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Guest Post: How climate action can save global health

Tags: public health

By Junaid Nabi, MD, MPH, is a Research Associate in Surgery at Harvard Medical School, Boston (Twitter: @JunaidNabiMD). Thilmeeza Hussain is a former deputy ambassador of the Maldives to the United Nations (@Thilmeeza). Abhilasha Karkey, MD, DPhil, is a medical microbiologist at the Oxford University Clinical Research Unit in Kathmandu, Nepal (@abhilashakarkey). They are 2018 New Voices Fellows at the Aspen Institute, Washington, D.C.

Each one of us grew up in a region that is surrounded by such beauty that tourists from across the globe flock to see the marvels of nature. Whether it is the bright and snowy glaciers of Kashmir (JN), turquoise blue waters of Maldives (TH), or the imposing and majestic mountains of Nepal (AK) – each place signifies millions of years of natural processes that led to such unique landscapes.

Slowly, but surely, we are losing the places we grew up in; the places we call home. Unless global health practitioners work towards reducing global greenhouse gas emissions by 2030, the health of the global population is threatened as well.

The recent report by the fourth National Climate Assessment by the U.S. government and United Nations Intergovernmental Panel on Climate Change (IPCC) is a devastating reminder of what is at stake. The 700-page report declared that, as a planet, we have only 12 years to institute comprehensive international policies that protect the environment, before the damage to our environment is irreversible.

Every year, inch-by-inch, the shimmering glaciers in Kashmir are receding, the white sandy beaches of Maldives are eroding, and it is getting increasingly difficult—if not impossible—for people in Nepal to live alongside unstable weather changes that have engulfed the Himalayan range. Thousands of people are losing their homes, while countless others are losing their ability to make a decent living.

The response requires individual action and political will—both of which are lacking.

Our actions can affect everyone around us, including those in other countries (Photo by slon_dot_pics from Pexels)

To start with, as IPCC has suggested, reliance on fossil fuels and coal for industrial and infrastructure purposes needs to be reduced by 66 percent. That can happen only with international cooperation. Action on the part of ordinary citizens is no longer going to be enough to bring meaningful change, individual apathy is not the greatest threat to climate change. While we must continue to consume less meat, carpool when possible, and take shorter showers we should concentrate our efforts on bringing policy changes and electing officials into office who are willing to bring the necessary changes.

We are already witnessing the health effects of international political apathy. Antibiotic resistance, especially in chronic infections, is undoing the massive success global health has achieved in the last few decades. A recent study from the University of Toronto and Boston Children’s Hospital on the relationship between rising temperatures and antibiotic resistance reported that with rising temperatures, the probability of a person acquiring a drug-resistant infection is higher.

Dengue, a mosquito-borne infection that leads to significant disability and loss of income in low- and middle-income countries, has been effectively controlled through large-scale global health endeavors. Now, with rising temperatures, these projects may be jeopardized. Research on trends in global dengue incidence has revealed that infection rates have increased significantly over the last half century, and large part of this trend has been driven by rising global temperatures.

These changes put a particular stress on low- and middle-income countries as they often need to balance current healthcare needs with an impending healthcare crisis. Surprisingly, this rise in the dengue incidence is not limited to countries in the global south; these worrying trends threaten European countries as well, environments where lack of historical infections put their populations at significant risk. We don’t have the luxury of waiting to fix this.

In the remote hills of western Nepal, climate change is impeding healthcare delivery and threatening lives right now. We witnessed one such example recently: A 17-year-old girl in obstructed labor needed emergency care that local caregivers couldn’t provide. Landslides from the heavy monsoon rains had blocked roadways to the nearest hospital. The only option was to fly. The monsoon season was supposed to be over, but rain has become erratic these days—unpredictable and scary. The plane arrived safely—this time—whisking the girl and her mother away to the hospital. Ironically, the same airplane that saved her life is contributing to climate change. And what about the next time a patient needs emergency care? Will unpredictable rains prevent an air rescue?

Climate change is advancing more rapidly in the high Himalayas than in many other parts of the world, affecting both people and natural systems. Increasing temperatures mean shrinking snow caps and rapidly rising glacial lakes. More than 50 glacial lake outburst events have been recorded in the Himalayan region leading to flooding of pastures, damaging people’s lives and property in the mountains and also in downstream areas.

Around the tropical Maldives, beach erosion, coral bleaching, and contaminated freshwater aquifers show today’s toll of climate change—these changes will alter the natural history and symptomology of clinical conditions in this small island state. Clean freshwater is no longer available in many islands across the country, so people are relying on desalinated water or harvesting rainwater during monsoons—directly altering their way of life. South Asia as a region is especially vulnerable to climate change because of factors such as high poverty and low adaptive capacity.

Climate change, together with health inequality and infectious diseases, is a major challenge in public health in this region and around the globe. It is likely to influence mortality and morbidity due to mosquito- and animal-borne diseases, water-borne diseases, flooding and malnutrition.

It is essential to recognize that while the challenge of global warming may seem insurmountable, and the available time to act running out, we still have an opportunity to preserve the beauty and sustainability of our planet. This is our only home.

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