A Stitch in Time: Adaptation to Climate Variability and Change

1. A Stitch in Time: Adaptation to Climate Variability and Change Kristie L. Ebi, Ph.D., MPH Krisebi@gmail.com July 2006

2. Vulnerability • The degree to which individuals and systems are susceptible to or unable to cope with the adverse effects of climate variability and change. Vulnerability is a function of: • Sensitivity to changes in weather and climate (exposure-response relationship), including population characteristics • Exposure • Adaptation baseline

3. Adaptation Actions taken by individuals, institutions, and governments • Anticipatory • Actions taken in advance of climate change effects • Responsive The severity of impacts will depend on the capacity to adapt and its effective deployment

4. Vulnerability and Adaptation Ebi et al. 2005

5. Adaptation Baseline • What is being done now to reduce the burden of disease? How effective are these policies and measures? • What could be done now to reduce current vulnerability? What are the main barriers to implementation? • What measures should begin to be implemented to increase the range of possible future interventions?

6. Why Not Just React to Climate Change as It Happens? • Long time frame and uncertainties with climate change make anticipating adaptation difficult • There may be irreversible and catastrophic impacts that cannot be mitigated • Opportunities to mitigate climate change impacts through anticipation may be missed

7. Difficulty with AnticipatingClimate Change and its Impacts • Direction • Magnitude • Timing • Path

8. Questions for Designing Adaptation Policies & Measures • Adaptation to what? • What are the future projections for the outcome? Who is vulnerable? • On scale relevant for adaptation • Is additional intervention needed? • Modifying existing prevention measures • Reinstitute effective prevention programs that have been neglected or abandoned • New risks • Who adapts? How does adaptation occur? • When should interventions be implemented? • How good or likely is the adaptation?

9. Remove Your Tie – Save the PlanetJapan Times 30 April 2005

10. Global Alps Global and Alpine Temperatures 1901-2000 1.5 1 0.5 Beniston, M., 2000: Environmental Change in Mountains and Uplands, Arnold, London Change in T relative to 1961-1990 [°C] 0 -0.5 -1 -1.5 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000

11. +3°C? 2050? Glacier Retreat:Tschierva Glacier, Engadine 2000 Courtesy: Max Maisch University of Zürich, Switzerland

12. Tam Pokhari 3 Sept 1998 Photo: Danek ~1997 Source: Dwivedi 2003

13. Flood From Tam Pokhari Photos: Lakpa Gœljen Sherpa 1998 Source: Dwivedi 2003)

14. Potential for Glacial Lake Outbursts: Bhutan Glacier Glacier lake Lake that poses a threat Beniston 2004

15. Ganges Discharge at Calcutta 40000 35000 Average discharge 30000 25000 Failing monsoon, with glacier meltwaters Discharge [m3/s] 20000 15000 Failing monsoon, without glacier meltwaters 10000 5000 0 J F M A M J J A S O N D Beniston 2004

16. Integration of Public Health with Adaptation to Climate Change: Lessons Learned and New Directions • What modifications to public health systems might be necessary to enhance adaptive capacity to climate variability and change? • What lessons can be drawn from the history of managing environmental and other threats that can be applied to adaptation to climate variability and change? Editors: Ebi, Smith, Burton Taylor & Francis 2005

17. Adaptation is a Process that Requires Sustained Commitment • It is easy for societies to become complacent and assume that problems are solved forever, and to not maintain efforts to monitor for the emergence or re-emergence of problems, or evaluate the ongoing effectiveness of solutions • Continuous monitoring and regular evaluation of interventions are needed because health risks and their drivers change over time

18. Distribution of Aedes aegypti in the Americas

19. Emergence of Dengue Hemorrhagic Fever in the Americas

20. Need to Understand the Multiple and Interacting Determinants of Disease • Climate change may exacerbate or ameliorate disease determinants, with the possibility that thresholds may be encountered • Increased understanding of the impacts of climate variability is likely to facilitate adaptation to future climatic conditions

