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Philippine Strategy on Climate Change Adaptation: Policy Health Handbook SectorExecutive SummaryHealth is considered central to the survival of populations when we talk about climate changeimpacts. It is affected by other sectors as much as it conversely mediates them. It has both direct andindirect effects. The direct effects have more stable measures but are not that dominant. The indirecteffects have harder metrics and are more dominant. Having cross mediatory effects and having moreindirect effects with harder metrics makes climate change health impacts more complex, as for themost part, the relationships may predominantly be non-linear.Internationally, climate change and health has been in the forefront of WHO, and UNFCCCdiscussions. It has figured prominently in the Intergovernmental panel on climate change (IPCC)fourth assessment report (AR4). This report was accomplished by a large group of multi-countryscientists who have recently won a Nobel peace prize for it. In the Philippines, formal investigations inclimate change and health impacts started about a decade ago with a health section reported in thefirst national communications that was submitted to the UNFCCC that came out in 1999. It has beenassigned a more focused investigation in three areas in the second national communications comingout this 2010. As it is in its infancy, awareness to correlation of the health effects of climate changehave been slow in coming.Our country has not been spared. In the recent months ending 2009, we have seen storms comingone after the other, albeit seemingly increasing in frequency, that have caused disease leading todeath and destruction to a significant part of our population. Floods from the typhoon have bothdirect effects – drowning and indirect effects- Leptospirosis from the urine of rats that have enteredthe broken skin of people who have had to wade and swim through the floodwaters.We are not strangers to extremes of climate events and natural disasters. This is so because thecountry is a pathway – both for typhoons and earthquakes, as it lies also in the pacific rim of fire. TheIPCC has noted the correlation of climate change to an increase in the frequency of these extremeclimate events. The extreme climate events have translated to favoring disease pathways andincreases in disease incidence, which have in turn affected human health.Population health has been affected significantly with each passing disaster. For the most partthough, there has not been a conscious correlation of the health impacts that diseases bringsecondary to climate change in the country. What is now becoming evident, after continuedinformation, education and communication (IEC), is an apparent awareness at the initial success ofcorrelating the increase in disease incidence that the change in the climate brings.Health campaigns should continue to keep up the awareness and translate the IEC to a behaviorchange communication (BCC), hopefully effecting the needed behavior modification to act on thisphenomenon. This however will be weak unless it is backed by medical evidence- based andscientifically grounded proof. This in turn can only be achieved as we continue in-depth research intoclimate change and health impacts correlation.Impacts of health on climate change should consider the epidemiologic triad of disease occurrence inhealth (environment-agent-reservoir) as a major pathway for disease causation. 1 This will then helphighlight the alternative pathway of environment causing disease. That is to say those alterations toenvironment – to climate will in turn affect the epidemiologic triad. Of parallel importance are theeffects of the burden of climate change (disease sensitive) health outcomes.It will be important then to start the identification and study of these diseases which may be altered bythe environment. We will call them ‘climate sensitive’ diseases as they are those which lifecycles areenhanced by the changes in weather and climate parameters which in turn can mediate an increaseor decrease in infirmity.This paper aims to look at several aspects of health and climate change. It will scan the situationalstate of the health sector vis a vis climate change. It will discuss the initiatives prevailing and identifygaps and issues that have come out of these. It will likewise try to report how the sector plans toaddress the issues arising from the phenomenon with the concomitant strategies for adaptation. It willlikewise report on the institutional arrangements that are coming to fore as much as the sustainabilitymeasures to move the initiative.1 Paraso GV. Health Poster – UNDP-EMB Second national communications climate change and health 200956 2
Philippine Strategy on Climate Change Adaptation: Policy Health Handbook SectorAcronymsACCBio - Adaptation to Climate Change and Conservation of Biodiversity in the Philippines ProjectADB - Asian Development BankAO - administrative orderAR4 - Fourth Assessment Report of the IPCCBCC - Behavioral change communicationsBLHD - Bureau of local health developmentCC - Climate changeCCA - Climate change adaptationDENR - Department of Environment and Natural Resources.<strong>DOH</strong> - Department of HealthDOST - Department of Science and TechnologyDRR - disaster risk reductionEMB - Environmental Management BureauESR - epidemiological surveillance and responseField Implementation and Coordination Teams (FICT)FIMO - Field implementation management operationsGIDA - geographically isolated and disadvantages areasGTZ (GmbH) - Deutsche Gesellschaft fur Technische ZusammenarbeitHIV-AIDs - Human Immunodeficiency Virus - Auto immune deficiency syndromeHSRA - Health Sector Reform AgendaIACCC - Inter-Agency Committee on Climate ChangeICD 10 - International Classification of DiseasesILHZ - Inter local health zoneIPCC - Intergovernmental panel on climate changeIRA - Internal revenue allotmentJICA-CESM - Japan International Cooperation Agency – Center for Environmental Studies and managementLGU - Local Government unitMMDA - Metro Manila Development AuthorityNCCA+2 - National Climate Change Adaptation +2 yearsNCDPC - National Center for Disease Prevention and ControlNHIP - National Health Insurance ProgramNOH - National Objectives for HealthPhilhealth - Philippine Health Insurance CorporationPIPH - province-wide investment plan for healthPOPCOM - Commission on PopulationPPP - Public-Private PartnershipsPSDTAT - Policy, Standards Development, and Technical Assistance TeamsR&D - research and developmentSNC - Second national communicationsUNDP - United Nations Development ProgramUNFCCC - United Nations Framework Climate Change CommissionWATSAN - Water and sanitationWB - World BankWHO - World Health Organization1. Introduction and Background to the SectorThe impacts of climate change on human health have far reaching consequences for our survival.Moving from awareness to action is necessary as the complexity of the process does not provide alinear cause and effect equation on population but rather a geometric increase in those affected.Climate change knows no country boundaries and thus will affect those that are more vulnerable -health wise. It will significantly contribute to the global burden of disease and may wipe out any healthgains that development may afford.Climate change affects more those who are further vulnerable to its effects. Human health becomes avery sensitive indicator for this vulnerability. In the human development index (HDI), health figures asa major indicator for measurement of the quality of life of populations. As it is, the Philippines is a thirdworld categorized country according to its economic status. This also becomes an indirect measure ofits poverty and corresponding inadequate health status.On top of the health vulnerability is the increasing frequency of extremes of climate events which visitthe country. The IPCC scientists in its Fourth Assessment report (AR4) has concluded the evidencethat puts to bear on climate change which effect an increase in the frequency and severity of extreme57 1
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