The Philippines confronts climate change

Climate and weather significantly affect human health, and even relatively minor changes to a country’s climate can exacerbate and spread disease and multiply deaths. Worse, extreme weather events can greatly undermine a country’s clean water and food supplies, infrastructure, health systems and social protection systems. Between 2030 and 2050, climate change could result in nearly 250,000 deaths per year globally, according to the World Health Organisation (WHO). High temperatures, sea-level rise, flooding caused by high rainfall and other severe weather events can increase rates of cardiovascular, infectious, and respiratory diseases such as diarrhoea, malaria and dengue fever, as well as malnutrition. This is expected to have a global cost $2bn to $4bn per year by 2030. With this in mind the Philippines has taken several important steps towards combating climate change.

Geography

With a location in the pathway of typhoons and on the earthquake-prone Pacific Rim, a tropical climate and thousands of miles of coastline, the Philippine is highly susceptible to climate change effects. Apart from direct health consequences such as disease and mortality, indirect health impacts specific to the Philippines include the displacement of large numbers of people, which in turn can disrupt agricultural and economic activities. The damage of Typhoon Haiyan, which struck the archipelago in November 2013, was just one of the latest reminders of the importance of implementing an integrated plan to cope with natural disasters. The typhoon was associated with 6300 deaths and affected 16m people and displaced 4.1m, according to the Department of Health (DoH), which also noted that the typhoon caused approximately $16m in damage to 571 health facilities.

Climate change’s combination of more rainfall and warmer temperatures is likely to expand the vectors for waterborne communicable diseases as well. In the Philippines, a marked correlation between the amount of rainfall and the incidence of dengue fever exists, according to the Asian Development Bank. The Philippines already has a high incidence of dengue fever. In 2015 it recorded more than 200,000 dengue fever cases and 600 deaths from the viral disease. During the first five weeks of 2016, the country reported almost 13,000 cases, slightly higher than the same period in 2015, when 12,766 cases were reported. Floods from typhoons like Haiyan and Koppu often result in water contamination, which in turn enables the rapid growth of mosquitoes and other insects by providing a hospitable environment in which to lay eggs, thereby increasing the incidence of dengue fever and other mosquito-borne diseases such as filariasis and malaria.

In addition, the disruption caused by floods can mean rubbish goes uncollected and human waste is improperly disposed of, both of which increase the likelihood of a cholera outbreak. Coming into contact with the water from such floods also increases the possibility of acquiring leptospirosis, a bacterial infection that can damage kidneys and cause death.

Planning Ahead

In the absence of strategic forward planning and improvements to health system infrastructure, an increasing number of Filipinos will be exposed to the effects of severe weather events. The segment of the population most vulnerable to climate change are the poor living in rural areas, such as indigenous people, forest workers and upland subsistence farmers. It is in these critical areas that the shortfalls of the public health sector are amplified. Many rural health units suffer from inadequate health facilities, buildings that are not constructed to withstand severe weather events, as well as an inadequate supply of medical personnel and insufficient diagnosis and treatment technology.

Compounding the complexities of health delivery during a natural disaster, the devolution of health services to local government units (LGUs) has differentiated the response of each region’s health authority to the challenges posed by climate change.

Adaptive Strategies

Keenly aware of its particular vulnerabilities to disruptive weather events and their impact on human health, the Philippines has adopted a national health strategy and has been carrying out projects to ensure health adaptation strategies are adopted across the country. These include guaranteeing climate information is incorporated into an integrated disease surveillance and response system, which also has an early warning system for climate-sensitive health risks.

The DoH has also partnered with the WHO Philippines to respond to the challenges presented by climate change. Steered by the World Health Assembly Resolution of 2008 that urged member states to take decisive action to address health impacts from climate change, the department has carried out advocacy and awareness campaigns and public health worker training in several regions to increase the population’s understanding of the impact of climate change on health.

In addition, the national government has issued policy interventions on health and climate change, including the Philippine Climate Change Act; the DoH National Framework on Climate Change and Health Adaptation; the DoH Technical Committee on Climate Change and Health; the Climate Change Unit at the DoH; and the DoH National Policy on Climate Change Adaptation for the Health Sector. More recently, the Climate Change Adaptation for Health (CCAH) Strategic Plan 2014-16 was tabled to direct the country’s efforts towards comprehensive climate change adaptation in the health sector. The plan builds on a previous CCAH plan as well as the DoH’s established frameworks, policies and guidelines to create a “climate-risk resilient Philippines” and to protect Filipinos’ health. The plan gives priority to population groups living in areas that are vulnerable to the effects of climate change.

The policy for the most recent CCAH plan is directed towards designing and implementing responsive adaptation measures and interventions in the country’s health care delivery system. This involves translating the CCAH’s policies and framework into guidelines that regional administrators and LGUs can comprehend and adapt to their localities, as well as supporting certain mitigation measures. The plan focuses its assistance on 20 provinces that were identified as high-risk based on a combination of climate- and weather-related disaster factors, such as rainfall change, temperature increase, typhoon risk and El Nino-caused drought.

Promising Signs

The government’s coordinated efforts seem to be gaining traction. Though still rated “extremely vulnerable” to climate change by risk analysis company Verisk Maplecroft, the Philippines has moved down the company’s latest climate change vulnerability index (CCVI). In the 2016 CCVI, the Philippines was ranked the 13th-most-climate-vulnerable country of 186 countries, which, while remaining high, is an improvement over its place in the previous year’s index, when it was ranked the eighth most climate-vulnerable country.

A Verisk Maplecroft spokesperson said that the Philippines’ better ranking was partly due to the country’s improved disaster risk management, as well as a diminished dependence on the agriculture sector and improved access to clean drinking water, which is linked to preventing illnesses brought on by floods and drought.

The 2016 index evaluated the vulnerability of each country to extreme climate-related events and changes in climate parameters over a 30-year time-span. The rankings were based on three weighted criteria: adaptive capacity (25%), exposure (50%), and sensitivity (25%). The sensitivity criterion, which measured to what extent the population would be affected by an extreme climate-related event or changes in climate parameters, was determined in part by a community’s accessibility to health services. In another positive sign, in February 2016 the UN Office for Disaster Risk Reduction (UNISDR) congratulated the Philippines for making a “paradigm shift” in its disaster risk reduction and management. It cited the country’s use of more efficient response systems, more sophisticated methods of gauging typhoons’ impact, and improved disaster preparedness. The UNISDR also praised the Philippines for reducing storm-related deaths by ensuring timely evacuations and using early warning systems.