Untitled - DOH

More documents

Recommendations

Info

Philippine Strategy on Climate Change Adaptation: Policy Health Handbook Sectorclimate events. This is seen to mediate the effects of the climate on the diseases which in turn affectthe populations. It will be important then to measure the vulnerability of populations as to health andits potential effects from the changes in climate. An assessment then will be in order to establish theresponses in order that they can adapt and cope to these changes.Eight of the 10 leading causes of morbidity in the Philippines are infectious in nature. Among themare pneumonia, diarrhea, bronchitis, influenza, tuberculosis, malaria, chicken pox and measles. 2Pneumonia and tuberculosis still are in the top 10 causes of mortality in the Philippines. Mosquitobornediseases, such as malaria, dengue and filariasis, are ever present danger in endemic areas.Although malaria is no longer a leading cause of death, it has remained among the leading causes ofmorbidity in the country, especially in rural areas. The surge in dengue cases occurring in cyclicaloutbreaks every three to five years remains a threat to public health. Efforts to eliminate filariasis arehindered by the limited resources for the annual mass treatment in endemic areas. 3The National Objectives for Health (NOH 2005-2010) does not specifically mention climate change asan area of concern; it rather looks at the health effects from a focused approach. It looks atenvironmental degradation with air carrying pollutants and particulates and its effects on the health ofpopulations 4 ; and disasters from a perspective of affectation of health due to loss of limb and life. 5 Sothat its response and corresponding budget allocation is carved in programs (focused in part toclusters of diseases - infectious and non-infectious) that have more specific thrusts. Public healthspending while it has been given priority still lacks the appropriations needed to fully respond to thesediseases. While WHO recommends around 5% of GDP, we have spent around 1.49% of GDP forpublic health (private - 1.4% + public - 1.49% total =2.88%) in 1990 6 and (Php 136 billion) 2.9% ofGDP in 2003 7 .The Department of Health has started looking at climate change and health impacts quite recently,around a decade or so when there a section on climate change impacts appeared in the first nationalcommunications. 8 Here initial trends and associations where established between the notifiablediseases and climate parameters which were arrayed against it. As it is, the initiative is in its infantstages so that program and process integration will take time as advocacy for investigating the healthimpacts continues.2. Sector Profile (Situationer)The improvement of public health is the major thrust of <strong>DOH</strong> and environmental health effects are anessential part of it. Health outcomes from climate sensitive diseases are a new field where the <strong>DOH</strong>has not as yet made in-depth strides in. For the most part we look at diseases from a biologicalperspective. That is to say that disease cause and effect are investigated from the disease causingagent (usually bacterial or viral) its effect on the host. Programs and policies then are made aroundthis premise for diagnosis and treatment. We should broaden our consideration to shift the paradigmto an epidemiologic triad of environment-host-reservoir of disease occurrence when we think ofimpacts of climate change on human health as the relationship of these three will show the dynamicsof disease transmission. Covering this section though we will have to tackle related aspects that willhelp us understand the situation prevailing.2.1 The epidemiologic disease occurrence triadThis gives us the window then for considering that another dimension to the disease transmissioncycle exists; the effect of the environment on the life cycles of these disease agents which mayattenuate, thus detrimentally affect population health or conversely have a detrimental effect on theagent and decrease disease incidence. This we can call climate sensitivity of