There are opportunities for technology transfer in relation to the potential health impacts at several levels. Minimisation of the health impacts of impending, or unavoided future, climate change can entail:
With respect to the first of those three modalities, the health of communities and populations depends fundamentally upon social and natural environmental conditions. Therefore governments should be fully aware of the potential public health impacts when assessing options for adaptation to climate change.
With respect to the second modality, population vulnerability can be reduced generically by improving the social and technical circumstances and by reducing socio-economic inequalities. Vulnerability can be reduced more specifically by adaptations directed at specific exposures, or susceptibility to them. For example, improved housing design and domestic temperature regulation can reduce vulnerability to thermal stress, while vaccinations and control of "vector" insects reduce the risks of various infectious diseases. The health gains from these specific adaptations will largely be confined to the population taking action.
With respect to the third issue, national public health infrastructure is of fundamental importance. The poorest countries, where impacts are likely to be greatest, are also least able to maintain a public health infrastructure. This area should therefore be a priority for technology transfer.
Monitoring and Surveillance
The most elementary form of adaptation is good health monitoring and surveillance systems. Within the health sector, only basic measures of population health status (e.g., life expectancy) can be measured simply and uniformly around the world. However, disease (morbidity) surveillance varies widely depending on the locality, the country and the disease. Many less developed countries have inadequate surveillance systems. Weather and climate forecasts should be used, where appropriate, in preventing deaths and injuries, and in disease prevention and control.
Control of infectious disease
The last decade has seen the resurgence of several major infectious diseases which were previously controlled, such as malaria. International efforts to control malaria - a known climate-sensitive disease - are failing because of drug resistance and the socio-economic, geographical and ecological conditions in much of today's world. The recent resurgence of malaria in areas where it had previously been eradicated (Azerbaijan, Tajikistan) or under control (Iraq, Turkey) reflects declines in malaria prevention and mosquito control programmes due to conflict and economic crises. In Ethiopia, indoor spraying campaigns with DDT were effective at reducing both malaria morbidity and mortality, but over the last 20 years there has been a programmatic breakdown because of civil war and the forced movement of people. WHO has recently launched a new initiative, the "Roll Back Malaria" programme, to be implemented in close co-operation with the World Bank and other international agencies.
The coverage of existing vaccination programmes aimed at elimination of diseases such as yellow fever should be expanded. Other strategies are important to combat diseases like malaria. For example, periodic checks should be carried out on parasite sensitivity to the commonly used antimalarial drugs. The use of insecticide-impregnated bed nets has been successful in reducing malaria transmission in endemic areas.
The incidence of certain water-borne and vector-borne infections can be reduced by several environmental measures. A broader approach to preventing water- and food-borne diseases would consider the interactions between climate, vegetation, agricultural practices and human activity. Strategies to control climate-sensitive disease require intersectoral collaboration between the health, forestry, environment, and conservation sectors.
Improve coverage of health system
There are many existing health inequalities between rich and poor; these inequalities are widest in developing country cities. Strategies to reduce poverty and improve access to health services in urban environments will serve to reduce vulnerability to climate change
Role of the UN system
Public policies to reduce socio-economic and environmental vulnerability will enhance population capacity to adapt to climate change. Conventional health sectors are not equipped nor empowered for this multidimensional task. International co-operation is required, for data collection, analysis, and policy-making to reduce health impacts.
The specialised agencies of the United Nations are primarily mandated to support government planning and management in Member States, by strengthening sectors such as industry, health and agriculture. Implementation of the following three-tier strategy endorsed by the Interagency Committee for the Climate Agenda (IACCA) is entrusted to WHO:
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