Why Climate Change Is Worsening Public Health Problems
By Chelsey Kivland and Anne Sosin
Around the world, the health care debate often revolves around access.
Dr. Tedros Adhanom Ghebreyesus, head of the World Health Organization, recently announced, "All roads lead to universal health coverage." Discussions for how to translate this vision into a road map for action is central to the agenda of the WHO's executive board meeting this week in Geneva.
Yet focusing on access is not enough. The imperative for access must be paired with a frank acknowledgment that climate change is making communities around the world more vulnerable to ill health. A 2017 commission of The Lancet, a leading health research journal, tracked the effects of climate change on health and found evidence of harms "far worse than previously understood."
As a global health professional (Sosin) and a cultural anthropologist (Kivland), we have witnessed how the global exchange of health technology, expertise and aid has contributed to dramatic gains in the delivery of health care in Haiti and other settings, especially around infectious diseases. Yet climate change threatens to undermine the health gains in vulnerable communities across the globe.
As firsthand witnesses to sharp health disparities globally, we argue that world leaders need to insist that any health care strategy must address the social and environmental vulnerabilities driving poor health in the first place.
The Health Burden of Climate Change
Climate scientists argue that global warming is exacerbating extreme weather events. And natural disasters are often the source of health crises, particularly in fragile settings. Consider the case of Puerto Rico. The official death toll of the storm was estimated at 64; however, later reports have estimated that the disruption of health care services contributed to upwards of 1,052 deaths on the island.
Lagging recovery efforts have exposed how natural disasters deepen the relationship between socio-economic inequality and health disparity. In Puerto Rico, where poverty rates are double those of the poorest continental state, people already struggling with illnesses such as diabetes and kidney disease have seen their conditions worsen as the long-crumbling health care system is overwhelmed with patients and neglected by the mainland government.
The health impacts of the storms may persist even beyond the restoration of health services.
Hurricane Harvey exposed the toxic afterlife of disastrous storms. Storm damage to 40 industrial sites released chemical toxins linked to cellular damage, cancer and other long-term health problems. As The Lancet's Commission on Pollution and Health found, air, water and soil pollution is now the leading environmental cause of death and disability, accounting for more than 9 million deaths annually. These numbers will only grow in the face of climate-induced disasters.
Restoring health care systems is vital for these communities, but it will merely treat the symptoms and not the causes of post-disaster illness. We believe that policymakers must address the link between environmental and health crises.
Haiti as Case Study
We have learned this lesson from our work in Haiti. Once a death sentence in rural Haiti, today HIV is largely controlled thanks to widespread access to antiretroviral therapy. The prevalence of the disease in pregnant women fell from 6 percent to just over 2 percent in the 10-year period from 1993 to 2003. Likewise, vaccines against cholera, introduced in 2015, have proven to be up to 90 percent effective against the disease.
However, even as vaccine coverage continues to grow, the population remains at risk for cholera and other emergent threats. Only 58 percent of the population has access to safe water and only 28 percent has access to basic sanitation. These conditions worsen in the wake of natural disasters. Hurricane Mathew in 2016 triggered spikes in cholera and other waterborne diseases, especially diarrhea, the second leading cause of death among children.
Hitting the one region of Haiti that had not yet been denuded of trees and vegetation, Hurricane Matthew seemed to complete the destruction of the country's food systems.
Since the late 1980s, the erosion of waterways, loss of habitats and destruction of agricultural land have fueled the importation of cheap, processed foods. Rice and pasta have replaced a diet once rich in fruits, vegetables and whole grains. The high-sugar, low-nutrition foods contribute to the dual health burdens of obesity and under-nutrition.
These trends are ongoing, but they are exacerbated by the disastrous shocks of extreme weather events, which are made more likely by climate change. As Hurricane Matthew came ashore, it decimated fishing villages and tore through farming communities, killing livestock, uprooting crops and denuding backyard fruit trees. The United Nations estimated that 800,000 people suffered food shortages.
Closing the Vulnerability Gap
Haiti is often cast as behind the global curve. But as a reflection of the dangerous intersection of climate change, poverty and ill health, it is in fact predictive of what is to come in the rest of the world. Haiti teaches us that our own health is not bound up simply in the present decisions we make about health care systems but rather more broadly situated in the changing natural environment.
Closing the access gap has been a long battle and the gains cannot be underestimated. Yet the challenge ahead is even more daunting. Whereas increasing access has centered on extending health care technologies to underserved populations, closing the vulnerability gap will require approaches that extend beyond the health sector and national borders.
In the past year, the health care debate in the U.S. has centered on attempts to limit or expand access to care. Meanwhile, the Trump administration has left the Paris agreement and unraveled environmental protections for national and transnational corporations—with little resistance from health advocates. We believe that leaders must recognize that environmental policy is health policy. Rollbacks of environmental regulations will cause far greater consequences on health, in the U.S. and globally, than any health care bill.
Fixing health care systems while we undermine the environmental conditions for health are a textbook example of what Haitians describe as "lave men, swiyè atè"—washing your hands but drying them in the dirt.