21. Climate Change and Malaria under Different Scenarios (2080) • Increase: East Africa, Central Asia, Russian Federation • Decrease: Central America, Amazon [within current vector limits] Van Lieshout et al. 2004 A1 A2 B1 B2 Van Lieshout et al. 2004

22. Average % Deviation in Malaria Cases, Colombia Deviation From Trend in Malaria Cases (%) 25 15 5 0 -5 -15 -25 Niño+1 Niño0 Other Years (1960-1992) Bouma et al. Tropical Medicine and International Health 1997;2:1122-1127

23. Disease Determinants • Climate change is one of many factors influencing human health and social well-being • Public health challenges presented by climate change need to be addressed within the context of issues such as inadequate nutrition, access to clean water and sanitation, and diseases such as HIV/AIDS • Poverty a major underlying factor

24. Campylobacteriosis Notifications, New Zealand

25. Campylobacteriosis in New Zealand (Weinsten & Woodward 2005) • Campylobacteriosis is an “emerging” human gastrointestinal disease, with a dramatic increase in cases in the last few decades • In New Zealand, natural vegetation was replaced with pastoral farming • This increased sources for disease (animal waste) and reduced the ability of natural vegetation to remove the wastes from runoff • This has resulted in contamination of half of New Zealand’s rivers and streams

26. Multiple Political, Social, Economic, Technological, and Human Factors Determine Whether Measures Are Effective • Effective interventions are embedded in an understanding of human factors and are tailored to address local situations • Also, maladaptation and unintended consequences of interventions can occur in many different ways

27. Or - • Differences in culture, education, knowledge, availability and affordability of technology, and other factors means that a “one size fits all” approached is likely to fail

28. Surveillance and Early Warning Systems Can Reduce Vulnerability Maximum Temperature 10 August 2003

29. Heat Watch/Warning Systems Save Lives: Estimated Costs and Benefits for Philadelphia 1995-1998Ebi et al. BAMS 2004 • Heatwaves defined as days categorized as maritime tropical or dry tropical • Included 3 days following a heatwave day • 45 days included in analysis; 21 warning days and 24 days following a warning • Mortality for 65 and older age group • Analysis based on excess mortality • Difference between reported mortality and underlying mortality trend estimated from years prior to 1995 (1964-66, 1973-76, 1968, 1980-88) • Data analyzed using linear regression

30. Results • Excess Mortality = 3.27 – 0.05*Time of Season – 2.6*Warning Indicator • When a warning was issued, assuming no mortality displacement, 2.6 lives were saved, on average, for each warning day and for the three following days • Therefore, PWWS saved an estimated 117 lives over the period 1995-1998 • Net benefits around $468 million over the three-year period • Estimated the value of a statistical life at $4 million • Most of the actions undertaken by city of Philadelphia do not have direct costs; they include actions taken by city employees as a normal part of their jobs, actions taken by volunteers, and delayed actions; estimated costs of $10,000 per day

31. Collaboration and Coordination is Required: Potential Transmission of Schistosomiasis, Jiangsu Province Yang et al., 2005

32. Underlying Theme • There is a need to establish an institutional structure with the responsibility to maintain vigilance in responding to climate variability and change, and to commit sufficient resources on an ongoing basis to identify and respond to problems • Effective interventions rarely result from a one-off solution • The consequences of a less than effective intervention can be severe in terms of human disease and death

33. Adaptations Should • Make sense anyway • And make even more sense considering climate change • Policies that reduce vulnerability to climate variability will generally reduce risk to climate change • Be flexibility and efficiency • Perform well under a variety of climates (current climate, hotter and drier, hotter and wetter) • Consider benefits under current climate and timing of climate change benefits • Be efficient (have marginal adjustments and low cost) • “No regrets”

34. Pohnpei 1997-98

35. Thank You