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WATER, CLIMATE CHANGE AND HEALTH

WATER, CLIMATE CHANGE AND HEALTH. R Aertgeerts Regional adviser, water and sanitation Co-secretary, Protocol on Water and Health. System adaptation to climate change.

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WATER, CLIMATE CHANGE AND HEALTH

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  1. WATER, CLIMATE CHANGE AND HEALTH R Aertgeerts Regional adviser, water and sanitation Co-secretary, Protocol on Water and Health TFEW April 21 - 22, 2008

  2. System adaptation to climate change • A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health, as well as more direct health improving activities. • Health services provide a buffer against the climate variability and change. • Emergency medical services have a role in limiting excess mortality. TFEW April 21 - 22, 2008

  3. Agenda • Impact of climate change on health systems, and adaptation mechanism. • Impact of climate change on the water and sanitation sector, and adaptation mechanisms. • The Protocol as a tool to promote adaptation through TFEW, TFIR, TFWRDS • Conclusions. TFEW April 21 - 22, 2008

  4. Health systems TFEW April 21 - 22, 2008

  5. Health outcomes of climate change • Water-borne (ingested): • Infectious diarrhoeal diseases • Pollutant-related diseases • Water-washed: • Intestinal helminths, • Eye and skin infections • Vector-borne: malaria, dengue fever • Water-based: Legionellosis • Viral diseases ??? TFEW April 21 - 22, 2008

  6. Basis for health sensitivity studies • Health impacts from extreme events • Spatial studies • Temporal studies • Experimental laboratory and/or field studies TFEW April 21 - 22, 2008

  7. Assessment of potential health impacts • Limited local-specific changes • Multiple, interacting and multicausal outcomes make attributing outcome to climate difficult • Difficult generalising outcomes • Limited inclusion of different development scenarios in health projections • Difficulty in identifying climate thresholds TFEW April 21 - 22, 2008

  8. Health system constraints TFEW April 21 - 22, 2008

  9. Health sector adaptation strategy • Health action plans • Emergency medical services • Improved climate-sensitive disease surveillance and control • Safe water and improved sanitation • Strengthened health services TFEW April 21 - 22, 2008

  10. Six building blocks • Service delivery • Trained health workforce • Health information systems • Access to essential medical products, vaccines and technologies • Adequate and sustainable financing • Leadership and governance TFEW April 21 - 22, 2008

  11. Conclusion on health systems • Health systems are a key player in the detection of health threats and in the curative aspect of long-term health outcomes, as well as in dealing with emergency situation. • The TFIR, the TFWDS, and the TFEWE are important for the implementation of the WHO programme on health systems TFEW April 21 - 22, 2008

  12. Water supply and sanitation, climate change and extreme events TFEW April 21 - 22, 2008

  13. Regional impact Asia • Decrease freshwater availability in C, S, E and SE Asia • Coastal and river flooding in S, E and SE Asia • Increase in endemic morbidity and mortality due to diarrhoeal diseases TFEW April 21 - 22, 2008

  14. Regional impact Europe • Magnified regional differences: decrease in surface flow in S, increase in N • Reduced water availability in S: general decrease in summer flow • Glacier retreat in mountain areas • Increased water stress in S Europe • Polar regions: hydrogeological changes TFEW April 21 - 22, 2008

  15. Floods • Global warming is projected to intensify the hydrological cycle and increase the occurrence and frequency of flood events • Health outcome: drowning, injuries, contamination of resource waters, outbreaks of infectious diseases. • Stagnant pools favour vectors. TFEW April 21 - 22, 2008

  16. Droughts • Climate change has likely increased the frequency and/or severity of droughts • Health effects include deaths, malnutrition, infectious disease and respiratory disease. • Extended drought reduces resistance to vulnerable disease and population of mosquito predators. TFEW April 21 - 22, 2008

  17. Groundwater • Changing quality due to changes in surface water quality • Accelerating hydrological permeability, leading to quicker transport of pollutants • Increased salinity, through seawater intrusion • Increased evapotranspiration • Increased soil temperature. TFEW April 21 - 22, 2008

  18. Aquatic ecology • Changes in self-purification of rivers due to decreased oxygen content. • More stable vertical stratification in deep lakes affecting oxygen, nutrient cycling and plankton • Eutrophication, change in timing of algal blooms and increase of harmful algal blooms • Alterations to habitats and distribution of aquatic organisms incl protozoan invaders TFEW April 21 - 22, 2008

  19. Conclusion on water and sanitation • Climate extremes cause both physical and managerial stresses on water supply systems, although well-managed public water supply systems should be able to cope with climate extremes. • … well managed? TFEW April 21 - 22, 2008

