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Building Resilient Health Systems to Climate Change Among SIDS

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Health Ministers and Environment Ministers, Experts, Officials and other key stakeholders from Small Island Development States (SIDS) of Africa and South East Asian regions, namely Cabo Verde, Comoros, Madagascar, Maldives, Mauritius, Reunion Island, Sao Tome and Principes and Seychelles participated in the World Health Organization (WHO) Third Global Conference on Climate Change and Health on 21-22 March 2018 in Mauritius. This special Initiative was launched by the WHO in view of supporting SIDS countries in the adoption of a streamlined and concerted approach to climate change and health. During the conference, the participants focused on climate change and health, with a vision that by 2030 all health systems in SIDS will be resilient to climate variability and change. The importance of a collaborative approach towards having a regional and national institutional mechanism for mitigating the impacts of climate change has been stressed upon by the WHO.

Dr (Mrs) Joyce St John, Assistant Director-General Climate and Other Determinants of Health in WHO Head Quarters, Geneva, Dr Magaran Bagayoko, delegated by Dr Moeti, Regional Director of the WHO Regional Office for Africa, and representatives from various international institutions, including United Nations Environment Programme (UNEP) and the Indian Ocean Commission participated in the conference. Dr St John addressed the representatives from the different SIDS countries at the opening of the conference and said that ‘SIDS should speak in one strong voice to make them heard by the whole world as SIDS countries contribute little to climate change and yet, they suffer most of the adverse effects of climate change.’ She reiterated her full support and commitment in supporting SIDS countries in mitigating the impacts of climate change. She pointed out that ‘the outcome of the deliberations once finalized will be submitted in the form of a Regional Action Plan at the forthcoming World Health Assembly in May 2018 in view of obtaining support and assistance to enable SIDS to cope with health and climate challenges’. During the two days conference, the SIDS countries recognised that climate change cannot be dissociated from health as it affects, in profoundly adverse ways, some of the most fundamental determinants of health, including clean air, safe drinking water, sufficient food and secure shelter.

Dr. M. Bagayoko from WHO AFRO highlighted the global initiatives taken by WHO to mitigate impacts of climate change such as the United Nations Framework Convention on Climate Change (UNFCC) in 1992 which recognises human health and welfare as a priority response for climate change and Paris Agreement 2015 which cites the right to health to implement the agreements as a public health treaty. It was recalled that WHO launched the Small Islands Development States (SIDS) initiatives in collaboration with UNFCC and Fijian Presidency of COP-23 in view of providing the SIDS countries all the necessary technical and financial support to build climate resilient health system to address the effects of climate change. According to Dr Bagayoko, SIDS countries from African and South East Asian Region (SEAR) will have to lead the way for developing sustainable climate resilient model of health systems that will also focus on diseases prevention through integrated diseases surveillance and early warning system. In the same line, he emphasized the need for SIDS countries to ensure sustainable funding for addressing the impacts of climate change at national and regional levels. It was noted that the WHO special initiative on climate change and health in SIDS was launched by Dr Tedros Adhanom Ghebreyesus, Director General of WHO, who made health impact of climate change and environment on SIDS Countries ‘one of his main priorities’ and consequently, climate change and health was incorporated in the WHO Global Programme of Work for 2019-2022.

At the opening of the Global Conference, the Health Minister, Dr Hon. Anwar Husnoo, pointed out that ‘climate change constitutes potential threats to SIDS due to their small size, geographical remoteness, level of development and vulnerability to national disasters’. He added that ‘SIDS are in the front line exposed from acute to long term risks, from extreme weather events including torrential rains, flash floods, storm to impending risks as a result of water and food borne infectious diseases, and the rise in sea level constitutes imminent danger and hazard to healthcare facilities especially those on coastal areas.’ He highlighted that the average temperatures in Mauritius have increased over the region by 0.74 °C to 1.2 °C since 1950 and the minimum temperature has increased by a larger magnitude. On the other hand, summer temperatures have been observed to be increasing more rapidly than winter ones and the number of days with maximum temperatures above the threshold value of 30 degrees Celsius is on the rise over the entire Republic of Mauritius. He recalled that Mauritius has already been experiencing the adverse effects of climate change during the flash flood that occurred in 2013 causing the loss of lives.

Dr Husnoo stated that as a small island, Mauritius remains highly vulnerable to climate change, given that the Aedes mosquito and Anopheles mosquitoes, the local vectors of dengue and malaria are present in the country, and with the recent heavy rainfalls, there is high risk of proliferation of these mosquitoes, rendering the country highly vulnerable to emergence of mosquito related infectious diseases. He stressed upon all the precautionary measures taken by the Government of Mauritius at points of entry to reinforce surveillance of communicable diseases. Mauritius though not endemic for dengue fever, has already experienced several outbreaks so far, namely in 2009, 2014 and 2015 when locally transmitted cases were reported. About ten years ago, an epidemic of Chikungunya affected about 30% of the population. Dr Hon A. Husnoo also highlighted the ageing of the population of Mauritius as a factor that increases the vulnerability of the country to communicable and non-communicable diseases.

Dr Laurent Musango, the WHO Representative in Mauritius, in his opening remarks said that ‘climate change among SIDS is no longer a distant threat’. He added that climate change is ‘a shared problem in need of a global solution, and above all, multilateral, integrated and coordinated approach and solutions’ It was pointed out that SIDS countries will require massive technology transfer and financial support to take climate-friendly measures. Dr Musango, stated that ‘developed countries not only need to reduce their emissions adequately but they are also expected to help meeting the technology and financial needs of developing countries, including SIDS countries.’ He made an appeal to all the representatives of the SIDS countries present to join forces to build solidarity and re-commitment to a global partnership for sustainable development.

During the course of the meeting, the Framework for action on climate change was discussed. SIDS countries realise that the challenges for small islands are the same and joint actions are necessary to raise a strong common voice at global level. Action points along the four strategic line actions, namely empowerment of leadership, building evidence, implementation and facilitating access to resources were discussed and targets and indicators were identified to address the challenges through participative approach.

The deliberations of the Conference will adequately inform the formulation of a regional action plan on climate change for the period of 2019 to 2023 for SIDS in the African and South East Asian Regions. In the same vein, the SIDS countries agree to leverage the existing regional mechanism to ensure that health and climate change is placed high on the agenda at regional and global levels. It was also agreed to strengthen the collaboration between different sectors at country level for evidence generation, surveillance, building capacities and resource mobilisation. Further, it was highlighted that existing networks for evidence generation needs to be strengthen in terms of human resource capacity in the areas of data generation, data use and dissemination across various regional and global platforms. Other recommendations from the participants from the Global Conference include placing the health agenda item at the UNFCC and AOSIS (Alliance of Small States) so that voices of SIDS countries are heard at the highest level possible, be it at WHO level or other bodies.