diseases. Disease2 Field Health Survey Information System (FHSIS) 2002. Department of Health.3 National Objectives for Health 2005-2010, Reducing Burden of Disease, Chapter 4, p.132. Available fromhttp://www2.doh.gov.ph/noh2007/NOHWeb32/NOHperSubj/Chap4/PreventionCCD.pdf4 National Objectives for Health 2005-2010, Reducing Burden of Disease, Chapter 4, p.254. Available fromhttp://www2.doh.gov.ph/noh2007/NOHWeb32/NOHperSubj/Chap4/EnvironmentalHR.pdf5 National Objectives for Health 2005-2010, Reducing Burden of Disease, Chapter 4, p. 249. Available fromhttp://www2.doh.gov.ph/noh2007/NOHWeb32/NOHperSubj/Chap4/EnvironmentalHR.pdf6 Atlas country page Philippines. Health. Available from http://ucatlas.ucsc.edu/country/165/health#7 Philippine National health accounts 2003.8Flavier J., Paraso G, Baylon, M, section on health: 1 st national communications, climate change and health,UNFCCC -DENR/EMB,1999.58 2
Philippine Strategy on Climate Change Adaptation: Policy Health Handbook Sectorpathways will have to consider how the agents react to the dynamics of weather parameters(extremes of weather – humidity, precipitation, rainfall) for the short time – everyday/weekly/monthlywhich becomes the climate –when we talk about weather for the long term – at least severaldecades. 9These bring us to the realm of environmental health in consideration of how attenuation of diseaseoutcomes is enhanced by these climate parameters. That is to say that the environment is affected bychanges in the climate which in turn reflects on the lifecycle affectation of disease agents which mayincrease or decrease disease incidence and therefore the chances of infirmity in the humanpopulation. We will call this climate sensitivity of diseases.2.2 Vulnerability and adaptationWe know that when we talk about climate change we will have to consider the vulnerabilities that arepresent in systems and countries. The more underprivileged a country or population is, the more it willbe vulnerable. Poverty then figures high in the scheme of measuring vulnerabilities. It has both adirect and indirect effect on health. The direct effects of poverty will lead to marginalized access tofood and clothing and shelter essential to health while the indirect effects of poverty will bemarginalized access to health services by virtue of these populations not having the means –financialto go seek services or not have the corresponding health seeking behavior.Philippine health vulnerabilities can consider the following: technological inadequacy for diagnosisand treatment, inadequate health facilities and structures (not climate proof), changing patterns ofdisease where we are now shifting to have the double burden of disease – where primary healthdiseases of TB, Measles and the still abound while we enter the lifestyle diseases of cardiac,hypertension and cancers abound brought about by so called ‘less healthy food and lifestyle’ wherestress ranks high as causes. With the Philippines considered as a developing country, its publichealth systems are already challenged where the infectious disease era is still rife. We are nowentering the era of increasing development where pollution of our natural systems takes its toll onhuman population. Put on top of these experiencing extremes of climate events. This will make itmore vulnerable to the impacts and coping becomes a heavier burden. The capacity to cope thenbecomes a measure of the short term response that a community comes up with. It is the immediatesolution that spells its survival. 