following 7
steps for formulation and implementation. They
are:
 Climate change sensitization
 Climate vulnerability and adaptation
assessment
 Prioritization of adaptation options
 LAPA formulation
 LAPA integration in planning process
 LAPA implementation
 LAPA progress assessment
40

41. STEP 2:
VULNERABILITY
& ADAPTATION
ASSESSMENT
STEP 3:
PRIORITISATION
OF ADAPTATION
OPTIONS
STEP 4:
ADAPTATIONPLAN
DEVELOPMENT
STEP 5:
INTEGRATING THE
ADAPTATION
PLAN
STEP 6:
IMPLEMENTING
ADAPTATION
PLAN
STEP 7:
ASSESSING
PROGRESS
{Carried out in
all steps}
LAPA Steps
STEP 1:
SENSITISATION
{Carried out in
all steps}
41

42. The Doha Declaration on Climate, Health
and Wellbeing
• The international health and medical community have developed a joint
statement on climate health and wellbeing in Doha, Qatar on 2012.
• It calls for health to be central to climate action, and highlights the
opportunities to improve health through emissions reductions – pointing
out that reducing fossil fuel consumption and moving to low carbon
energy systems can deliver many benefits to health worldwide particularly
children, women and poorer people and those in developing nations.
42

43. Tackling climate change in cities: the role of
best practices
• Increasingly the burden of developing climate change policy with ‘real’
efficacy has shifted to cities.
• Cities now must interpret scientific findings into economic, and political
terms then devise physical and social policy; they must also localize global
ideas on climate change mitigation strategies.
43
(International centre for climate governance, 2014)

44. Contd…
• Analysis of municipal plans from 51 cities across the globe, has highlighted
commonalities in the efforts of cities to mitigate the adverse effects of
climate change on human health.
• Under the umbrella of transportation, cities are focused on improving
access to transportation, public transportation routes and services, variety
of transportation options such as trains, and buses; and promotion of
alternatives, namely cycling and walking (active travel), thereby improving
health outcomes.
44

45. Contd…
• Cities have focused on the built environment.
• Through the employment of green building guidelines such as LEED and
BREEAM, that are focused on increasing energy efficiency, using
sustainable building materials and a rating system to encourage
developers and cities to favor the construction of environmentally friendly
buildings .
45

46. Contd…
• Cities have increasingly been focused on Green Infrastructure (GI).
• GI includes blue infrastructure, namely protecting water resources
such as rivers, lakes, and wetlands.
46

47. Contd…
• Portland (US), Vancouver (Canada) and New York (US), are three cities that
tend to dominate in the realm of being green, with the City of Vancouver
setting out to be the Greenest City by 2020.
• New York, has a wide range of programs and initiatives aimed at mitigating
the impacts of climate change. Most notable of these is the city’s
Environmental Public Health Tracking program.
47

48. Contd…
• In Paris, after the 2003 heat wave, recognized the importance of
preventing heat related deaths.
• As part of their heat plan, they developed CHALEX (Chaleur Extreme) a
registry of vulnerable individuals and their addresses that would enable
municipal worker to visit or call these individuals during extreme heat
events to ensure that their health is not compromised.
• Nationally Singapore has NEWater practice, involves the purification of
waste water to potable quality through reverse osmosis.
48

49. Activities by the German Federal Environment
Agency on adaptation to climate
change (2010)
• In Germany, the Federal Environment Agency has invested a high level of
resources in developing measures to address the issue of climate change
and public health, in particular through establishing the national
Competence Centre on Climate Impacts and Adaptation, which created a
catalogue of climate change and health data that is and will be used by all
decision-making bodies.
• A climate change adaptation plan has been developed, including measures
such as awareness-raising at both national and local levels.
49

50. Contd..
• The plan involved 15 sectors, including health, and included a
database for sharing the information between stakeholders, rapid
alert system and climate change guide for small and mediumsized
businesses, which provides advice on issues such as pest control, the
health impacts of pollen, and adaptation measures.
50

51. Contd…
• An analysis of the heat health warning system and UV index was carried
out for three key sectors of the population: nursing homes, kindergartens
and elderly people living in single households.
• The heat-health warning system was well-received by some nursing
homes, and were interpreted as a principally appropriate instrument for
health-related adaptation.
• Although, for example 55% of nursing homes felt that the alerts were
unnecessary as they would have taken the precautionary measures
anyway, because of the prediction of the weather forecasts from the
media.
51

52. has been developed as a unique mechanism for increasing
financial flows to developing countries for promoting clean
technologies that not only reduce greenhouse gas emissions
but also contribute towards the sustainable development of
the country.
Nepal has recently deposited the instrument for accession to
the Kyoto Protocol and has thus fulfilled the first requirement
for participation in the Clean Development Mechanism.
Nepal in the process of CDM
52

53. A transfer of finances and contribution to sustainable
development in the Host Country
Developing Country (Nepal)
Flow of Finances
Flow of Carbon Credits
Developed Country
CDM Concept: An Opportunity to Reduce the Climate
Change Impacts
Clean energy
projects
53

54. Climate Change: Impacts and Urgent
Adaptation Actions in Dang District of Nepal
(2011)
• After intensive field based study in Dang district, different issues are found
due to climate change and variation in precipitation.
• Terai VDCs of Dang have climate induced disasters such as flooding and
landslide problems in slope land areas.
• Drought is another problem faced by farmers which reduced the
productivity of land.
54

55. Contd…
• Study recommended following intervening programmes to develop
climate change resilience capacity in communities:
 Development of physical infrastructures like access roads, electricity and
local market infrastructures fulfill demands of fertilizers to farmers on time
which help to increase high production of rice.
 Develop physical infrastructure like embankment and check dams to
control flooding.
 Forest management program and control mechanism of degradation of
forest resources.
55

56. Public Health Impacts of Climate Change in
Nepal.
56
Joshi HD, Dhimal B, Dhimal M, Bhusal CL. J Nepal Health Res Counc 2011
April;9(18):71-5.

