Assessment of the Current Public Health Vulnerabilities Due to Climate Change in Kosovo*
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Assessment of the current public health vulnerabilities due to climate change in Kosovo* The UNDP “Support for Low Emission Development” (SLED) project, funded by Austrian Development Cooperation 11 December 2014 Michele Faberi & Qamile Ramadani *This designation is without prejudice to positions on status, and is in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of Independence *This designation is without prejudice to positions on status, and is in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of Independence Table of contents 1 Brief on climate change and health ............................................................................ 8 1.1 Health effects related to climatic events .................................................... 8 1.2 The vulnerability assessment process according to WHO ........................ 10 2 Environmental exposure and Climate vulnerability in Kosovo ..................................... 13 2.1 Flood......................................................................................................... 14 2.1.1 Major threats in case of heavy rain events ....................................... 15 2.1.2 Analysis of strengths......................................................................... 16 2.1.3 Analysis of weakness ........................................................................ 16 2.1.4 Forecast ............................................................................................ 16 2.2 Drought .................................................................................................... 17 2.2.1 Forecast ............................................................................................ 18 2.3 Heat waves and cold spells ....................................................................... 19 2.3.1 Heat waves ....................................................................................... 19 2.3.2 Cold .................................................................................................. 19 2.3.3 Population exposure......................................................................... 19 2.4 Air pollution.............................................................................................. 20 2.4.1 Climate change and air pollution ...................................................... 22 2.4.2 Population exposure......................................................................... 23 2.5 Fire ........................................................................................................... 25 2.5.1 Analysis of strengths......................................................................... 25 2.5.2 Analysis of weakness ........................................................................ 25 2.6 Other environmental exposures potentially related to climate change ... 25 2.7 Qualitative VIA summary .......................................................................... 26 2.8 Emergency management.......................................................................... 26 2.8.1 Meteorological service ..................................................................... 29 3 Health status and health system in Kosovo ................................................................ 30 3.1 Health data ............................................................................................... 30 3.1.1 Life expectancy ................................................................................. 30 3.1.2 Morbidity .......................................................................................... 31 3.1.3 Mortality data................................................................................... 33 3.2 Health system ........................................................................................... 36 3.2.1 Operational structure for the public health service provision .......... 37 3.2.2 Health system cost ........................................................................... 37 2 3.2.3 Financial resources ........................................................................... 38 3.2.4 Human resources.............................................................................. 38 3.3 Health information system ....................................................................... 39 3.3.1 The Environmental Health Committee ............................................. 40 4 Adaptation policies and future steps .......................................................................... 41 4.1 Urban and peri-urban air pollution........................................................... 42 4.2 Water scarcity .......................................................................................... 43 4.3 Kosovo wide flood and urban flood ......................................................... 44 4.4 Other climate change exposures .............................................................. 45 4.4.1 Heat waves and cold spells ............................................................... 45 4.4.2 Parasites spread, mosquitos spread and related disease ................. 45 4.5 Summary of sectors and related actions to be considered, other than monitoring ........................................................................................ 48 4.6 Monitoring ............................................................................................... 49 4.6.1 Environmental indicators.................................................................. 49 4.6.2 Epidemiological surveillance............................................................. 49 5 Iterative process: next assessment............................................................................. 50 Tables Tab. 1 Health risks of climate change graded with a confidence rating ........................................................................................................................ 9 Tab. 2 DEPSEEA Scheme of climate change exposure according to WHO ......................................................................................................................... 12 Tab. 3 Areas exposed to flood according to the stakeholders consultation WG 1 ..................................................................................................... 15 Tab. 4 Qualitative assessment of water supply failure during the dry season ...................................................................................................................... 18 Tab. 5 Health effects attributed to air pollution in the Kosovo .............................................. 24 Tab. 6 Qualitative summary of the climate change related events’ concern for the Kosovo.............................................................................................. 26 Tab. 7 Infant mortality rate x 1.000 – 2004/2011 .................................................................. 31 Tab. 8 The number of cases of communicable diseases in Kosovo in 2012 and 2013........................................................................................................... 32 Tab. 9 Non communicable respiratory diseases by age group 2011 ....................................... 33 Tab. 10 Cause of mortality with a code vs un-coded in Kosovo 2006 - 2011.......................................................................................................................... 34 Tab. 11 Standardized mortality (all causes) rates x 100.000 Kosovo and Italy.................................................................................................................... 35 3 Tab. 12 Human resources of the health system x 1000 persons ............................................... 39 Tab. 13 Capability of the HIS to be verified / monitored during its implementation ........................................................................................................ 40 Tab. 14 Indicative costs to upgrade the water supply in Pristina ............................................. 44 Tab. 15 Causes of vulnerability to weather events from the point of view of the Health System of the Kosovo ................................................................... 50 Tab. 16 What to care to repeat the assessment ...................................................................... 51 Figures Fig. 1 Adaptation logical iterative process ........................................................................... 11 Fig. 2 Health risks related to climate changes ...................................................................... 14 Fig. 3 Structure of the Government bodies having responsibility with emergency management, environmental protection and weather forecasts...................................................................................................... 27 Fig. 4 Structure of the EMA Emergency Management Agency of the Kosovo ...................................................................................................................... 28 Fig. 5 Life expectancy 2004-2012 in Kosovo compared with neighbouring and high-welfare countries ................................................................... 30 Fig. 6 Infant mortality (0-1 year) x 1000 – 2004/2011 in Kosovo compared with neighbouring and high-welfare countries ........................................... 31 Fig. 7 Standardized rates for all causes of death per age group male + female .................................................................................................................... 34 Fig. 8 Standardized