The 21st Century climate challenge

2Climate shocks: risk and vulnerability in an unequal worldUrgent action is needed toconduct assessments ofthe risks posed by climatechange to public healthin the developing world,followed by a mobilizationof resources to createan enabling environmentfor risk managementlargely confined to urban areas. Latitudinalexpansion linked to climate change couldincrease the population at risk from 1.5 billionpeople to 3.5 billion by 2080. 115 Dengue feveris already in evidence at higher elevations inpreviously dengue-free areas of Latin America.In Indonesia, warmer temperatures have led tothe mutation of the dengue virus, leading to anincrease in fatalities in the rainy season. Whilethere is no proven evidence that climate changeis implicated, in the late 1990s El Niño andLa Niña events in the country were associatedwith severe outbreaks of both dengue andmalaria, with malaria spreading to highelevations in the highlands of Irian Jaya. 116Extreme climate events provide another setof threats. Floods, droughts and storms bringin their wake increased health risks, such ascholera and diarrhoea among children. Thereis already evidence in developing countries ofthe impacts of rising temperatures. During2005, Bangladesh, India and Pakistan facedtemperatures 5–6°C above the regional average.There were 400 reported deaths in India alone,though unreported deaths would multiplythis figure many times over. 117 Public healthin developed countries has not been immune.The heat-wave that hit Europe in 2003 claimedbetween 22,000 and 35,000 lives, most ofthem elderly. In Paris, the worst affectedcity, 81 percent of the victims were aged over75 years. 118 More events of this nature arelikely. For example, the incidence of heatwaves in most United States’ cities is expectedto approximately double by 2050. 119Public health authorities in rich nationsare being forced to confront the challengesposed by climate change. The city ofNew York provides an example of a widerprocess. Climate impact assessments havepointed to higher summer-season temperatures,with increasing frequency and duration of heatwaves. The prognosis: a projected increasein summer-season heat stress morbidity,particularly among the elderly poor. Summerheat-related mortality could increase 55 percentby the 2020s, more than double by the 2050sand more than triple by the 2080s. 120 Climatechange could also contribute indirectly to atleast three classes of wider health problems:incidence of certain vector-borne diseases suchas West Nile Virus, Lyme disease and malariamay rise; water-borne disease organisms maybecome more prevalent; and photochemical airpollution may increase. 121 Strategies are beingdeveloped to address the risks.Governments in the developed worldhave to respond to the public health threatsposed by climate change. Many authorities—as in New York—acknowledge the specialproblems faced by poor and vulnerablepopulations. Yet it would be wrong forcountries with first class health systems andthe financial resources needed to counteractclimate change threats at home, to turn ablind eye to the risks and vulnerabilities facedby the poor in the developing world. Urgentaction is needed to conduct assessments ofthe risks posed by climate change to publichealth in the developing world, followed by amobilization of resources to create an enablingenvironment for risk management. Thestarting point for action is the recognitionthat rich countries themselves carry much ofthe historic responsibility for the threats nowfacing the developing world.Conclusion“We are made wise not by the recollection ofour past” wrote George Bernard Shaw, “but bythe responsibility for our future.” Viewed fromthe perspective of human development, climatechange brings the past and the future together.In this chapter we have looked at the ‘earlyharvest’ climate change catastrophe. Thatharvest, which has already begun, will initiallyslow progress in human development. As climatechange develops, large-scale reversals will become106 HUMAN DEVELOPMENT REPORT 2007/2008