Change in african healthcare

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Each of the last 3 decades has been successively warmer than any preceding decade since 1. Although global warming may bring some localized benefits, such as fewer winter deaths in temperate climates and increased food production in certain areas, the overall health effects of a changing climate are likely to be overwhelmingly negative.

Climate change affects social and environmental determinants of health — clean air, safe drinking water, sufficient food and secure shelter. Extreme high air temperatures contribute directly to deaths from cardiovascular and respiratory disease, particularly among elderly people. In the heat wave of summer in Europe for example, more than 70 excess deaths were recorded 2.

High temperatures also raise the levels of ozone and other pollutants in the air that exacerbate cardiovascular and respiratory disease. Pollen and other aeroallergen levels are also higher in extreme heat. These can trigger asthma, which affects around million people. Ongoing temperature increases are expected to increase this burden. Globally, the number of reported weather-related natural disasters has more than tripled since the s.

Every year, these disasters result in over 60 deaths, mainly in developing countries. Rising sea levels and increasingly extreme weather events will destroy homes, medical facilities and other essential services.

More than half of the world's population lives within 60 km of the sea. People may be forced to move, which in turn heightens the risk of a range of health effects, from mental disorders to communicable diseases.

Increasingly variable rainfall patterns are likely to affect the supply of fresh water. A lack of safe water can compromise hygiene and increase the risk of diarrhoeal disease, which kills approximately children aged under 5, every year.

In extreme cases, water scarcity leads to drought and famine. By the late 21st century, climate change is likely to increase the frequency and intensity of drought at regional and global scale 1. Floods are also increasing in frequency and intensity, and the frequency and intensity of extreme precipitation is expected to continue to increase throughout the current century 1. Floods contaminate freshwater supplies, heighten the risk of water-borne diseases, and create breeding grounds for disease-carrying insects such as mosquitoes.

They also cause drownings and physical injuries, damage homes and disrupt the supply of medical and health services. Rising temperatures and variable precipitation are likely to decrease the production of staple foods in many of the poorest regions. This will increase the prevalence of malnutrition and undernutrition, which currently cause 3. Climatic conditions strongly affect water-borne diseases and diseases transmitted through insects, snails or other cold blooded animals.

Changes in climate are likely to lengthen the transmission seasons of important vector-borne diseases and to alter their geographic range. For example, climate change is projected to widen significantly the area of China where the snail-borne disease schistosomiasis occurs 3.

The Aedes mosquito vector of dengue is also highly sensitive to climate conditions, andstudies suggest that climate change is likely to continue to increase exposure to dengue.

Measuring the health effects from climate change can only be very approximate. Nevertheless, a WHO assessment, taking into account only a subset of the possible health impacts, and assuming continued economic growth and health progress, concluded that climate change is expected to cause approximately additional deaths per year between and ; 38 due to heat exposure in elderly people, 48 due to diarrhoea, 60 due to malaria, and 95 due to childhood undernutrition 4.

All populations will be affected by climate change, but some are more vulnerable than others. People living in small island developing states and other coastal regions, megacities, and mountainous and polar regions are particularly vulnerable. Children — in particular, children living in poor countries — are among the most vulnerable to the resulting health risks and will be exposed longer to the health consequences.

The health effects are also expected to be more severe for elderly people and people with infirmities or pre-existing medical conditions. Areas with weak health infrastructure — mostly in developing countries — will be the least able to cope without assistance to prepare and respond. Many policies and individual choices have the potential to reduce greenhouse gas emissions and produce major health co-benefits. For example, cleaner energy systems, and promoting the safe use of public transportation and active movement — such as cycling or walking as alternatives to using private vehicles — could reduce carbon emissions, and cut the burden of household air pollution, which causes some 4.

This includes:. Overwhelming evidence shows that human activities are affecting the global climate. Climate change has serious implications for public health. Extreme weather events, variable climates that affect food and water supplies, ecosystem changes are all associated with global warming and pose health risks.

Continuing climate change will affect, in profoundly adverse ways, some of the social and environmental determinants of health: food, air and water, according to WHO Director-General Dr Margaret Chan.