  20. Economic vulnerability Countries with annual GDP per capita of less than 6,000 USD are assumed to be at additional risk of diarrhoea. TFEW April 21 - 22, 2008

  21. Europe’s rural population in 2004 • EUR-A 24% • 86 million • EUR-B 44% • 97 million • EUR-C 30% • 72 million In rural areas, water scarcity is associated with multiple adverse health outcomes, incl parasites, vector borne diseases associated with faulty water-storage systems, and malnutrition. TFEW April 21 - 22, 2008

  22. (Lack of) access to improved water supply • EUR-A: • Universal house connection • EUR-B: • 84% have house connection, 95% of urban and 66% of rural areas • EUR-C: • 83% have house connection, 92% of urban and 56% of rural areas TFEW April 21 - 22, 2008

  23. (Lack of) access toimproved sanitation • EUR-A • 62 % have house connection, 61% of urban and 44% of rural areas • EUR-B • 71% have house connection, 88% of urban and 27% of rural areas • EUR-C • 67% have house connection, 85% in urban and 24% in rural areas TFEW April 21 - 22, 2008

  24. Guidelines for drinking-water quality • 1984 – 1987 First edition • 1993 – 1997 Second edition • 2004 Third edition • Thereafter ‘rolling revision’ TFEW April 21 - 22, 2008

  25. Need for more holistic approach TFEW April 21 - 22, 2008

  26. Risk scoring matrix ? ? TFEW April 21 - 22, 2008

  27. D O C U M E N T A T I O N O F W S P Supporting programs Validation System assessment C O N T I N U O U S R E V I E W Identify hazards Determine existing control measures Assess and prioritize risks Identify additional or improved control measures Controlling hazards Implement and maintain control measures Establish operational monitoring Define corrective actions Verification and auditing Description of water supply system TFEW April 21 - 22, 2008

  28. WSP and floods • Floods • Infrastructure adaptation • Functionality assessment • Protection of sewerage systems • Protection of production units • Contingency plans for rehabilitation TFEW April 21 - 22, 2008

  29. WSP and droughts • Demand management to safeguard drinking water supply • Resource allocation on consensual river basin management plan, but mandatory allocation possible • Increase reuse of treated wastewater for irrigation and for aquifer recharge TFEW April 21 - 22, 2008

  30. General adaptation issues for the water sector • Differentiate adaptation strategy by sub-region • Improve understanding of climate change impact at the basin level • Ensure that current legislation develops to include climate adaptation measures at the local, national and supranational level. TFEW April 21 - 22, 2008

  31. Water sector adaptation strategies • Address the existing situation • Ensure the fulfilment of the basic human right to water for those who do not yet have sustainable house connections to drinking water and/or sanitation • Plan for increasing demand as lifestyles change ( baths, washing machines…) • Protect the most vulnerable first TFEW April 21 - 22, 2008

  32. Water adaptation strategies 2. Demand and supply management • Inter-sectoral cooperation (agriculture) for water resource conservation IWRM • O&M optimization • Safe storage • Re-use of treated wastewater • New techniques (desalination) • Realistic pricing with social programmes TFEW April 21 - 22, 2008

  33. Protocol on water and health TFEW April 21 - 22, 2008

  34. Safeguard water supply and sanitation • Joint and coordinated action • Notification of threats of disease outbreak • Cooperation on transboundary water management • Joint and coordinated water management plans • International support for national action • Project facilitation mechanism TFEW April 21 - 22, 2008

  35. Safeguard water supply and sanitation • TF on Indicators and Reporting • Management, protection from pollution and use of water resources for dw production • Access to water supply and sanitation • Performance of service provider (loss reduction) • Quality of drinking water supplied • Safe reuse/disposal of treated wastewater/sludge TFEW April 21 - 22, 2008

  36. Strengthen health systems • Task Force on water-related disease surveillance • Assess current surveillance systems • Provide guidance on reduction of water-related diseases • Assist in the development of contingency plans • Assist in strengthening response capacity TFEW April 21 - 22, 2008

  37. Manage extreme events • Task Force on indicators and reporting • Discharges of untreated storm water • Task Force on water supply and extreme events • Exchange information on management of water and sanitation utilities under extreme drought/ flooding • Codify good practice guidance documents in this area TFEW April 21 - 22, 2008

  38. Conclusion • Climate change will pose considerable challenges for the realisation of the basic human right to safe drinking-water, both in quantity and in quality. • WHO through the Protocol on Water and Health is in the forefront of supporting adaptation efforts by its Member States. TFEW April 21 - 22, 2008

  39. THANK YOU TFEW April 21 - 22, 2008

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