Overview of Climate Change Impacts on Human Health in the Pacific Region Prepared
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Overview of Climate Change Impacts on Human Health in the Pacific Region Report to: COMMONWEALTH OF AUSTRALIA Department of Climate Change and Energy Efficiency Prepared by: Dr E.G. Hanna: RN, RCCN, BA (Hist & Phil of Sc), MPH, PhD , FRCNA; Convenor Climate Change Adaptation Research Network – Human Health. Associate Professor D. Harley: BSc (Zoology, Hons I), MBBS, PhD, FAFPHM, MMedSc (Clin Epid); Associate Professor of Epidemiology. Ms C. Xu: BA (Intel Journalism), MPH, Research Assistant. Professor A.J. McMichael: MBBS, PhD; Professor of Population Health, and NHMRC Australia Fellow. National Centre for Epidemiology & Population Health College of Medicine, Biology & Environment Australian National University 1 December, 2011 Overview of Climate Change Impacts on Human Health in the Pacific Region National Centre for Epidemiology & Population Health 2 Overview of Climate Change Impacts on Human Health in the Pacific Region Contents Page Contents Page .................................................................................................................................. 3 ACKNOWLEDGEMENTS ........................................................................................................................... 5 EXECUTIVE SUMMARY ............................................................................................................................ 6 KEY FINDINGS .......................................................................................................................................... 7 Glossary of terms ............................................................................................................................. 8 Key definitions ................................................................................................................................. 9 SCOPE OF SERVICES ............................................................................................................................... 10 KEY QUESTIONS ..................................................................................................................................... 11 METHODS .............................................................................................................................................. 12 Part 1: CONTEXT OF CLIMATE CHANGE IN THE PACIFIC REGION .......................................................... 14 1.1 Current Knowledge and Understanding ............................................................................ 14 1.2 Introduction ....................................................................................................................... 15 1.3 Existing Health Challenges ................................................................................................ 23 1.3.1 Health Status ............................................................................................................. 23 1.3.2 Non-communicable diseases ..................................................................................... 26 1.3.3 Communicable Diseases ............................................................................................ 29 1.3.4 Population and demographics .................................................................................. 31 1.3.5 Health Infrastructure ................................................................................................. 32 1.4 Projections ......................................................................................................................... 40 Part 2: CLIMATE CHANGE IMPACTS ON HUMAN HEALTH .................................................................... 43 2.1 Extreme weather events and disasters .................................................................................... 45 2.1.1 Heat Waves ............................................................................................................... 47 2.1.2 Storms and cyclones .................................................................................................. 52 Case Study 1 – Cyclone Heta Niue ............................................................................................. 52 2.1.3 Coastal Inundation .................................................................................................... 55 2.1.4 Flooding ..................................................................................................................... 56 2.2 Vector-borne Infectious Disease .............................................................................................. 58 Case Study 2 - Malaria in Papua New Guinea ........................................................................... 60 2.3 Food Security and Food-borne disease .................................................................................... 62 2.3.1 Food-borne Disease ................................................................................................... 65 Case Study 3 - Food Security and Child Health.......................................................................... 65 Food insecurity – a climate change risk ................................................................................... 66 Food insecurity through economic vulnerability ..................................................................... 67 Child health ............................................................................................................................... 69 Climate and food and health .................................................................................................... 71 2.4 Water security, Water-borne Disease and Sanitation ............................................................. 73 2.4.1 An overview of water supply issues in the Pacific Island Nations ............................ 74 2.4.2 An overview of water-borne disease and sanitation in the Pacific .......................... 75 2.5 Chronic (non-communicable) Health Conditions ..................................................................... 81 Part 3: IDENTIFIED CHALLENGES AND HEALTH INTERVENTIONS .......................................................... 85 3.1 Challenges and Gaps ................................................................................................................ 85 3.2 Recommendation for health interventions ............................................................................. 86 3.2.1 Recommendation 1: Research .................................................................................. 87 National Centre for Epidemiology & Population Health 3 Overview of Climate Change Impacts on Human Health in the Pacific Region 3.2.2 Recommendation 2: Expand Population Health Programs ....................................... 88 3.2.3 Recommendation 3: Emergency Response Programs .............................................. 89 3.2.4 Recommendation 4: Data Management / Surveillance ............................................ 89 3.2.5 Recommendation 5: Education ................................................................................. 90 3.2.6 Recommendation 6: Governance.............................................................................. 90 REFERENCES .......................................................................................................................................... 91 APPENDIX ............................................................................................................................................ 107 Appendix 1: Map of Pacific Island Countries ............................................................................... 107 National Centre for Epidemiology & Population Health 4 Overview of Climate Change Impacts on Human Health in the Pacific Region ACKNOWLEDGEMENTS We thank Marijia Apostoloska (medical student, University of Tasmania), Hayley Engel, Haiyao He, Jana Li, Agnes Luty, Rajivi Prematunga, and Paris Ramrakha (medical students, Australian National University). Their project work on climate change and human health in the Pacific region has contributed background information to the preparation of this report. We also acknowledge the valuable input provided during the Noumea workshop by regional stakeholders, the Secretariat of the Pacific Communities (SPC), World Health Organization (WHO) and researchers as listed on Appendix 2. We also thank the Department of Climate Change and Energy Efficiency (DCCEE) and the Australian National University (ANU) and the National Centre of Epidemiology and Population Health (NCEPH) for their support and contributions. National Centre for Epidemiology & Population Health 5 Overview of Climate Change Impacts on Human Health in the Pacific Region EXECUTIVE SUMMARY The United Nations Framework Convention on Climate Change (UNFCCC) recognises that developing countries are the most vulnerable to the adverse effects of climate change because they have fewer resources to adapt geophysically, socially, technologically and financially.(1) Small Island Developing States (SIDS) face multiple stresses that affect their exposures and sensitivity as well as their capacity to adapt. This overview examines the context of climate change, including existing major health challenges in the Pacific region, and its likely impacts on human health. We present an assessment of the existing health issues and future projections for Pacific Island Countries (PICs) and East Timor, countries vulnerable to climate change and likely to suffer significant negative human health impacts. Our analysis