Areas with weak health infrastructure — mostly in developing countries - will be the least able to cope without assistance to prepare and respond.

Main navigation Home Health topics All topics ». Plans would involve the specific steps or strategies for evacuation and regular fire drills as well as mass evacuation and temporary resettlement plans.

One big problem with addressing climate change impacts especially adaptive capacity of household and individuals in sub-Saharan Africa is that of poverty. In spite of however poverty is defined and whatever indicators are used in measuring it, there is no contesting the fact that poverty is widespread or generalised in most countries in Sub-Saharan Africa.

According to a recent World Bank Report [ 28 ] people living in poverty in Sub-Saharan Africa grew from million in to million in The poor are usually in the epicentre of impacts of climate change because those who are poor suffer generalised socio-economic debilitations and inadequacies even before the onset of climate change.

Therefore, in the event of climate change adversity the poor are usually the first affected and the most impacted. For instance, it is reported that malnutrition cause about 1. The response of public health to climate change should go beyond the usual focus on epidemiology and diseases prevention and control to anchor on social framing of health issues and engendering appropriate behavioural and attitudinal responses in the public.

In this sense, health workers and professionals should embody strategies towards motivating appropriate behaviours in people as well as the political capital and tool for eliciting innovative policies especially from political leaders and policy makers. Public health should in terms of climate change focus on the promotion of safety and health parts of its core mandates. It should ideally work towards reducing the pre-existing burden of disease and evolve activities that build social capital, community engagement and collaborative initiatives that enhance community resilience.

From the point of view of responding to climate change challenges, the preparedness and response of public health institutions should enable activities that build community resilience as well as reduce vulnerability in the population [ 30 ]. In other words, while climate change reverberates with health security, its challenges can be approached from a robust public health system that facilitates both mitigation and adaptation processes. Thus, the relationship between health of the people and climate change within a public health framework can be depicted in a Venn diagram as shown below Figure 1.

Nexus between Climate Change and Public Health. There is no doubt that intervention in climate change adaptation is clearly in the core mandate of public health. Therefore, focusing on the public health impact of climate change is really consistent with key medical ethics of beneficence protection of people from harm now and in the future and more generally in terms of boding good for people , non-maleficence avoids harm or injury , and justice equitable and fair to all concerned.

The problem or issue of justice resonates with health provision even prior to climate change given noted inequalities in health. These inequalities are especially heightened in the case of Africa and other developing parts of the globe where economic and social limitations negatively impact peoples access to health and health facilities.

As has been insightfully posited, people in poor countries will willy-nilly face more health risks in the context of limited resources and thus less resilience than the situation in the developed or wealthy nations of the world [ 31 , 32 , 33 , 34 ]. It is a given that climate change has the tendency and potency to exacerbate existing health disparities and even introduce new ones.

Incidentally, health disparities and inequalities are imbued in public health; and public health practices and policies aim to eliminate these disparities.

These overriding goals of public health are more than desired now that climate change poses a formidable challenge to the health of people in these developing regions of the world.

It is conventional wisdom that one approach to climate change is to improve the adaptation and resilience of people to adverse weather events. Adaptation to climate change incidentally occurs mainly at the individual, family and community levels. As a result, public health agencies and institutions given their location at the local communities are especially in a position to build the resilience of people to climate change especially climate change induced or generated disasters and afflictions.

Public health institutions should be core part of the preparedness, response and recovery activities associated with climate change. In other words, public health agencies with their felt presence in the local communities can play critical roles at the three levels of building resilience to climate change.

Preparedness focuses on anticipating and making provision for the impacts and influence of climate change on people activities and programmes that build and improve absorptive capacities ; response has to do with a robust and timely response to the emergencies and problems that arise in times of adverse weather events like floods, wildfires and hurricanes creating and deploying buffers that stunt or stop the influence of adverse events ; and recovery is all about enabling the prospects and processes of overcoming the effects of adverse weather events at both the individual and community levels activities and strategies towards engendering and facilitating recovery from such events in the community.