57. The noncommunicable diseases: effects of climate change
mitigation and adaptation strategies (S. Friel et al, 2011)
Sector Strategy Climate change
implication
Pathways for
climate change
to NCDs
NCD risk
Energy Reduce household
use of solid
(biomass) fuels
Mitigation: reduce
GHG emissions
Reduced indoor air
pollution
• Reduced CVD
• Reduced respiratory
diseases
• Reduced COPD
Urban
planning
Improve walking
and cycling
infrastructure
Mitigation: reduce
GHG emissions
Increased active
transport, physical
activity
• Reduced CVD
• Reduced obesity
• Reduced respiratory
diseases
Food and
agricultur
e
Support rural
development:
new
food production
techniques,
rural livelihoods
Adaptation:
Improve
resilience to
climate change
Improved and
expanded
supply of
nutritional
food sources
•Decreased
undernutrition
and improved
resilience to
NCDs
57

58. Vulnerability
• “The degree to which a system is susceptible to,
and unable to cope with, adverse effects of climate
change”
Intergovernmental Panel on Climate Change,
Fourth Assessment Report 2007
(IPCC AR4, 2007)
58

59. Vulnerability = f (Exposure,
Sensitivity,
Adaptive capacity)
Background (contd.)
59

60. Definition of Vulnerability (cont.)
Vulnerability = susceptibility to adverse effects + inability to adapt
60

61. 61
Vulnerable Groups of Climate Change Impact:
- By location: rivers banks, steep slopes, slums and
squatter settlements & remote areas
- By social groups: poor, women and children,
disabled, and refugees
- By occupation groups: those working in hazard
activities such as garment, carpet, brick kilns,
stone crushing
Determinants of Vulnerability
• Character, magnitude, and rate of climate change
• Sensitivity to climate change
• Coping capacity (adaptation)

62. Adaptation and Mitigation
Global Environmental
Changes, affecting:
• Climate
• Water
• Food yields
• Other materials
• Physical envtl. safety
• Microbial patterns
• Cultural assets
Natural
processes and
forcings
Impacts on human
society:
• Livelihoods
• Economic productivity
• Social stability
• Health
Human society:
• Culture, institutions
• Economic activity
• Demography
Adaptation:
Reduce impacts
Human pressure
on environment
Mitigation: Reduce pressure
on environment
Mitigation for health sector: to promote and support initiatives that protect health by
reducing greenhouse gas emissions
Adaptation for health sector: strengthen prevention, surveillance
and early warning systems pertaining to climate sensitive diseases
62

63. References
• Dhimal M, Bhusal CL. Impacts of Climate Change on Human Health and
Adaptation Strategies for Nepal. J Nepal Health Research Council 2009
Oct;7(15):140-141.
• Badu M. Assessing the impact of climate change on human health: status
and trends of malaria and diarrhea with respect to temperature and
rainfall variability in nepal. Kathmandu University Journal of Science,
Engineering and Technology VOL. 9, No. I, July, 2013, pp 96-105.
• Climate change and public health in UTAH. The Great Seal of the State of
UTAH.
• Report of national workshop on Climate change and human health:
Potential impact, Vulnerability and Adaptation in Nepal. NHRC.
• WHO. Climate Change, extreme weather events and public health-
meeting report. 2010 november 29-30; Bonn Germany.
63

64. References (II)
• Climate change and human health: Impacts, vulnerability and public
health. Journal of the Royal Institute of Public Health (2006); 120, 585–
596.
• Thapa K.B. Climate Change: Impacts and Urgent Adaptation Actions in
Dang district of Nepal. 2011 November 8.
• S. Friel et al. Climate Change, Noncommunicable Diseases and
Development: The Relationships and Common Policy Opportunities.
Annual Review Public Health Journal. 2011.32:133-47.
• Huss J.J, McDowells J. Z., Luber G. Integrating Climate Change Adaptation
into Public Health Practice: Using Adaptive Management to Increase
Adaptive Capacity and Build Resilience. Environ Health Perspect 120:171–
179 (2012).
• Joshi HD, Dhimal B, Dhimal M, Bhusal CL. Public Health Impacts of Climate
Change in Nepal. J Nepal Health Res Counc 2011 April;9(18):71-5.
64

65. References (III)
• Mills J.N., Gage K.L., Khan S.A. Potential Influence of Climate Change on
Vector-Borne and Zoonotic Diseases: A Review and Proposed Research
Plan. Environmental health perspectives. 118:1507–1514;2010.
• D. Sabrina (ICCG). Tackling climate change in cities: The role of best
practices. ICCG Reflection No. 23/May 2014.
• Madhav Karki, Pradip Mool and Arun Shrestha: Climate Change and its
Increasing Impacts in Nepal, ICIMOD, Kathmandu, Nepal,
65

66. Thank U
Discussion ???
66