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Budi Haryanto University of Indonesia

SCENARIOS OF PUBLIC HEALTH ADAPTATION TO CLIMATE CHANGE INDONESIA-AUSTRALIA 2008-2020: ACADEMIC/PROFESSIONALS AND NGOs. Budi Haryanto University of Indonesia. UNDERLYING IDEAS. Hypothesis :

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Budi Haryanto University of Indonesia

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  1. SCENARIOS OF PUBLIC HEALTH ADAPTATION TO CLIMATE CHANGE INDONESIA-AUSTRALIA 2008-2020: ACADEMIC/PROFESSIONALS AND NGOs Budi Haryanto University of Indonesia

  2. UNDERLYING IDEAS • Hypothesis: • that there is a potential Australian-Indonesian bilateral component of global civil society that can form around shared interests in the resolution of questions of climate change, energy insecurity, and related issues such as pandemics • Constraints clear in interests and problems • Possible state and civil society strategies for optimizing chances of finding entry into shared problem framing?

  3. CURRENT BILATERAL RELATIONSHIPS • Reified notions of “the Australia-Indonesia relationship” • Volatile - think of the successive “crises” • Fragile • Thin - strongest aspect is government; weakest are civil society and business • Asymmetry: • Indonesia much more important to Australia than vice versa • But systematically mis-recognized in Australia

  4. Layered frames for analyzing bilateral security impacts • bio-physical and social-ecological systems under consideration • historically formed relationship between the two societies and states • intentional collective efforts to address actual and expected climate change through mitigation of greenhouse gas generation and release, and adaptation to specific patterns of climate change

  5. The climate change and security field: three approaches • Informed enthusiasts • Academic skeptics (>>Academic adaptation approaches as compromise) • Systems approaches

  6. Reframing Australia-Indonesia security project: five goals • Model impacts on human and state security of climate change, climate change adaptation and mitigation • Apply model to bilateral relationship • Document for Indonesia and Australia • Model national and bilateral policy responses, government, business and civil society • Possibility of trans-border cooperation by emergent communities of shared interests and transnational moral communities

  7. JUSTIFICATION Climatic changes have already affected numerous damaging impacts on human health. Spreading infectious disease, longer and hotter heat waves, and extreme weather claim thousands of additional lives nationwide each year. Warming climate is creating the ideal conditions for spread of infectious disease, putting millions of people at risk. Climate change has lead to increase the outbreaks and spread of Dengue Hemorrhagic Fever (DHF), malaria, cholera, encephalitis, hantavirus, and other diseases all over the world. Ironically, the countries which have less contributed to the global warming are highly susceptible and more outbreaks of diseases and deaths due to global warming impact

  8. Moderating influences Health Effects Health effects Temperature-related Temperature - related illness and death illness and death Extreme weather Extreme weather- - related (floods, storms) health effects related health effects Environment Impacts: Air pollution-related Air pollution - related health effects health effects Microbial changes: Contamination paths Regional weather Regional weather Climate Climate Water and food - borne Contamination changes changes Change Change Water and food-borne diseases pathways diseases • • Heat waves Heat waves Transmission Transmission dynamics Vector - - borne and Vector borne and dynamics • • Extreme weather Extreme weather rodent - - borne diseases rodent borne diseases • • Temperature Temperature Changes in agro-ecosystems, hydrology Effects of food and water shortages • • Precipitation • Sea-level rise Mental, nutritional, infectious-disease and other effects Socioeconomic and demographic disruption

  9. CLIMATE CHANGE IMPACTS ON HUMAN HEALTH IN INDONESIA Direct effects: • Increasing of injuries associated with extreme weather events Indirect effects: • Increasing of vector borne diseases (malaria, dengue, filariasis) associated with increasing of temperature, rainfall, humidity, and vector density. • Increasing of water borne diseases (diarrhea, cholera, typhoid, leptospirosis) associated with decreasing of water quality and water supply as well as floods and droughts.

  10. Indirect effects… • Increasing of malnutrition cases is related to food production and land use shifts • Increasing of cardio cerebral vascular diseases, hypertension, and mental disorders are associated with urban stress, life style, displacements and conflicts. • Increasing of influenza (ARI) and respiratory diseases (asthma, pneumonia) are associated with increasing of air pollution outdoor as well as indoor • Increasing of food borne diseases is associated with contamination, food handling, and poverty.

