The Greatest Threat to Health

Catherine Thomasson, executive director of Physicians for Social Responsibility has called climate change “the greatest threat to public health in the 21st century”. There is no doubt that the...
An Afghan doctor checks a patient's tonsils at a medical clinic in Sarobi district, Kabul province, Afghanistan, Dec. 7, 2013. The Combined Joint Special Operations Task Force -Afghanistan medics visited the clinic as part of a medical outreach program which would help provide Afghan doctors with proper supplies in order to give patients the proper medical attention they require. (U.S. Army photo by Spc. Sara Wakai/ Released)

Catherine Thomasson, executive director of Physicians for Social Responsibility has called climate change “the greatest threat to public health in the 21st century”. There is no doubt that the effects of climate change are becoming more and more prominent.

Climate change may affect health in multiple ways; for example as a result of increased frequency and intensity of heat waves, increase in floods and droughts, changes in the distribution of vector-borne diseases and effects on the risk of disasters and malnutrition. Therefore the overall balance of effects of climate change on health is likely to be negative. Populations in low-income countries are likely to be particularly vulnerable to the adverse effects although the experience of the 2003 heat wave in Europe shows that high-income countries can also be affected. Adaptation to climate change requires public health strategies and improved surveillance.

The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality, respiratory illnesses due to heatwaves, and preventable diseases to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance.

The MENA (Middle East and North Africa) region, like the rest of the world, has been experiencing harsh climatic conditions which have been prominent in the past few years. Citizens of Jordan have admitted that the summers are becoming “suffocating” as some have described, and winter storms have been escalating to become worse every year. Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths worldwide from malnutrition, malaria, diarrhoea, and heat stress; 38,000 due to heat exposure in elderly people; 48,000 due to diarrhoea; 60,000 due to malaria.

Malaria could be of particular concerns to countries like Sudan and Egypt where it is endemic. The public health and economic consequences of Falciparum malaria are once again regarded as priorities for global development. There have been speculations whether anthropogenic climate change is exacerbating the malaria problem, especially in areas of high altitude where Falciparum malaria transmission is limited by low temperature. Therefore, not only countries where malaria is endemic are going to face the challenges caused by this illness. The Intergovernmental Panel on Climate Change has concluded that there is likely to be an extension in the distribution of malaria and an increase in incidence within this range.

Extreme heat air temperatures contribute directly to deaths from cardiovascular and respiratory diseases, particularly among elderly people. As for the heat wave that took place this past July, doctors in the capital of Jordan, Amman, have noticed an increase in respiratory related admissions. High temperatures raise the levels of pollutants in the air thus exacerbating respiratory diseases. Aeroallergen levels are higher in extreme heat. These can trigger asthma, which affects around 300 million people and the ongoing temperature rises are expected to increase this burden.

Many of the metropolitan cities suffer from pollution due to industrial activities, car exhaustion etc. and therefore they experience poor air quality and a continuous rise in respiratory illnesses. Taxi drivers in Amman have admitted that the number of cars in the city has increased remarkably within the past 5 – 7 years. The influx of refugees, NGO’s, growing business in the country have contributed to the increase in number of cars in the city, and hence worsening air quality in the city. It is also noticeable that almost every home in Amman has at least two cars.  In addition Amman and Jordan in general is a favourable summer destination by those who live in the Gulf who tend to bring their cars with them during the vacation. This adds up to the pollution faced by the city in addition to traffic challenges. Alternative routes have been built and are still being built in attempt to solve the problem of traffic jam. This may reduce the trouble caused by immense traffic but minimum amount of effort seems to be directed towards combating air pollution caused by car exhaust.

In 1990 the Mexico City government presented the 1st Comprehensive Program Against Air Pollution (PICCA) as a systematic plan to combat air pollution. Since then, the program underwent failures and multiple modifications until 2002. From 2002 to 2012 the motorbus and the shared bike program (Ecobici) began operating. Emissions reduced over this time period were estimated at 817,132 tons/yr of CO2 and 64,779 tons/yr of NOx in addition to other greenhouse gases. Mexico city has established another plan called ProAire IV 2011-2020 which was published in 2011 and is focused in improving air quality and reducing GHG emissions by 2020. Due to these efforts it is only natural that Mexico city wins the city climate leadership award. Amman, Cairo and other cities in the Arab region should apply more effort in reducing air pollution, perhaps starting with alternative means of transport. Doing so will reduce air pollution related illnesses, and therefore improve health conditions.

Itlala Ahmed

Itlala is a 24 year old doctor who has great passion towards humanitarian activities. She has worked with the International Federation of Red Cross and Red Crescent societies in Nairobi, Kenya where she was engaged in a mapping process of the health projects that were conducted by the IFRC in Africa. She did her medical internship (postgraduate training) in Jordan. She truly believes that with hardwork, strong will, passion and belief we can make positive changes in the world.
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