Rethinking Public Health in Eastern Africa in light of the COVID-19 Pandemic? Part 2

17 May, 2020 Article 6

Lead Author: Dr Esther Onyango, Environmental Futures Research Institute at Griffith University Australia

Contributions by ICPAC Climate Change Technical Working Group

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© Common wealth fund

Current health systems are neither built to meet the impacts of a changing climate nor respond to the global health security risks posed by emerging and re-emerging diseases. Other factors such as poverty, weak health infrastructure, corruption and low economic potential increase the vulnerability of populations.

This is the time for African leaders to priorities health, and allocate financial and human resources towards climate resilient health systems including universal health coverage. We need a paradigm shift that recognises that strengthening health systems to respond to these threats will require inputs from all sectors of government and civil society. Collaboration between many academic disciplines, and new ways of international cooperation to overcome identified challenges. This means we need a systematic approach that recognizes these threats affect all aspects of the society. Public health professionals must work in collaboration with other sectors, such as water, energy, food, agriculture and urban planning to develop multi-sectoral strategies for action. Strong community engagement and mobilization is also essential. Health promotion activities using trained community health workers, local radios, among other channels, to reach rural and remote populations should be used to increase education and awareness of climate change and health risks.

This is not a one-size fits all approach. Actions taken need to start with a baseline assessment of existing health vulnerabilities and the capacity to cope for that country or region, taking into account the differential needs of the population. In the short term, public health responses that allow rapid detection of new outbreaks of diseases are required. These include constant surveillance to monitor population health and environmental exposure, robust research, quick access to testing, prompt diagnosis, a trained and adequate workforce, and climate-proof infrastructure. In the longer term, managing the threats to human health and wellbeing, and the threats to the environment, will require strong and resilient health systems all across the supply chain with continued monitoring and evaluation to review if current actions are effective. This includes balancing the need for economic development, and water and food security against the need to protect the environment and our health. Furthermore, conducting health risk assessments alongside environmental risk assessments of large infrastructure projects to include public health input into building and design. Additionally, more research using integrated risk assessments that link climate models with disease and species distribution models including other socio-economic and demographic factors are needed in order to understand how disease distribution may change over time under different climate conditions.

The WHO proposes a framework that illustrates the actions needed to increase health system resilience to climate variability and change based on the six components of a well-functioning health system. This framework can be used by national ministries of health to identify key functions that need to be strengthened. In order to provide a comprehensive public health response to decrease their vulnerability and increase their capacity to cope with existing and new disease threats in a warmer world. Strengthening these functions can increase the capacity of the system to recognise climate risks and inform decisions to monitor, anticipate, prevent, and respond to emergencies and changing risks. Over time this can improve the system by adapting to new conditions through learning from successes and failures.

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WHO Framework for building climate resilient health systems

In a warmer world with the double threat of existing diseases and new diseases, strong resilient health systems will ensure that we are adequately prepared to act at the first flap of the butterfly’s wings to navigate through the next pandemic and the next climate change health crisis.

Coronavirus disease (COVID-19) Pandemic https://bit.ly/363k8Jg

Key components of a well functioning health system https://bit.ly/2AnKsBZ

Food demand and forests in sub-Saharan Africa https://bit.ly/2AzlX5b

Special Report: Global Warming of 1.5 ºC https://bit.ly/2yQQF9r

Health risks of warming of 1.5 °C, 2 °C, and higher, above pre-industrial temperatures https://bit.ly/2WXwZIS

Impact of recent and future climate change on vector‐borne diseases https://bit.ly/2y9C5te

Naming the coronavirus disease (COVID-19) and the virus that causes it https://bit.ly/2yZcqDU

One-third of our greenhouse gas emissions come from agriculture https://go.nature.com/2Lx6HrC

Operational framework for building climate resilient health systems https://bit.ly/2X2SiZq

Health Care Facilities Resilient to Climate Change Impacts https://bit.ly/3cBJKzd

Tags: Health , Climate Change