Editor's note: In the run-up to COP 28 in Dubai, United Arab Emirates (UAE) later this year, Nigeria Health Watch, interviewed Simon Bland, Chief Executive Officer of the Global Institute for Disease Elimination (GLIDE), a partnership between the President of the UAE and the Bill & Melinda Gates Foundation. GLIDE works to progress disease elimination and eradication in endemic countries, with a particular focus on malaria, polio, lymphatic filariasis, and river blindness. Simon Bland shares his thoughts on the climate-health nexus -- what it is and what it means for global health.
Global awareness of the health impacts of climate change is increasing, thanks to communications and discourse at the global level by institutions such as the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development (OECD).
A growing body of evidence points to direct and indirect health impacts such as food insecurity and malnutrition, infectious disease emergence and re-emergence, heat-related illnesses and mental health concerns such as anxiety and depression.
In addition, climate change influences the social determinants of health, contributing to the loss of housing and income, as well as migration and displacement as a result of floods and other natural disasters. All of which have significant indirect implications for health. The evidence, however, is insufficient, because the causal mechanisms of the health impacts of climate change are still poorly understood.
According to Bland, while there is some evidence of the health impacts of climate change, the existing literature is scant. "I think intuitively, we recognise the connection between our individual health and climate and weather, but the relationships are not entirely straightforward or clear or linear. So, there's a common feeling... a warmer climate means more disease, and that's generally probably true, but we don't have data behind that. It may also mean that a changing climate means less disease in some places... we need to understand a lot more".
The global scarcity of data is particularly worse in low- and middle- income countries (LMICs). African countries contribute to about 4% of global greenhouse gas emissions, but are worse hit due to poor adaptation and mitigation mechanisms and weak health systems. Bland emphasised the need for countries to invest in reliable data, while also discussing the body of evidence in LMICs, particularly in Africa, "Reliable data are invaluable. Data are expensive. You have to be deliberate and invest in the production, collection, and analysis of data, an important first step towards bridging the knowledge gaps". Integrating data collection with a multi-disease approach is essential to overcome resource constraints in LMICs. Investing in data is crucial to better understanding the climate-health nexus and collectively developing adaptation measures for the climate crisis.
Celebrate and learn from past successes -- Nigeria
Nigeria was declared wild polio-free in 2020, has eliminated the transmission of river blindness and lymphatic filariasis in Nasarawa and Plateau states, and is close to declaring the elimination of these two neglected tropical diseases in seven more states.
These exemplars of success should be studied and adapted to tackle the global climate-health challenge. The integrated, community-based approaches employed in the elimination of these diseases are best practices and further buttress the need to employ robust health-in-all-policies and multi-sectoral approaches to tackle the health impacts of climate change and eliminate disease.
A key part of telling success stories, is obtaining evidence of what works. The second iteration of the Falcon Awards for Disease Elimination was launched by GLIDE in January 2023 to rapidly increase the evidence base of the intersection between disease elimination and climate in the lead-up to COP 28. Nine awards were given to LMICs, six of which are in the African region -- Ghana, Zambia, Mozambique, Madagascar, Zimbabwe, and Tanzania.
These young awardees will conduct formative research on topics ranging from collecting climate data relevant to health to the impact of climate on malaria, leishmaniasis, lymphatic filariasis, and other neglected tropical diseases. Findings from these will increase understanding of the climate-health nexus, add to the body of evidence of the health impacts of climate change, and inform global health policies and practices.
How responsive are current global health frameworks to these challenges?
According to Bland, global health frameworks such as the Sustainable Development Goals (SDGs) successfully identify the interlinkages between health and various factors such as the environment, gender, food systems, and Water, Sanitation and Hygiene (WASH) in the 17 goals. Still, given the enormity and complexity of the global climate-health challenge, there is a wide gulf between these sectors, the size of which has not yet been quantified by evidence. He recommends that global health institutions continue to:
- Recognise the interlinkages between climate and health, acknowledging where the linkages are unclear and investing in building the body of evidence to improve understanding and finding and investing in adaptation and mitigation solutions.
- Persist in driving discourse and improving understanding of the climate-health nexus to drive global action. These challenges must remain top of mind to ensure that recent learnings are not forgotten, as is the case with the COVID-19 pandemic, where countries seem to be moving on very quickly as amnesia sets in post-recovery.
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- Be equitable in designing policies and deploying solutions, bearing in mind that richer countries will adapt much more easily than the vulnerable, as the COVID-19 pandemic has shown.
The role of global conferences in driving discourse
"Human beings are very complex, and so many anthropogenic activities affect the world in which we live... the world is a huge, complex system. Global processes and negotiations can sometimes make people yawn, but they are important in showing the other big issues we often talk about -- what's the climate angle to global health? What's the health angle to climate? What's the gender angle to global health?"
The United Nations Framework Convention on Climate Change (UNFCC) historically has not recognised health as one of the key sectors affected by climate change, but will for the first time, be hosting a health day at COP 28. Conversations on the climate-health nexus are also being driven on the African continent, where leaders are jumping in front of discourse on the need to support African countries who contribute the least to greenhouse gas emissions and yet are worst hit by the impact of climate change. As COP 28 approaches, Bland hopes it presents an opportunity to promote persistence and carry on these conversations. He looks forward to hearing country voices, showcasing and communicating evidence from the Falcon Awards, networking, and exploring collaboration opportunities.
