Technologies for Adaptation to Climate Change Impacts on Human Health F. Agyemang-Yeboah

1. Technologies for Adaptation to Climate Change Impacts on Human Health F. Agyemang-Yeboah UNFCC SEMINAR ON THE DEVELOPMENT AND TRANSFER ON ENVIRONMENTALLYSOUND TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE, TOBAGO, 14-16 JUNE 2005 School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

2. Summary of Presentation • Potential Climate Change Impacts on Human Health-An illustrative model • The Ghanaian Case Study • Identification of technologies from the Ghanaian perspective • Other options of Adaptation technologies • The decision making process • Conclusion

3. Potential Impacts of Climate Change on Human Health It is now established that global climate change would affect human health via pathways either directly or indirectly at different time rate. Climate change act via less direct mechanism to affect the ecosystem and therefore the transmission of many diseases. It also affects food security. The distribution and abundance of vector organisms (carriers) and intermediate hosts are affected by both physical (temp. humidity. rainfall etc.) and biological factors (vegetation, host species, competitors, predators etc.) in the ecosystem INTRODUCTION AND BACKGROUND

4. POORRAINS Inadequate in volume and distribution Poor grass Poor Harvest People Underfed (Malnutrition) Overgrazing where grass is good Less meat, less milk Animals underfed Grass /vegetation cover lost Over-grazing, trees cut down for fuel Poverty Animal death LAND DEGRADATION

5. TYPICAL CASES FROM GHANA

6. Mean air temperature scenario – seasonal pattern

7. Distribution of the number of malaria cases and maximum air temperature High maximum air temperature values corresponds to low number of malaria cases and vice versa.

8. Generally, increasing mean relative humidity corresponds to increasing incidence of malaria, whilst decreasing mean relative humidity corresponds to decreasing incidence of malaria.

9. Distribution of the number of malaria cases and rainfall amount

10. Comments • Baseline study shows that under the present climatic conditions malaria is perennial. • Mean air temperature ranges from mean air temperatures 24.8ºC to 27.9ºC for Ashanti Region • The maximum number of malaria cases occurs in June at mean air temperature of 25.8ºC. • Low number of malaria cases occurs in February , March and April where mean air temperature ranges from 27.6ºC in April , 27.9ºC in both February and March respectively.

11. Distribution of Meningitis cases and maximum air temperature Periods ofhigh meningitis cases coincide with periods of high maximum air temperature

12. Distribution of diarrhoea cases and rainfall amount High number of diarrhoea cases corresponds to periods of high rainfall amount and vice versa

13. Malaria Cost of malaria treatment – 2003 figures • Total cost = Direct Cost + Indirect Cost • Direct Cost = Costs of Drugs + OPD fees + Laboratory fees etc. • Indirect Cost = Opportunity Cost of Labour for affected person and caring parent

14. Total Cost for Children Total Cost for Children = Direct Cost + Indirect Cost • Direct Cost = 210, 680 × ¢21500 = ¢4, 529, 620, 000.00 • Indirect Cost = 210680 × ¢9600× 7 = ¢ 14, 157, 696, 000.00 • Total for Children = ¢ 18, 687, 316, 000.00

15. Total Cost of Adults Total Cost for Adults (Direct + Indirect) Direct Costs = 353608 × ¢23,000 = ¢ 8132984000.00 Indirect Cost = 353608 ×¢9,600×7 = ¢ 23762457600 Total Cost for Adults = ¢ 31, 895, 441, 600.00

16. Total Cost Burden Total Cost Burden for Adults and Children in the year 2003 Total for Children + Total for Adults = ¢18, 687, 316, 000.00 + ¢31, 895, 441, 600.00 = ¢50, 582, 757, 600.00 (1US$~¢8,000 at 2003 which is approximately US$6,000,000/year) NB. Only two regions of Ghana.

17. Summary of socioeconomic impacts • Reduced income of affected individuals due to loss of productivity • Increased expenditure of affected families • Increased insecurity of employment (low skilled workers and casuals) • Diminished quality of life • Social disruption • Reduction in Gross Domestic Product • Increased cost of Health Delivery at the National Level

18. Population Vulnerability and Adaptive Response • It should however be mentioned that human populations as with individuals, vary in their vulnerability to certain health outcomes. This will thus affect not only the type but the choice of adaptive strategies to offset those effects.

