PROCEEDINGS Proceedings NATIONAL LEVEL WORKSHOP ON BUILDING CLIMATE RESILIENCE FOR ENSURING TRANSFORMATIONAL HEALTH OUTCOMES Understanding Climate and Health Associations in India (UCHAI) March 6–7, 2017, New Delhi PROCEEDINGS NATIONAL LEVEL WORKSHOP ON BUILDING CLIMATE RESILIENCE FOR ENSURING TRANSFORMATIONAL HEALTH OUTCOMES Understanding Climate and Health Associations in India (UCHAI) March 6–7, 2017, New Delhi © The Energy and Resources Institute, 2017 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without prior permission in writing to The Energy and Resources Institute, New Delhi, India, or as expressly permitted by law, or under terms agreed with the appropriate organizations. Enquiries concerning reproduction should be sent to the address: The Energy and Resources Institute Darbari Seth Block, India Habitat Centre, Lodhi Road, New Delhi – 110 003, India Citation Balbus JM, Dhiman R C, Dogra NK, Gupta V, Krishnan A, Kumar S, Salve HR, Sehgal M, Taneja PK (eds; on behalf of UCHAI initiative). 2017. Proceedings of the National Level Workshop for Building Climate Resilience for Ensuring Transformational Health Outcomes, March 6–7. New Delhi: TERI. (The names are in alphabetical order.) Disclaimer This report is the work product of an employee or a group of employees of various organizations, institutes, departments of the Government of India and non-government organizations. However, the statements, opinions, or conclusions contained herein are those of the authors and do not necessarily represent the statements, opinions, or conclusions of the GoI or their affiliated organizations or institutes. This report is the work product of an employee of the United States National Institutes of Health (NIH), however, the statements, opinions, or conclusions contained herein do not necessarily represent the statements, opinions, or conclusions of the NIH, its component institutes and centres, or the United States government. The authors declare they have no actual or potential competing financial interests. UCHAI Secretariat Team Ms Meena Sehgal, Fellow, TERI Dr Nitish Dogra, Consultant, UCHAI Ms Vidhu Gupta, Research Consultant, TERI Ms Valsa Charles, Secretary, TERI Editorial and Design Team Ms Spandana Chatterjee, Assistant Editor, TERI Ms Naina Mukerji, Assistant Editor, TERI Mr Santosh Kumar Singh, Graphic Designer, TERI Published by The Energy and Resources Institute (TERI) Website: www.teriin.org For more information Project Monitoring Cell T E R I Tel. : 2468 2100 or 2468 2111 Darbari Seth Block E-mail : [email protected] IHC Complex, Lodhi Road Fax : 2468 2144 or 2468 2145 New Delhi – 110 003 Web : www.teriin.org India India +91 • Delhi (0)11 Table of contents Table of Contents Preface 4 Foreword 5 Acknowledgements 6 Message from the Chair 7 Executive Summary 9 Central-Level Actions 9 State-Level Actions 9 Municipality-Level Actions 9 Background 11 Proceedings 12 Central-Level Actions 12 State-Level Actions 13 Municipality-Level Actions 14 Expert Group Consultations 14 Group Discussion I 22 Group Discussion II 29 Appendix I: Workshop Agenda 31 Appendix II: List of Participants 35 Appendix III: Photo Documentation 38 About NIEHS/UCHAI/TERI 40 3 National Level Workshop on Building Climate Resilience for Ensuring Transformational Health Outcomes Preface It is my great pleasure and honour to welcome readers of “Proceedings for the National Level Workshop on Building Climate Resilience for Ensuring Transformational Health Outcomes.” The National Institute of Environmental Health Sciences (NIEHS) believes its mission, which is to discover how the environment affects people to promote healthier lives, crosses national boundaries. Certainly, the environmental stressors associated with climate variability and change cross national boundaries. Our Institute is proud to be part of this effort to raise awareness about linkages between climate and health to promote healthier lives by exploring ways to enhance the resilience of health systems and, hence, communities and people, in India. Our collaboration, through the Understanding Climate and Health Associations in India (UCHAI) initiative, provides a platform for two-way learning that benefits not only our countries but the international community as well. The UCHAI initiative is moving into its second phase. We have worked together for the past two years to develop a community of researchers, students, public health professionals, and others who are interested in climate, weather extremes, and health. Our community has grown in size but also kept a dedicated core of advisors and committed scientists who have kept momentum going in an challenging environment. We are now finding ways to engage the community with mainstream