March 2019 saw a dark cloud hanging over Southern Africa. Cyclone Idai ravaged through four countries leaving a trail of catastrophic destruction in its wake. Idai was recorded as the second-deadliest tropical cyclone in the Southern Hemisphere ever. In the immediate aftermath, over 4000 cases of cholera were reported, with about 20 casualties recorded so far. It is estimated that fifty million dollars was urgently needed for Public Health efforts to affected cyclone victims. While experts can not conclusively say that the cyclone was a direct result of climate change, researchers warn that cyclones of this nature will be a constant feature on our planet in the not so distant future. Succedant to such disasters, there are disease outbreaks like those we saw after Cyclone Idai.
The conversation on climate change is incomplete without mention of its health implications. With melting of polar ice caps and rising sea-water levels; landslides, cyclones and other natural disasters are becoming more common. These not-so natural disasters can inflict direct damage to already established health infrastructure which will need millions of dollars to rebuild. The unplanned displacement of populations in these affected areas will make them susceptible to water-borne and vector borne diseases. Developing countries who are still strengthening their disaster response systems are more likely to feel the bulk of the brunt of climate change. If the dire effects of climate change are to be minimized then establishment of robust disaster response and public health systems should be taken as urgent matters by developing countries.
Climate change affects the way in which disease carrying vectors and parasites are going to be distributed in the future. With the rise in global temperatures, parasites are likely to spread into areas they were previously not endemic. They will also re-emerge in areas they were previously eradicated and coupled with drug resistance, will thrive in areas they already are. Mosquitos, which kill over half a million people annually will move into areas where malaria has never been reported before. Neglected Tropical Diseases are also going to be on the rise. There are already reports that the bulinus species of snails which transmits the schistosoma fluke is appearing in areas where it had not been reported before in North Africa and Asia.
Some cancers and mental health diseases are to increase. The depletion of the protective ozone layer will allow some noxious ultraviolet radiation to permeate into the earth. The UV-A and UV-B rays are important aetiological agents in the pathogenesis of some skin cancers like malignant melanoma and basal cell carcinoma. According to a 2018 research in the United States, even the slightest increase in temperature is associated with an increase in mental health problems including suicide. While the direct causal association is unclear and is yet to be elucidated, the trend is demonstrated in history beyond doubt since the mid- 1950s. Again, the greater burden falls onto developing countries who have weak public health systems and cancer screening programs making them more vulnerable in the future. The rising mental health issues arise at a time when the world is grappling with a world-wide shortage of psychiatrists and other mental health practitioners.
While global warming may bring some local benefits, such as fewer winter deaths in temperate climates and increased food production in certain areas, the negative impacts of a changing climate overwhelmingly outweigh the benefits. Climate change affects social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter.
The majority of developing countries are signatories to the Paris Agreement which aims to curb the scourge of climate change. This agreement could save about a million lives a year worldwide by 2050 through reducing air pollution alone. This is a necessary but unfortunately not sufficient measure. Such agreements should be accompanied by radical local actions like reducing carbon dioxide emissions, designing smart cities and campaigns to educate populations on the need to stop climate change. Furthermore, health practitioners and enthusiasts should take it upon themselves to campaign and advocate for policies towards climate action. Climate action falls squarely in the domain of Public and Global Health.
The adage remains true, “We don’t own the planet, we borrow it from future generations”. Climate change is probably the single greatest threat to health in the 21st Century as it spreads its tentacles on many fields within Healthcare. We owe it to future generations to have a cleaner, safer and healthier planet by the time they inherit it.