19. HEALTH ADAPTION STRATEGIES FROM THE GHANAIAN PESPECTIVE • Two main strategies can be identified • PREVENTIVE STRATEGY( Primary, Secondary and Tertiary) • CURATIVE STRATEGIES (Diagnosis, Management and Monitoring) All technologies for adaptation (Ghana’s perspective) to combat the effect of climate change/variability on health will be discussed along this line.

20. ADAPTATION OPTIONS NB. 1-3….PREVENTIVE ADAPTATIONS 4……CURATIVE ADATATIONS • PRIMARY PREVENTION: Any intervention implemented before there is evidence of disease or injury (e.g. avoiding hazardous exposure to asbestos, pollen, using insecticide-impregnated mosquito nets etc.) • SECONDARY PREVENTION: Any intervention implemented after disease has begun but before symptoms show (e.g. early detection or screening for say cholera) and subsequent treatment to avert full progression to disease. Enhancing monitoring and surveillance, improving disaster response and recovery and strengthening the public health system. 3. TERTIARY PREVENTION: Any intervention to minimize the adverse effects of an existing disease and injury (e.g. better treatment of heat stroke, improved diagnosis of vector-borne disease. 4. MANAGEMENT – Any intervention taken to treat or manage existing diseases or injury (drug prescription and compliance)

21. HEALTH ADAPTATION STRATEGIES EXAMPLES FROM THE GHANAIAN PESPECTIVE

22. OTHER SPECIFIC ADAPTION TECHNOLOGY OPTIONS Heat-related illness- • Design buildings to be more heat resistant (insulation, air flow, air-conditioning) • Planting trees to reduce urban heat effect • Creating public education campaigns to offset risk of heat wave • Establishing new weather watch/warning systems that focus on health related adverse conditions Agricultural Stresses- • Production of climate- resistant seeds, plants, high yielding varieties eg. “Obaatanpa” maize- Genetically modified grains? (ethical issues) • Promoting land reform and management systems that favour environmentally sound land usage • Reducing the proportion of monocultural farming practices to increase yield and also for better resistance to pests. • OTHERS- ELISA(Diagnostics), enzymes for biodegrading waste, Affrostestation, Bushes fires, bio-fuel to reduce air pollution

24. THE DECISION MAKING FRAMEWORK FOR ADOPTING A TECHNOLOGY-Key Questions(Monitoring and Evaluation) • What are the main drivers behind the decision? Is it mainly about adapting to future climate? If not, could climate change be important? Is it most appropriate to meet local needs? • What are the criteria for recognizing a successful outcome? What are the legislative requirements or constraints? What are the rules for making the decision? -risk averse or focused on maximizing benefit or minimizing cost • What is the lifetime of your decision? What climate variables could be most important? How could climate change affect your ability to meet your objectives? • What range of technology options should be considered? High Tech, Medium Tech or Low Tech? • How do these options rate against your criteria? Could particular options make it difficult for others to manage climate change? • Is there a clear preferred option? • Did the decision deliver the expected benefit or not?

25. 1 1 Identify problem and objectives 8 Monitor 2 Establish decision making criteria 3 7 Assess risk Implement decision 4 5 Appraise options No Identify options Yes Problems defined correctly? YES Criteria met? 6

26. Effective technological adaptation and transfer will require individuals skilled at recognizing, reporting and responding to health threats associated with climate change. Building capacity is therefore an essential step in preparing adaptation strategies. Education, awareness creation and the creation of legal frameworks, institution and an environment that enables people to take well-informed, long-term sustainable decision are all needed. Building adaptive capacity in public health will also require strong and determined vision of appropriate healthcare delivery systems. It must be stressed adapting to climate change will require more than financial and technology, human resource and knowledge are essential as well as institutions that are committed to face the health challenges associated with climate change. Conclusion

27. END THANK YOU !