Attachments
Executive Summary
The current El Niño event was first declared in June 2023. Since the first El Niño Public Health Situation Analysis published in July 2023, evolving climate forecasts have warranted an update to this document. The past three months have already demonstrated that several of the predicted weather-related risks and attendant health consequences associated with El Niño have already come to pass in multiple settings around the globe (with the caveat that any climate-related event is multifactorial and thus difficult to attribute specifically to El Niño). These have included a large dengue outbreak in Bangladesh, forest fires in Australia, increases in the water quality risk and alterations to the crop cycle in Central America, widespread flooding in northern India, heat waves in southern Europe, increases in cholera in East Africa, and increases in wildfires and associated air pollution in Indonesia. Even with some negative effects already observed, most of the negative health effects of El Niño are projected as still to come: the ongoing El Niño is highly likely to have wide-ranging health implications on a global scale well into 2024.
This document is organized around several main themes: a description of the El Niño climate pattern and the sub-regions and locations most likely to be affected; the anticipated health risks, their anticipated relative importance, and rationale for their inclusion; the anticipated influence of El Niño on key determinants of health; a discussion of the availability of health resources and services relevant to the response to health threats associated with El Niño, and potential threats to health infrastructure itself; and an overview of the humanitarian health response being undertaken to mitigate the aforementioned risks. A table of climate forecasts and detailed risks per country can be found in the Annex.
In the coming months, the most severe health risks are likely to arise from malnutrition due to ongoing food insecurity, compounded by the effects of El Niño. Other very high risks include cholera and other waterborne diseases; heat stress and air pollution; malaria; and arboviral diseases such as dengue, Zika virus disease, and chikungunya. Stakeholders focused on specific health risks are referred to the risk tables 2a and 2b and the narratives under the section ‘Health Risks’.
Health resources and services to address the health risks associated with El Niño, and their vulnerability to the effects of El Niño, vary greatly from one country to another, and within countries. Droughts, flooding and intense rainfall (including cyclones) may damage or close health facilities, thus reducing regular health service delivery and restricting access to healthcare during the emergency and well beyond the event.
The ultimate impact of El Niño on health can be characterized according to the intersection of the likelihood of its severe effects (as per the risk tables) versus the consequences in the underlying context. Many of the locations projected to be affected by El Niño are already suffering humanitarian emergencies and thus already have highly vulnerable health systems. Stakeholders focused on health systems strengthening and broad humanitarian response are referred to the ‘Health Resources and Services Availability’ section of this PHSA for information relevant to mitigating the effects of El Niño on health systems.
The key humanitarian response elements for mitigating the health effects of El Niño are: disease surveillance and control, provision of safe water and sanitation services, risk communication and community engagement, provision of emergency health supplies, vaccination, prevention of sexual exploitation and abuse, and assuring continued access to health care. WHO acts as part of an UN-wide coordination and monitoring mechanism for El Niño, and supports countries through programmatic work to address key health threats, and via direct support to countries. WHO and partners already have emergency response plans in place in many crisis-affected countries projected to be most affected by El Niño, and are supporting local authorities to mitigate these effects. For humanitarian response stakeholders at the regional, national or sub-national levels, in order to ensure optimal evidence-based operational decision-making, the findings in this PHSA should be contextualized with more granular local information; the table in the Annex may serve as a starting point.