3 Ways #ClimateChange Affects Our Health Today https://t.co/ezKI1wbytd @350 @climatehawk1 @foe_us @SierraClub @MichaelEMann @greenpeaceusa— EcoWatch (@EcoWatch)1509630195.0
Reposted with permission from our media associate The Conversation.
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theDOCK aims to innovate the Israeli maritime sector. Pexels<p>The UN hopes that new investments in ocean science and technology will help turn the tide for the oceans. As such, this year kicked off the <a href="https://www.oceandecade.org/" target="_blank" rel="noopener noreferrer">United Nations Decade of Ocean Science for Sustainable Development (2021-2030)</a> to galvanize massive support for the blue economy.</p><p>According to the World Bank, the blue economy is the "sustainable use of ocean resources for economic growth, improved livelihoods, and jobs while preserving the health of ocean ecosystem," <a href="https://www.sciencedirect.com/science/article/pii/S0160412019338255#b0245" target="_blank" rel="noopener noreferrer">Science Direct</a> reported. It represents this new sector for investments and innovations that work in tandem with the oceans rather than in exploitation of them.</p><p>As recently as Aug. 2020, <a href="https://www.reutersevents.com/sustainability/esg-investors-slow-make-waves-25tn-ocean-economy" target="_blank" rel="noopener noreferrer">Reuters</a> noted that ESG Investors, those looking to invest in opportunities that have a positive impact in environmental, social and governance (ESG) issues, have been interested in "blue finance" but slow to invest.</p><p>"It is a hugely under-invested economic opportunity that is crucial to the way we have to address living on one planet," Simon Dent, director of blue investments at Mirova Natural Capital, told Reuters.</p><p>Even with slow investment, the blue economy is still expected to expand at twice the rate of the mainstream economy by 2030, Reuters reported. It already contributes $2.5tn a year in economic output, the report noted.</p><p>Current, upward <a href="https://www.ecowatch.com/-innovation-blue-economy-2646147405.html" target="_self">shifts in blue economy investments are being driven by innovation</a>, a trend the UN hopes will continue globally for the benefit of all oceans and people.</p><p>In Israel, this push has successfully translated into investment in and innovation of global ports, shipping, logistics and offshore sectors. The "Startup Nation," as Israel is often called, has seen its maritime tech ecosystem grow "significantly" in recent years and expects that growth to "accelerate dramatically," <a href="https://itrade.gov.il/belgium-english/how-israel-is-becoming-a-port-of-call-for-maritime-innovation/" target="_blank" rel="noopener noreferrer">iTrade</a> reported.</p><p>Driving this wave of momentum has been rising Israeli venture capital hub <a href="https://www.thedockinnovation.com/" target="_blank" rel="noopener noreferrer">theDOCK</a>. Founded by Israeli Navy veterans in 2017, theDOCK works with early-stage companies in the maritime space to bring their solutions to market. The hub's pioneering efforts ignited Israel's maritime technology sector, and now, with their new fund, theDOCK is motivating these high-tech solutions to also address ESG criteria.</p><p>"While ESG has always been on theDOCK's agenda, this theme has become even more of a priority," Nir Gartzman, theDOCK's managing partner, told EcoWatch. "80 percent of the startups in our portfolio (for theDOCK's Navigator II fund) will have a primary or secondary contribution to environmental, social and governance (ESG) criteria."</p><p>In a company presentation, theDOCK called contribution to the ESG agenda a "hot discussion topic" for traditional players in the space and their boards, many of whom are looking to adopt new technologies with a positive impact on the planet. The focus is on reducing carbon emissions and protecting the environment, the presentation outlines. As such, theDOCK also explicitly screens candidate investments by ESG criteria as well.</p><p>Within the maritime space, environmental innovations could include measures like increased fuel and energy efficiency, better monitoring of potential pollution sources, improved waste and air emissions management and processing of marine debris/trash into reusable materials, theDOCK's presentation noted.</p>
theDOCK team includes (left to right) Michal Hendel-Sufa, Head of Alliances, Noa Schuman, CMO, Nir Gartzman, Co-Founder & Managing Partner, and Hannan Carmeli, Co-Founder & Managing Partner. Dudu Koren<p>theDOCK's own portfolio includes companies like Orca AI, which uses an intelligent collision avoidance system to reduce the probability of oil or fuel spills, AiDock, which eliminates the use of paper by automating the customs clearance process, and DockTech, which uses depth "crowdsourcing" data to map riverbeds in real-time and optimize cargo loading, thereby reducing trips and fuel usage while also avoiding groundings.</p><p>"Oceans are a big opportunity primarily because they are just that – big!" theDOCK's Chief Marketing Officer Noa Schuman summarized. "As such, the magnitude of their criticality to the global ecosystem, the magnitude of pollution risk and the steps needed to overcome those challenges – are all huge."</p><p>There is hope that this wave of interest and investment in environmentally-positive maritime technologies will accelerate the blue economy and ESG investing even further, in Israel and beyond.</p>
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