A very pragmatic approach to the evolvement of good practices and behaviours among the populace may be also emphasising co-benefits of health which have undoubted utility to climate change efforts. There is no gainsaying the fact that actions which embody health co-benefits i. These issues are often construed as beyond the immediate influence of the individual; a view which often debilitates action on the individual level against climate change.

Responding to climate change would entail of necessity both innovation and radicalization of some conventions of policy and practice. For instance, climate change requires a longer time frame in public health planning than is usually the case [ 35 ].

Research is actively needed in order to continue to refine approaches to tackling the peculiar and general health challenges of climate change; also, to discover new and emerging nexus between adverse weather events and health. In other words, there should be endless quest for new evidence and innovative solutions. New evidence of association, whether in the short or long run between climate change and health as well as exerting efforts and resources on discovering innovative solutions to climate change induced or enhanced health challenges.

Interestingly, while preparedness is critical to public health interventions in climate change, it often occurs within the context of scientific uncertainty and inadequacy of facts. Thus, such events as pandemics, hurricanes and even tornadoes cannot be predicted with precision, public health is expected to be innovative and prepared enough to respond within a limited time frame. It is in recognition of the above that preparedness is all about anticipation. This preparedness or anticipatory strategy finds support in both conventional wisdom and scientific orthodoxy.

Preparedness would therefore compel public health agencies to act or think strategically even when there are not enough or satisfactory precise scientific evidence. This would involve an element of risk management. Risk management as the name suggests is the systematic and evolving efforts towards identifying, tackling and reducing perceived risks to the health of a given population. Both the risk management principle and strategic thinking embodied in the notion of preparedness derives from the cognition that climate change could exert enormous costs on health but this could be significantly reduced if adaptation and mitigation efforts specific to health are undertaken at the onset.

Apparently, the discourse on climate change and public health does not seemingly embody health security. However, the above view is only tenable when health security is given a narrow or circumscribed definition and approached from a climate sceptical stance.

But health security is concerned with all actions and systems that portend good health and wellbeing of citizens now and in the future. Thus, responding to the nascent health challenges of climate change within the framework of public health should be rightly conceived as crucial to realising the broad goals of health security.

After all, health security as generally acknowledged is about actions and activities that are needed whether proactively or otherwise in order to curtail or minimise the impact or deleterious effects of acute or serious health events. In its conventional sense, health security is approached from a global perspective that privileges concerted action at different levels. In the same vein, climate change issues have been approached largely from a global perspective and have been perceived as portending acute public health challenges globally.

However, while global efforts remain paramount, actions at regional and sub-regional levels can be coordinated in the case of climate change to build into the global health security agenda. As part of the effort at adaptation and strengthening health security, public health should actively and robustly link people to needed and appropriate health service and support in the event of adverse weather events. Therefore, there is need for a strong and integrated infrastructure for delivering health service and interventions as part and parcel of the response to climate change at the community level.

Besides the recent global challenge of COVID, climate change has been in the forefront of realistic efforts towards health security in the past three decades. Thus, climate change and its responses should be seen as lying squarely within the rubric of health security.

Apparently, there can be no real or sustainable health security especially in developing regions of the world without accounting for climate change. Putting climate change within a responsive and robust public health system logically responds to the glaring need for health security in almost the same way as a global compact on COVID and its vaccines.

A good theoretical landing in responding to the health challenges of climate change is through adopting the systems theory. Systems thinking in this regard embodies multi-disciplinary and linkage propensity in the sense that it is oriented to drawing a nexus between disciplines. Therefore, in public health and climate change the systems approach become relevant in ensuring linkages and manifold nexus between disciplines that breeds concerted action.

Without doubt, climate change is the area where multi-disciplinary approaches are needed in order to fully embody and respond to its various impacts and manifestations.

Systems thinking also privileges diverse impacts and manifestations. It thus enables the understanding and acceptance of the impacts of both climate change and health on other spheres of the social system. In spite of accelerating research on climate change in the last few decades, there is still no contesting the need for more research efforts especially in pinpointing specific and directional interaction between climate change and health or diseases especially in the case of new and re-emerging infectious diseases in Africa.

