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Action on Climate Change Is Good for Public Health

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or Mother Earth, revered by the indigenous people of the Andes to this day, is considered to be a benevolent deity that presides over planting and harvesting and who, through her creative power, sustains life.  This belief system also holds that when people damage Mother Earth, problems arise because her life cycles are affected. 

Rapid climate change—caused by the injurious impact of man-made actions on the environment—has become a priority issue in the 21st century since it has the potential to negatively impact the economic and social development of countries across the world. While solid scientific evidence on climate change has led to heightened awareness about this challenge in recent years, policy action at the international level has not lived up to expectations.  

Uncontrolled, man-made carbon emissions, which climbed to a new record of 30 billion tons worldwide in 2010, are at the core of the climate change threat. Curbing this trend is not only a daunting task that requires sophisticated technical solutions, but its complexity is intensified by disagreements among countries on the size of the problem and what to do about it.  In large measure, entrenched political and economic interests are behind these disagreements, which have slowed down progress to address this global challenge.

Climate change should matter to all of us. Changing weather patterns, including more frequent extreme climate events (e.g., the 13 warmest years on record have been in the last 15 years), sea level rise (e.g., while global sea level rose about 17 centimeters in the last century, the rate in the last decade  is nearly double that of the last century), and natural disasters (e.g. in some regions the number of particularly large hurricanes has increased), negatively impact the lives, health conditions, and well-being of people—the raison d’être of economic and social development.

A landmark 2009 report by The Lancet Commission documented how climate change over the coming decades could have a disastrous effect on health conditions across the world. There are both direct and indirect health threats through changing patterns of disease, water and food insecurity, vulnerable shelter and human settlements, extreme climatic events, and population growth and migration.  But, as this report highlighted, while vector-borne diseases will expand their reach and death toll as a result of climate change, the indirect effects on potable water, food security, and extreme climatic events are likely to have the biggest negative effect on health conditions.
If the negative impacts of climate change are not mitigated, they will only exacerbate existing global health inequities, particularly affecting the poorest and less developed countries, such as those in sub-Saharan Africa.  This will help perpetuate poverty across generations, increase malnutrition and ill health, and cause premature mortality, undermining competitiveness, employment and wealth creation across countries.  And this, in turn, has the potential to aggravate social tensions and increase the risk of political unrest. 
Call for Policy Action

Not everything is bleak however.  As documented in a recent World Bank report, Climate-Smart Development, prepared in advance of the U.N. Secretary General’s Climate Summit in September 2014, if public policies and market- based approaches that reduce emissions and other short-lived climate pollutants are implemented, they can have clear and measurable economic, health, and other social benefits. 
Case studies prepared for the report simulate benefits to be realized from the application of key measures in six regions or countries (the United States, China, the European Union, India, Mexico, and Brazil) and the impact on global GDP. These studies show that regulations, taxes, and incentives to stimulate a shift to clean transport, improved industrial energy efficiency, and more energy-efficient buildings and appliances would generate annual benefits by 2030 that include an estimated GDP growth of between $1.8 and $2.6 trillion.  
The report also estimates that approximately 94,000 premature pollution-related deaths could be avoided, and that these measures would avoid production of 8.5 billion metric tons of carbon dioxide-equivalent (CO2e) emissions and save almost 16 billion kilowatt-hours of energy—a savings roughly equivalent to taking 2 billion cars off the road.
It should be clear, therefore, that action on climate change — and control of its potential negative health consequences — will require  adoption and adaptation of multisectoral approaches, coupled with participation, collaboration, and consensus among  governments, communities, individuals, businesses, and international organizations. Such collaboration should result in policies and market-based approaches aimed at reducing carbon emissions and other heat-trapping gases that we are adding to the atmosphere, particularly in fast-growing cities, which account for two-thirds of energy demands and emissions.

Public Health Platforms
In the health sector, it is imperative that we move beyond biological and medical concepts of health and disease and focus on the social determinants of health to better understand the health risks associated with climate change and the possible response of the health sector to this phenomenon.
We should also be ready to collaborate on multi-sector economic analysis to better illustrate, for example, the environmental and health benefits of shifting behaviors to use public transport systems and advanced cook stoves, and to walking and cycling, by adopting road safety measures to protect the safety of pedestrians and bicycle riders on city roads. 
To help reduce vulnerability and build resilience in countries, it is important that institutions such as the World Bank , working in tandem with other agencies such as the World Health Organization, the U.S. Centers for Disease Control and Prevention (CDC) and the European Center for Disease Prevention and Control (ECDC), redouble  support to countries to develop and strengthen essential public health platforms (e.g. surveillance systems and epidemiological intelligence capacity) to anticipate, prevent, and deal with adverse health outcomes associated with climate change.

Although tackling climate change often seems to be an insurmountable challenge, we should be optimistic that the tide will turn, much as we witnessed in the last decade in relation to HIV/AIDS.
With committed political leadership at the highest level of government, active social movements pressing for action, new scientific and technological developments adapted to local realities, and sustained allocation of resources for action over the medium term, it will be possible to modify human activity which is contributing to global warming and its negative impact on public health and development.  
And if we succeed, Mother Earth will begin to be cured, and the natural course of climate restored.
Follow the World Bank health team on Twitter: @worldbankhealth
The Lancet Commission: Managing the Health Effects of Climate Change (2009)
World Bank Report: Climate-Smart Development

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Patricio V. Marquez

Former World Bank Group (WBG) Lead Public Health Specialist

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