by Tony McMichael
The Australian National University
Observer at 2008 World Health Assembly, for the International Society for Environmental Epidemiology
The 61st World Health Assembly, held in Geneva during this past week and attended by national delegations from 193 Member States, has underscored the urgency of tackling global climate change and its diverse risks to health around the world. Those risks will press particularly on vulnerable regions and poorly-resourced populations.
On Saturday May 24, the Assembly passed unanimously a strongly worded resolution, seeking to engage the health sector, at international and national levels, in responding to climate change. A key component of this task is to alert policy-makers and populations to the fundamental nature of the risks posed by climate change, not just by dint of physical hazards, but also by affecting many biological and ecological processes upon which human health depends.
Earlier this year WHO proclaimed “Protecting Health from Climate Change” as its theme for World Health Day, April 7. The Director-General of WHO, Dr Margaret Chan, has stated in public addresses in recent months that the risks to human health must be at the core of the climate change discourse. The fact that climate change poses serious long-term risks to human health and survival provides a profoundly important signal of the seriousness of this extraordinary human-induced disruption of the Earth system.
In her opening address to the Assembly, Dr Chan identified three emerging global public health crises, each threatening international security. Already apparent this year, she said, is the crisis of regional food shortages and soaring food prices, a threat to the very foundation of child development and lifelong health: adequate nutrition. The crisis of climate change now threatens the world with more droughts, floods and tropical storms, increased risks of various diseases, and greater demands for humanitarian assistance. For both these crises – food and climate – the poor are at greatest risk. The third crisis, pandemic influenza, lurks menacingly in the future. In Dr Chan’s words: “The threat has by no means receded, and we would be very unwise to let down our guard or slacken our preparedness measures.”
The preamble to the Assembly’s formal resolution on climate change noted the recent strengthening of evidence regarding the science of climate change and its impacts; the range of health risks, both now and in future; the likely unequal distribution of impacts; the serious threat posed to achievement of the Millennium Development Goals; and the several needs for joint international action, for stronger health systems, and for WHO to assist member states in the tasks of risk assessment and management.
The ‘action’ part of the resolution called on WHO to act to help the international community understand the extent of the risks to health to take this information into account in further developing national and international responses to climate change). The resolution mandates WHO to engage actively with other international agencies and within the UN Framework Convention on Climate Change, and it also commits member states to equivalent engagement. It specifies an agenda of information gathering and research, spanning: (i) fuller documentation of the risks to health, (ii) development of health protection strategies, (iii) identification of health consequences (mostly ‘co-benefits’) of actions taken by other sectors to reduce greenhouse gas emissions or to make sector-specific adaptations, (iv) development of decision support tools for member states, and (v) estimation of financial costs of actions and inactions.
An unusually large number (45) of national delegations spoke during the opening debate on the resolution. Few resolutions that come before the Assembly attract such a high level of active participation. Further, the level of concern expressed and the extent of awareness of the risks to health, particularly at local and regional scales, were as high as was the level of support within the Assembly for the resolution. (A few eyebrows were raised when the US delegation stated that President Bush’s policy on climate change was based on scientific evidence.)
The resolution, as crucial and timely as it is, could perhaps have been further enhanced by an even more explicit statement that a key reason for elucidating the risks to health is to help spur international agreement on achieving rapid cuts in greenhouse gas emissions. That, after all, is where true public health primary prevention lies – in halting and then eliminating this extraordinary environmental hazard. In the words of the Director-General, Dr Chan, on World Health Day this year: “Consideration of the health impact of climate change can help political leaders move with appropriate urgency”. Fuller understanding of the health risks posed by this momentous change can help the world to avert delayed or inadequate action