14.6 Lessons learned
The reduction of population vulnerability is, in general, the most cost-effective
strategy to deal with the health impacts of climate change. In the lowest-income
countries, where impacts are likely to be greatest, strengthening the public
health infrastructure should be a priority. There has been a widespread decline
in public health training, facilities, and programmes over the past decade (McCally
et al., 1998).
Equally important, the health of communities will be improved by social-economic
development that promotes income redistribution and the reduction in health
inequalities. Impoverished populations are at greater risk of adverse health
outcomes (such as those due to exposure to infectious agents, vulnerability
to thermal extremes, and marginal nutritional status) because they have fewer
choices. For populations whose health status is already compromised, the consequences
of climate change will often be a critical further stress upon health.
Population health vulnerability would also be reduced by taking specific steps
to lessen the health impacts of climate change. Examples include improved urban
and housing design, vaccination programmes, upgraded wastewater and refuse disposal
systems, and public education and early-warning programmes. Improved understanding
by the public and policymakers of the potential health impacts of climate change
is a prerequisite to reducing the impacts. This can be achieved by:
- Encouragement of research institutions to pursue long-term, multidisciplinary
- Dissemination and public discussion of research results and risk assessments.
- Monitoring of, and quantification of, any early health outcomes.
With respect to the mitigation of climate change, awareness of potential health
impacts should be a central consideration in the public discourse. The social
incentives for GHG mitigation would be further enhanced by market mechanisms,
particularly pricing, that take account of human health costs.
With respect to the capacity of populations to adapt to climate change, public
policies to reduce socio-economic and physical-environmental vulnerability are
necessary. Health sector institutions and processes, however, are not able to
deal effectively with health problems on their own. The task is multi-sectoral.
A structured approach for cross-sectoral strategies and international cooperation
is therefore required, entailing explicit reference to environmental health
impact assessment of all policies. Low-income countries are unable to afford
many of the basic health protection measures without international assistance.
Overall, intergovernmental agreements are needed for national policy making
and funding, and for coordinated research and monitoring to reduce the health
impacts of climate change.