14.5.2 Promoting Public Health Trans-sectorally as a Policy Criterion
Greater emphasis must now be given to helping countries where there is a particular
need to improve vulnerability assessment, to identify climate change health
risks, and to define needs and resources for mitigation and adaptation programmes.
The strengthening of intersectoral efforts at the international level (for example,
between the health, meteorology, agriculture, and fisheries sectors) could be
a longer-term goal. WHO collaborates with other UN agencies on a number of monitoring
programmes, such as GEMS (Global Environmental Monitoring System) that provides
monitoring and assessment of air and water quality. International monitoring
programmes could be extended to include exposures to the direct and indirect
health hazards associated with climate change and sea level rise (McMichael
et al., 1996; WHO/MRC/UNEP, 1998). Linkages between health-related early warning
systems that are already in existence, such as Global Information and Early
Warning System (GIEWS) and ProMED, will need to be strengthened.
Research requires the availability of quality data. Many international agencies
have a responsibility to collect and disseminate data; e.g., WHO supports a
major international database focused on the incidence of infectious diseases
worldwide. They also have a responsibility to ensure that financial considerations
concerning access to data do not impede research (Colwell and Patz, 1998). International
agencies could support the formation of a central clearinghouse for data on
climate-health linkages in order to facilitate the gathering of data for research,
especially for developing countries and particularly for data generated by global
Food security in some countries may be worsened by climate change while it
may be improved in others (IPCC, 1996 WGII [Chapter 13]).
In the former countries, personal, community and national level adaptation options
are likely to be severely limited. The most effective strategies for adaptation
would entail changes in the international mechanisms of agriculture, trade and
finance. Global organisations such as the World Trade Organisation may be best
placed to implement the required changes of policy - provided there is the political
will to address the issue seriously.
In recent decades, there has been a shift of economic power away from national
governments to various private and public organisations (e.g., multi-national
corporations, the World Trade Organization, and regional free trade associations)
which are not explicitly accountable for, nor concerned by, the social, health
and environmental effects of their actions. The "globalisation" and
liberalisation of international systems of trade and finance has facilitated
the exploitation of poorly protected environmental resources in the short term
(McMichael, 1995). Although responsibility for population health remains primarily
national, there is need for new mechanisms for international collective action
in favour of forms of social and economic development that are compatible with
sustained good health (Jamison et al., 1998; McMichael et al., 1999).