In other words, nothing would be better than an evidence-based response to climate change i. Despite the above, there is no gainsaying the need for radicalization of the public health systems in Africa and repositioning them towards innovative and concerted response to real, emerging and even anticipated impacts of climate change on health.

These would entail not only fundamental mainstreaming of climate change into public health but equally building individual and community resilience through programmed interventions; tackling extensive health inequities or disparities especially those generated by or associated with poverty as well as reforming health institutions and infrastructure to embody robust innovations and concerted response to climate change especially in this era of global pandemic and beyond.

Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3. Published: November 17th, Firstenberg Book Details Order Print. Impact of this chapter. Abstract The study examined the impact of climate change on public health provisioning in Sub-Saharan Africa. Introduction The chapter examines the impact and influence of climate change on public health in Sub-Saharan Africa which is a developing region of the world.

Hypothermia Cold 2. Hyperthermia Heat including heat waves and heat stress 3. Famine Droughts; Floods 4. Internal Displacement Floods; Drought 5. Personal injuries Floods; Hurricanes; Wildfires; Tornadoes 6. Death including drowning Floods; Droughts; Wildfires; Landslides 7. Vector Borne Diseases malaria; dengue fever; rift valley fever General adverse climatic conditions especially precipitation; floods; 8.

Food contamination and shortages impact on nutrition and disease resistance General adverse climatic conditions especially precipitation; floods; 9. Cardiovascular and respiratory diseases General adverse weather and climate. Table 1. References 1. Haines A and Patz JA. Health effects of climate change. JAMA ; 99 — 2. Epstein PR. Climate change and human health. N Engl J Med: ; — 3. Climate change and human health: Present and future risk. Lancet : ; — 4. Thomalla F. Reducing hazard vulnerability: Towards a common approach between disaster risk reduction and climate adaptation.

Disasters : ; 39 — 48 5. The impacts of climate change on the risk of natural disasters. Disasters : ; 5 — 18 6. Action on climate change: The health risks of procrastinating. Climate change and human health: Review of evidence. Lancet : b; - 8. Climate change The physical science basis — Contribution of working group 1. Cambridge: Cambridge University Press, p.

Summary for policymakers. In Climate change Impacts, adaptation and vulnerability. Cambridge: Cambridge University Press, pp. Introduction: Climate change and human health, in The impacts of climate change on human health in the United States: A scientific assessment. Washington, DC: U.

S Global Change Research Program; pp. Leischow SJ and Milstein B. Systems thinking and modelling for public health practice. American Journal of Public Health : ; 96 3 : — Climate change: The public health response. American Journal of Public Health: ; 98 3 : — Impact of regional climate change on human health. Nature : ; — Climate change and health: Global to local influences on disease risk.

Annals of Tropical Medicine and Parasitology: ; - Climate change and human health: Impacts, vulnerability and public health. Public Health: ; — Climate change and human impacts in the United States: An update on the results of the US national assessment. Environmental Health Perspective: ; — Disease emergence from global climate and land use change.

Med Clin North Am : ; - ClimaDev — Africa. Policy Brief Coumou D and Robinson A. Historic and future increase in the global land area affected by monthly heat extremes. Environmental Research Letters: ; 8 3 : Cambridge: Cambridge University Press; Midgley GF and Thuiller W. Potential responses of terrestrial biodiversity in Southern Africa to anthropogenic climate change. Regional Environmental Change : ; 11 S1 : — Climate change: Present and future risks to health and necessary responses.

Journal of Internal Medicine : ; 5 : — Regional Environmental Change 15 8 Regional Environmental Change ; 12 1 : — Impact of Climate Change on global malaria distribution. Mapping the Rift Valley fever and malaria risk over West Africa using climatic indicators. Atmospheric Science Letters: ; 96 — Climate change and highland malaria: Fresh air for a hot debate.

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Quote There should be an opportunity for entrepreneurs to enter the health delivery space in Africa. Attribution Azure Tariro Makadzange. Access is still the greatest challenge to health care delivery in Africa.

