Health advances under threat

Climate change is “the biggest global health threat of the 21st century”, according to the report of a year-long joint study by the University College London Institute for Global Health and the medical science magazine The Lancet. The gains made in the 19th and 20th centuries – countering infectious and pest-borne diseases, reducing malnutrition, improving infant and maternal mortality levels – could not only be lost, but put into reverse.

Summarising current research, the report sets out the threats to health and lives:

Hunger, illness, stunted growth and death due to under nutrition are set to worsen as climate change affects crops, forestry, livestock, fisheries, aquaculture, and water systems. Increases in extreme weather events will damage crops and disrupt farming. Sea level rise and flooding of coastal lands will lead to salination or contamination of fresh water and agricultural lands, and the loss of nursery areas for fishing. Drought, and changing patterns of plant and livestock diseases and pest infestations, reduction of income from animal production, decreased crop yields, lessened forest productivity, and changes in aquatic populations will all affect food production and security. The regions most likely to be adversely affected are those already most vulnerable to food insecurity and malnutrition

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Populations with no immunity will be exposed to new infections such as malaria, and dengue fever. One model suggests that up to 320 million more people could be affected by malaria by 2080. As ocean temperatures rise, increased plankton blooms could provide nutrients for the cholera virus. Flooding brings outbreaks of diarrhoea, leptospirosis and cryptosporidiosis.

Current public health systems could not respond to these challenges and of course the most vulnerable people are in poor countries with minimal health infrastructure. A new advocacy and public health movement is called for to bring together governments, international agencies, non-governmental organisations, communities, and academics from all disciplines to adapt to the effects of climate change on health.

You can see where these public health specialists are coming from. They want a return to the pioneering days of public health, for example when in 1854, John Snow (the father of public health) tracked the source of a cholera outbreak around Broad Street in London to an infected water supply. This marked the beginning of a struggle for the transformation of water and sewage which remains the bedrock of health in Britain. Then there were the studies that connected rickets and tuberculosis with poverty, which led to poor children getting free milk.

None of these struggles were won by researchers and doctors alone, but by campaigns involving individuals and groups, including trade unions and working people’s associations. Achievements were made in the teeth of opposition from vested economic and political interests.

The report’s authors acknowledge that, so far, climate change has been viewed “only through the lens of economics”, with no sign that governments are mobilising the professional, civil and social forces needed to respond. But the “lens” in question – or rather, the tunnel vision of globalised corporations in pursuit of profit – is the only vision that governments have.

Taking on the vested interests of agri-business, Big Pharma, and all the energy-guzzling corporate giants who are preventing action on climate change, means bringing scientists and doctors together with the rest of civil society to create an unstoppable movement for change. Just as Snow and his supporters had to go to war against the establishment to make gains in public health in the past, so today’s passionate advocates will find it impossible to achieve what is required without a transformation of the status quo, not only in but also beyond, health care systems.

Penny Cole
Environment editor