Climate and health experts must collaborate to fight climate-sensitive disease. Ethiopia is leading the way, says Hiwot Teka.
Around 300,000 people die each year because of climate change, according to a report by the Global Humanitarian Forum published earlier this year.
That toll is predicted to rise to approximately half a million in 20 year's time. And by 2030, about 310 million people are expected to have suffered ill health due to climate change.
The burden will be heaviest on developing countries, which are already struggling to control climate-sensitive diseases, such as cholera and malaria. Clearly, these nations must develop ways of controlling and preventing climate-related effects on health.
To do that they must build their understanding of how climate variability and change might affect patterns of disease, and improve access to environmental data — such as temperature and rainfall — that help predict disease outbreaks.
Decision-makers will need information that is locally-relevant and timely if they are to tackle outbreaks.
So climate and health experts must work together. That means institutions and government departments from both sectors, including climate data providers and health officials, must collaborate closely.
Ethiopia leads the way
Ethiopia is leading the way with its Climate and Health Working Group, a collaborative initiative set up in 2008 between the health ministry, meteorological department and several nongovernment agencies.
The group helps decision-makers focus on climate and health issues, facilitating cooperation on all sides. It meets every month to develop strategies for increasing awareness — both public and within the health sector — of how weather and climate affect health.
Over the past year, two workshops have helped identify where climate information could be used for preventing and controlling malaria and meningitis. The working group has helped train health care decision-makers, through Columbia University in the United States, and has funded local masters students doing their theses on climate-sensitive disease.
We are finding ways for the health sector to use climate information to estimate the number of people at risk of disease. We also help institutions formulate data-sharing systems and build the capacity of national and local community-based organisations, letting them widen and strengthen their services.
In particular, we strive to help predict malaria epidemics. Our aim is to strengthen data collection and to integrate environmental indicators into health systems so that areas that favour malaria-carrying mosquitoes can be identified.
More than 50 million people in Ethiopia are already thought to be at risk of epidemic malaria. If local health services are to cope during severe outbreaks, they need to know where and when epidemics are likely to occur, with enough warning to prepare for prevention and control.
Traditionally, predicting epidemics relies on monitoring malaria case charts. But these tend to give just two weeks notice of an impending epidemic. Integrating environmental data into surveillance regimes can provide warnings up to four months before an epidemic.
The Ethiopia's Ministry of Health, supported by the Global Fund to Fight AIDS, TB and Malaria, is building the National Meteorological Agency's capacity to digitise rainfall, temperature and humidity data. These will be used to prepare monthly bulletins that map areas where malaria transmission may increase.
The National Meteorological Agency is also working to improve climate monitoring, with more sentinel weather stations that collect temperature as well as rainfall measurements.
Our working group hopes that these improved early warning systems will help decision-makers allocate resources more efficiently for controlling and preventing malaria. For example, more warning should help them plan for drug purchases, identify where and when to increase epidemiological surveillance or target vector control, and help them make communities more aware of the risk of an epidemic.
Other developing countries could learn from Ethiopia's efforts to combat climate-sensitive disease.
The most important lesson is that success relies on building effective working relationships between the health and climate communities. This is where a climate-health working group can be particularly valuable.
The health sector must take the lead in defining what climate information it needs and when, while meteorological services must be flexible enough to provide it. Often, the data may not be immediately available, in which case work — and money — will be needed to develop an appropriate data collecting system.
Of course, climate-sensitive diseases like malaria do not respect national borders, so regional collaboration will be needed.
This is already happening in East Africa. Kenya and Madagascar have followed Ethiopia's lead, creating similar initiatives to increase cooperation between institutions, so as to reduce the burden of climate-sensitive diseases.
I hope this initiative will extend to other African countries, and that ministries of agriculture and water resources will become involved in the planning process, as their efforts indirectly help reduce malnutrition and waterborne diseases.
Ultimately, perhaps we will see an African network on climate and health to target climate-sensitive disease across the continent.