Also, there is a shortage of trained health care professionals from Africa because many of them prefer to live and work in places like the U. African countries have to embrace technology to close the health care gap, and private-public partnerships can help with that. There should be an opportunity for entrepreneurs to enter the health delivery space in Africa. Unfortunately, due to aid and its influences, it is exceedingly difficult for local entrepreneurs to compete with the foreign-funded public programs.

There are no incentives for entrepreneurs to enter that space to provide health care to the middle classes and the working poor. I think there are several big challenges for health care delivery in Africa, says Adu-Ampoma who noted she was speaking for herself and not the companies she works for.

The number, quality, and capability of health care workers across countries as a ratio to the population is low. Corruption diverts much-needed resources away from health care delivery and reduces patient access to services. Examples include medical staff in public sector health care institutions who sell drugs that should be free, and theft for personal use or diversion for private sector resale of drugs and supplies at government storage and distribution points.

A darker consequence of the rise of technology is that it enables counterfeiters to run even more sophisticated operations and make counterfeit drugs that are harder to detect.

As a result, counterfeit drugs now present themselves as authentic drugs. Much of the current focus of health care delivery in Africa is on traditional and visible factors like HIV and malaria.

However, changes in lifestyle and a growing middle class are making noncommunicable diseases like cardiovascular disease, cancer, and diabetes big issues among populations.

Rapid urbanization and increased Westernization of lifestyles among the middle classes is causing an increase in the risk factors that cause noncommunicable diseases. People consume more fast food and packaged foods, which tend to have high levels of sodium; they engage in less physical activity, sitting in their cars and buses on their way to work; and they are more likely to consume alcohol in their leisure time.

There are approximately 1. To fully unlock this demographic dividend, we would do well by creating working partnerships that accelerate our investments in the education and health of this population.

As healthcare businesses, we have an invaluable role to play in moving forward the health access agenda. Every African deserves quality care. And as a business, we can indeed remain profitable if we find creative ways of sustainably contributing to delivering quality care. As a leader in diagnostics, Roche has a year strategic plan to deliver twice the number of medical advances at half the cost to society.

We believe that access to quality healthcare for all Africans is possible. It will take various stakeholder groups working together in a well-coordinated manner. Beyond the innovations we create, we must find innovative vehicles to take quality diagnostics and treatments to the people.

Partnerships — between healthcare stakeholders, providers, governments, corporates, NGOs etc. We need to unpack what true partnerships are to build them successfully. As we identify the collaborators who will join forces with us to ease the African burden, it is important to distinguish where a transactional relationship suffices and where only a strategic relationship can deliver desired goals. The latter requires more investment in time and effort to craft correctly.

Successful global health partnerships are, in essence, strategic. This is a strategic partnership with a long-term vision in mind.

True partners are bonded by transparency, trust and mutual respect. And whereas there may be variations in some goals, the ultimate vision to be delivered is always shared. Finally, it is clear what unique strengths each partner brings to the table. In the end, the whole is larger than the sum of its parts. There are different kinds of partnerships. When different African countries work together in true collaboration, we can achieve far more than they would individually.

For example, the Zazibona collaborative medicines registration partnership is paving the way for cooperation across borders and is fast-tracking access to medicine for people from 16 African countries. This initiative addresses widespread African healthcare challenges, such as delayed product applications, high staff turnover, long registration times, inadequate financial resources and limited capacity to assess certain types of products such as biologicals and biosimilars. At Roche, we aim to share innovations that can potentially increase access to diagnostics tenfold in Africa.

Traditionally, higher-income groups have few problems accessing the diagnostics they need. To reach the poorer majority, we need to think differently. In many African countries, most people cannot simply walk into a private hospital to get a viral test. But we still need to reach them. We need to take a less traditional approach to make this happen. That means collaboration on a broader scale, to find partners who can help us overcome logistical, financial and social barriers.

To increase the number of patients we reach tenfold, we must understand the reality in public facilities throughout the continent and identify opportunities to build access models in partnership with all the stakeholders involved.