10The Intergovernmental Panel on Climate Change (IPCC), in its Second Assessment Report, definesvulnerability as "the extent to which climate change may damage or harm a system." It adds thatvulnerability "depends not only on a system's sensitivity, but also on its ability to adapt to new climaticconditions".Identification of the vulnerabilities is the first step; a second step will be having and developing thecapacity to cope which then becomes the immediate adaptation mechanism that a country does todisease vulnerability. In the Philippines, the health sector coping capacity has been to a large extent afunction of each of the local government units’ availability of resources. The devolution of healthservices has been in place for more than a decade now and this has led to differences in healthresponses depending on the level of participation and political will of local chief executives and healthmanagers. Local health systems have been coping in their own way oblivious to or unaware ofclimate change impacts. Local governments will need to recognize this new aspect of beingvulnerable to climate change as that which adds on to the present burden of disease in a locality.The Fourth Assessment Report (AR4) of the IPCC released in Apr 2007 notes that “even the moststringent mitigation efforts cannot avoid the impacts of climate change in the next decades whichmakes adaptation essential”. 11 Adaptation options become the way to go if we are to work in ourenvironment that has resources that are limited. The burden of disease will happen with or withoutclimate change. In the latter part of this paper, the health sector adaptation options are identified.2.3 Non-health determinantsIt will be prudent to highlight that climate change is also mediated by non-health causes. Theseinclude disasters, social economic causes (poverty), geographical presentation where we arearchipelagic and we have what we call geographically isolated and disadvantages areas (GIDA)which are island groups with human populations that have little to nil health services access.9 Intergovernmental Panel on Climate Change 10 th anniversary brochure, p.4, Dec 2004 available fromhttp://www.ipcc.ch/pdf/10th-anniversary/anniversary-brochure.pdf10 Health Sector report, Second National communications (SNC), UNDP-EMB-PRRM, September 200911 Fourth Assessment report AR4. Intergovernmental Panel on Climate Change (IPCC), UNFCCC, 2007.59 1
Page 3 and 4:
Policies HandbookonClimate Change a
Page 5 and 6:
MESSAGESACKNOWLEDGMENTCOMPILATION O
Page 7 and 8:
MessageMessageThe ultimate impact o
Page 9:
REPUBLIC ACT NO. 9729CLIMATE CHANGE
Page 12 and 13:
Republic Act 9729: Climate Change A
Page 14 and 15:
Republic Act 9729: Climate Change A
Page 16 and 17: Republic Act 9729: Climate Change A
Page 23: Policy HandbookCCC AO 2010-01: Impl
Page 26 and 27: CCC AO 2010-01: Implementing Rules
Page 35: NATIONAL FRAMEWORKSTRATEGY ONCLIMAT
Page 38: National Framework Strategy on Clim
Page 41 and 42: National Framework Strategy on Clim
Page 57: Policy HandbookDepartment Circular:
Page 61: PHILIPPINE STRATEGY ONCLIMATE CHANG
Page 64 and 65: Philippine Strategy on Climate Chan
Page 83: Philippine Strategy on Climate Chan
Page 87 and 88: Policy HandbookCreation of a Techni
Page 89: Policy HandbookEXECUTIVE ORDERNUMBE
Page 92 and 93: Executive Order No. 26, S. 2011: Na
Page 94 and 95: Executive Order No. 26, S. 2011: Na
Page 97: Policy HandbookDOH ADMINISTRATIVEOR
Page 100 and 101: DOH AO NO. 005 S. 2012: National Po
Page 102 and 103: DOH AO NO. 005 S. 2012: National Po
Page 105: Policy HandbookDEPARTMENTPERSONNEL
Page 108 and 109: DOH DEPARTMENT PERSONNEL ORDER NO.
Page 111 and 112: KYOTO PROTOCOLPolicy HandbookKYOTO
Page 113 and 114: KYOTO PROTOCOLPolicy Handbookidenti
Page 115 and 116: KYOTO PROTOCOLPolicy Handbook9. Com
Page 117 and 118:
KYOTO PROTOCOLPolicy Handbookfully
Page 119 and 120:
KYOTO PROTOCOLPolicy Handbook7, par
Page 121 and 122:
KYOTO PROTOCOLPolicy Handbookin the
Page 123 and 124:
KYOTO PROTOCOLPolicy Handbookensuri
Page 125 and 126:
KYOTO PROTOCOLPolicy Handbookthe wr
Page 127 and 128:
KYOTO PROTOCOLPolicy Handbook4. Ins
Page 129 and 130:
KYOTO PROTOCOLPolicy Handbook2. For
Page 131:
Policy HandbookSIXTY-FIRSTWORLD HEA
Page 134 and 135:
61st WHAT RESOLUTION ON CLIMATE CHA
Page 137 and 138:
PROTECTING HEALTH FROM EFFECTS OF C
Page 139:
Policy HandbookRegional Framework f
Page 142 and 143:
Regional Framework for Action to Pr
Page 144 and 145:
Regional Framework for Action to Pr
Page 147 and 148:
Health Sector Strategy on Climate C
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
149Policy Handbook
show all

Untitled - DOH

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?