  11. Effects of Temperature Rise on Dengue Transmission Shorten viral incubation period in mosquito Shorten breeding cycle of mosquito Increase frequency of mosquito feeding More efficient transmission of dengue virus from mosquito to human

  12. Trend of Temperature and DHF Cases in Indonesia 1968-Sept 2007

  13. IR: 72/100.000 org CFR:1,01% IR: 43/100.000 org CFR: 0,74% Source: MoH, 2008

  14. DHF INCIDENCE IN INDONESIA, 2007 <5 5-19 20-50 >50 IR=incidence rate (per 100,000 population)

  15. Malaria Cases

  16. >75 0/00 25-75 0/00 0-25 0/00 Non Endemis 1 dot = 100 cases 1 dot = 500 cases Malaria Endemic Areas

  17. MAIN CONCERN: SPREADING OF DISEASES Unique transmission pathways Specific for every single disease outcome Once the impact occurred, the disease will spread from infected person to others and from the new infected people to broader population as a snow ball phenomenon The spread of disease may not be controlled directly even by manipulating or modifying the environment Analysis of each of these steps allows a logical determination of vulnerability and subsequent development of adaptive measures that aim to decrease vulnerability It will need specific discipline of technology, method, and expert such as public health/environmental health, medical, and pharmacy to deal with the impacts.

  18. PUBLIC HEALTH RESPONSE AND ADAPTATION IN INDONESIA (MOH) • Infectious disease surveillance • Health action in emergencies • Safe drinking water • Integrated vector management • Environmental health capacity building • Healthy public policy (healthy housing, school, forest, industry, city)

  19. WHO Adaptation Focus • Health security • Strengthening health systems • Health development • Evidence and information • Delivery • Partnership

  20. Impacts, Vulnerability, Adaptations Characteristics of exposed group (location, wealth, resources, health status, culture, etc.) Adaptations Vulnerabilityof group Learning Actions in response to impact Health Impact Exposure Mitigation: Reduced exposure BREAKING TRANSMISSION CHAINS

  21. PUBLIC HEALTH ADAPTATION IDEAS IN INDONESIA • Empowering ecological-diseases surveillance system and developing public health early warning system • Development response to disaster effects of climate change • Enhancing capacity building for government, private sector, and civil society on managing prevention and control climate change on human health • Increasing political awareness on climate change human health • Empowering public health services system for disease prevention and control • Generating research and method on epidemiology and medicine to find out the approach in breaking the disease transmission chains • Preventing and eradicating climate change vector-related diseases

  22. PUBLIC HEALTH ADAPTATION SCENARIOS FOR CLIMATE CHANGE 2008-2020 (Ind – Aus) 1. Development of collaborative frameworks of analysis and action. 2. Develop pre-figurative or iconic early warning facilities at hotspots or pressure points, in parallel in both countries. 3. Engage both the Australian and Indonesian military in discussions about the contribution each organisation could make, separately and in cooperation, to the following tasks: • Disease and climate change surveillance • Relief capacities in the event of CC-related health emergencies • Experience and wider lessons to be learned from their activities to protect their forces from the health consequences of climate change.

  23. PUBLIC HEALTH ADAPTATION SCENARIOS… 4. Propose tighter twinning of sister cities between Australia and Indonesia, specifically around expected shared problems of urban climate change-related disease patterns. • Link with RMIT University urban systems group re expanding capacity for stormwater, sewerage, and waste problems resulting from CC. • Explore models of community/government/business collaboration in implementing systems. • Engage with AusAID. 5. Encouraging Australia-Indonesia networks of community groups to identify each other for mutual support: Environment, Faith, Local government, Health services, Professional associations, Medical linkages

  24. PUBLIC HEALTH ADAPTATION SCENARIOS… 6. Exploring use of tax incentives for facilitating cross-border collaboration on sustainable and resilient CC-related/water-related infrastructures • Tax incentives for technology exchange, innovation, cooperation 7. Exploring possible role of children and schools in public awareness campaigns to minimize stagnant water – surveillance and education.

  25. PUBLIC HEALTH ADAPTATION SCENARIOS INDONESIA-AUSTRALIA ‘08-’20

  26. PHA SCENARIOS…

  27. PHA SCENARIOS…

  28. THANK YOU

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