Boiling Point
Climate change: A health emergency in the making
A ward for heatstroke patients at a hospital in Chennai, India, in May. The country experienced a severe heat wave over the spring and summer, raising concerns about the long-term impact of climate change-induced extreme heat on human health. | AFP-JIJI
From Japan to India, countries must work together to prepare for extreme heat and other impacts
Contributing writer
This summer has been even more uncomfortable than the last for many across the globe experiencing climate change-induced extreme heat. A “new normal” seems to have set in where each subsequent year breaks previous records — for example, Japan just experienced its hottest July on record.
Furthermore, around 1,300 people died in Japan every year due to heat-related illnesses over the five years through 2022. In India, where I come from and which experienced an intense heat wave this spring and summer, over 1,100 yearly deaths have been attributed to extreme heat between 2008 and 2019. And it is important to remember that data on heat-related illnesses and deaths is often underestimated.
How did the world reach this boiling point? The answer lies not only in what we have done in pursuit of economic growth and development, but also what we have failed to do. Is the main culprit the lack of effective climate change mitigation or has sluggish implementation of adaptation measures also played a role?
While pondering these questions, it is important to consider the burgeoning stress that global warming is having on human well-being and health care systems across the globe.
The Intergovernmental Panel on Climate Change’s sixth assessment report explains that as global warming intensifies, it increases risks to human health — of the kind that we are already witnessing. A web of factors links climate change — which results in biological, physical and ecological alterations — to health both directly and indirectly, including extreme weather events, air pollution, UV radiation, changing patterns of new and reemergent infectious diseases and allergies.
For example, extreme temperatures pose a serious threat by heightening the risk of heart attacks, heat exhaustion, heatstroke, organ failure, hyperthermia and mental health issues. Those particularly vulnerable are over-65-year-olds, children, people with preexisting medical conditions, outdoor workers and those who live in poverty or are socially isolated, according to the World Health Organization.
The WHO estimates that between 2030 and 2050, climate change is expected to cause 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress alone. It will also result in $2 billion to $4 billion worth of damage annually by the end of this decade — with developing countries the least capable of coping with these costs without assistance. This is compounded by the fact that some of the future health impacts are not yet quantifiable or well-understood.
A recently published multicountry study indicates that between 2000 and 2090, a warming climate can substantially alter the seasons in which deaths occur. The research suggests that health care systems should consider preparing for increased mortality during warm seasons and sustained high demand in cold seasons, despite a decrease in mortality, particularly in regions with arid, temperate and continental climates.
If we combine these risks with other adverse events like pandemics or conflicts, the damage becomes even more acute. Health crises can overwhelm countries’ economies and destroy livelihoods with knock-on effects on every aspect of people’s lives, as exemplified by the COVID-19 experience.
It is therefore time to move beyond traditional security frameworks in dealing with new threats presented by climate change-induced health emergencies. It is important to assess the vulnerabilities of health systems and the effectiveness of countermeasures to address these impacts. This not only allows us to better understand countries’ readiness in the face of future health emergencies but also develop necessary intersectoral and transnational action plans.
For example, Japan took a step in the right direction by introducing the Climate Change Adaptation Act in 2018, which led to the approval of its national adaptation plan three years later. The plan takes into consideration the impacts of heat, infectious diseases and air pollution on health, providing guidance for government adaptation measures.
However, to be effective, this kind of legislation should enable different stakeholders to continuously work together. This requires well-established frameworks for cooperation between government officials, policy experts and civil society not only from the environmental field but from sectors like health, energy, transport and urban planning as well — all of whose actions can have positive or negative impacts.
It is important to assess the vulnerabilities of health systems and the effectiveness of countermeasures to address these impacts.
There is increasing attention and urgency in addressing these needs. Yet on the global stage, we are still reminded that “the climate crisis is a health crisis, but for too long, health has been a footnote in climate discussions,” in the words of WHO chief Tedros Adhanom Ghebreyesus at the COP28 United Nations climate change conference in Dubai last December.
Many applauded discussions on the link between climate change and health at COP28 but it remains to be seen whether this topic will be center stage in climate negotiations, bringing governments together for coordinated action, on the road to this year’s COP29 in Azerbaijan and next year’s COP30 scheduled in Brazil.
However, the long-drawn-out negotiations at the WHO regarding a pandemic prevention, preparedness and response treaty that is yet to see the light of day give me pause: The intergovernmental body responsible for the drafting and negotiation process was set up in 2021 but has not yet yielded a convention, agreement or international instrument. How soon can we get countries to develop agreed actions to tackle the nexus between climate change and health?
In tackling this nexus, we must understand the importance of aligning climate policies with health policies. However, this momentum has not yet gained traction across high-level meetings. The commitments that countries make at forums like the G20, G7 and U.N. General Assembly — and COP, naturally — must be followed by concrete interventions to protect and use the environment sustainably and address health concerns.
To develop long-lasting, feasible solutions, we need to look at climate change and health as one problem. Countries must work together to support health and well-being and present and future generations’ right to a healthy environment. If we are to have any chance of slowing down global heating, resilience and adaptation must be baked into our societies.
Smritima D. Lama is a public health expert from India and a visiting researcher at Hitotsubashi University, Tokyo. She is the recipient of the Japan Foundation’s Indo-Pacific Partnership Fellowship 2023 and is researching national-level actions to deal with climate change-related health emergencies in Japan and elsewhere.
