188.8.131.52 National- and regional-level responses
Climate-based early warning systems for heatwaves and malaria outbreaks have been implemented at national and local levels to alert the population and relevant authorities that a disease outbreak can be expected based on climatic and environmental forecasts (Abeku et al., 2004; Teklehaimanot et al., 2004; Thomson et al., 2005; Kovats and Ebi, 2006). To be effective in reducing health impacts, such systems must be coupled with a specific intervention plan and have an ongoing evaluation of the system and its components (Woodruff et al., 2005; Kovats and Ebi, 2006).
Seasonal forecasts can be used to increase resilience to climate variability, including to weather disasters. For example, the Pacific ENSO Application Center (PEAC) alerted governments, when a strong El Niño was developing in 1997/1998, that severe droughts could occur, and that some islands were at unusually high risk of tropical cyclones (Hamnett, 1998). The interventions launched, such as public education and awareness campaigns, were effective in reducing the risk of diarrhoeal and vector-borne diseases. For example, despite the water shortage in Pohnpei, fewer children were admitted to hospital with severe diarrhoeal disease than normal because of frequent public-health messages about water safety. However, the interventions did not eliminate all negative health impacts, such as micronutrient deficiencies in pregnant women in Fiji.
Participatory approaches that include governments, researchers and community residents are increasingly being used to build awareness of climate-related health impacts and adaptation options, and to take advantage of local knowledge and perspectives (see Box 8.6).
Box 8.6. Cross-cutting case study: indigenous populations and adaptation
A series of workshops organised by the national Inuit organisation in Canada, Inuit Tapiriit Kantami, documented climate-related changes and impacts, and identified and developed potential adaptation measures for local response (Furgal et al., 2002a, b; Nickels et al., 2003). The strong engagement of Inuit community residents will facilitate the successful adoption of the adaptation measures identified, such as using netting and screens on windows and house entrances to prevent bites from mosquitoes and other insects that have become more prevalent.
Another example is a study of the links between malaria and agriculture that included participation and input from a farming community in Mwea division, Kenya (Mutero et al., 2004). The approach facilitated identification of opportunities for long-term malaria control in irrigated rice-growing areas through the integration of agro-ecosystem practices aimed at sustaining livestock systems within a broader strategy for rural development.