health systems in India through implementation of Early Warning Systems and other measures that begin to build resilience of populations and health systems. I am grateful to all who have joined this community of practice but especially to the dedicated core group who helped plan and organize this workshop. My thanks especially to Ms Meena Sehgal, TERI, for her leading role in organizing this workshop as well as to the leadership and staff of TERI for their extensive support for the workshop. And, I would like to express my continuing gratitude to Dr Sanjiv Kumar for his outstanding leadership of the UCHAI Advisory Committee and to Dr Nitish Dogra, who has provided outstanding intellect and energy to build the UCHAI initiative to its current size and influence. The workshop is just a first step, and it is one of many efforts underway by partners to enhance the resilience of India’s health systems to weather extremes, climate variability, and change. We look forward to our ongoing collaboration as we meet the health challenges of a changing environment. John M. Balbus, MD, MPH Senior Advisor for Public Health National Institute of Environmental Health Sciences 4 Preface / Foreword Foreword The well-established environmental factor of climate change will have significant and growing impact in various sectors including health. The impact of climate change on human health in India to till date has been insufficiently examined. Traditionally, the impact of environment or climate on health has not been considered with the same zeal as other sectors, such as agriculture and water. However, this is likely to change as in the recent past the Prime Minister’s Council on Climate Change has added a new Mission in the National Action Plan for Climate Change with a focus on human health. There are several dimensions to the planning challenge that include integrating climate resilience with health planning by adopting an improved infrastructure, forecasting current and future health risks for the timely surveillance and preparation for vector borne diseases, heat stress and climate disasters. Our ability to confront the present and future climate challenges lies in devising a synergistic approach that will benefit the population. Members from multiple professional fields and areas of expertise that include public policy, environmentalists, meteorologists, clinicians, and public health are required in order to realize the goal. Through the Understanding Climate and Health Associations in India (UCHAI) initiative and with the support of multiple national stakeholders, along with the National Institute of Environmental Health Sciences (NIEHS), United States, we organized a National-Level Workshop for Building Climate Resilience for Ensuring Transformational Health Outcomes. Though still in its nascent stage, this programme will support the critical integration of environment into health planning. TERI has been involved in drafting several State Action Plans for Climate Change and also the National Action Plan for Climate Change and Health. This places TERI in a unique position in its role as a think tank facilitating inter-sectoral action. It is hoped that through workshop dialogues involving the environment, meteorology, and the health sector the recommendations will reflect a joint approach that encourages research, supports evidence building, and its application in policymaking. This inter-sectoral approach to health is urgently needed since several of the exposures, modulators, and pathways lie outside the purview of the health domain. Prioritization of health in both the National Action Plan for Climate Change and the National Health Mission are critical opportunities which will help India in adapting and supporting progress related to sustainable development goals. Ajay Mathur Director-General, TERI 5 National Level Workshop on Building Climate Resilience for Ensuring Transformational Health Outcomes ACKNOWLEDGEMENTS The National-Level Workshop for Building Climate Resilience for Ensuring Transformational Health Outcomes organized by Understanding Climate and Health Associations in India (UCHAI) Network was made possible by the advice and hardwork of people both within the UCHAI network and outside. We are particularly thankful to Dr Ajay Mathur, Director General, TERI, and Dr Prodipto Ghosh, Distinguished Fellow, TERI, for providing vision and guidance for the workshop. We are grateful to Dr Sanjiv Kumar, Chair, UCHAI Advisory Committee and former Executive Director, National Health System Resource Centre for his insights into the health system and the feasibility of integrating climate resilience within the system. We are also grateful to the UCHAI Advisory Committee members