A Stitch in Time: Adaptation to Climate Variability and Change

Kristie L. Ebi, Ph.D., MPHKrisebi@gmail.comJuly 2006

VulnerabilityThe degree to which individuals and systems are susceptible to or unable to cope with the adverse effects of climate variability and change. Vulnerability is a function of:Sensitivity to changes in weather and climate (exposure-response relationship), including population characteristicsExposureAdaptation baseline

AdaptationActions taken by individuals, institutions, and governmentsAnticipatoryActions taken in advance of climate change effectsResponsive

The severity of impacts will depend on the capacity to adapt and its effective deployment

Vulnerability and AdaptationEbi et al. 2005

Adaptation BaselineWhat is being done now to reduce the burden of disease? How effective are these policies and measures?What could be done now to reduce current vulnerability? What are the main barriers to implementation?What measures should begin to be implemented to increase the range of possible future interventions?

Why Not Just React to Climate Change as It Happens?Long time frame and uncertainties with climate change make anticipating adaptation difficultThere may be irreversible and catastrophic impacts that cannot be mitigatedOpportunities to mitigate climate change impacts through anticipation may be missed

Difficulty with AnticipatingClimate Change and its ImpactsDirectionMagnitudeTimingPath

Questions for Designing Adaptation Policies & MeasuresAdaptation to what?What are the future projections for the outcome? Who is vulnerable?On scale relevant for adaptationIs additional intervention needed?Modifying existing prevention measuresReinstitute effective prevention programs that have been neglected or abandonedNew risksWho adapts? How does adaptation occur?When should interventions be implemented?How good or likely is the adaptation?

Remove Your Tie Save the PlanetJapan Times 30 April 2005

Global and Alpine Temperatures 1901-2000-1.5-1-0.500.511.519001910192019301940195019601970198019902000Change in T relative to 1961-1990 [C]Beniston, M., 2000: Environmental Change in Mountains and Uplands, Arnold, London

Glacier Retreat:Tschierva Glacier, Engadine2000Courtesy: Max MaischUniversity of Zrich, Switzerland

Tam Pokhari 3 Sept 1998Photo: Danek ~1997Source: Dwivedi 2003

Flood From Tam PokhariPhotos: Lakpa Gljen Sherpa 1998Source: Dwivedi 2003)

Potential for Glacial Lake Outbursts: BhutanGlacierGlacier lakeLake thatposes a threatBeniston 2004

Ganges Discharge at Calcutta0500010000150002000025000300003500040000JFMAMJJASONDDischarge [m3/s]Failing monsoon,with glacier meltwatersFailing monsoon,without glacier meltwatersAverage dischargeBeniston 2004

Integration of Public Health with Adaptation to Climate Change: Lessons Learned and New DirectionsWhat modifications to public health systems might be necessary to enhance adaptive capacity to climate variability and change?What lessons can be drawn from the history of managing environmental and other threats that can be applied to adaptation to climate variability and change?Editors: Ebi, Smith, BurtonTaylor & Francis 2005

Adaptation is a Process that Requires Sustained CommitmentIt is easy for societies to become complacent and assume that problems are solved forever, and to not maintain efforts to monitor for the emergence or re-emergence of problems, or evaluate the ongoing effectiveness of solutionsContinuous monitoring and regular evaluation of interventions are needed because health risks and their drivers change over time

Distribution of Aedes aegypti in the Americas

Emergence of Dengue Hemorrhagic Fever in the Americas

Need to Understand the Multiple and Interacting Determinants of DiseaseClimate change may exacerbate or ameliorate disease determinants, with the possibility that thresholds may be encounteredIncreased understanding of the impacts of climate variability is likely to facilitate adaptation to future climatic conditions

Climate Change and Malaria under Different Scenarios (2080)Increase: East Africa, Central Asia, Russian FederationDecrease: Central America, Amazon [within current vector limits]Van Lieshout et al. 2004A1B2A2B1Van Lieshout et al. 2004

Average % Deviation in Malaria Cases, ColombiaNio+1Nio0Other Years(1960-1992)251550-5-15-25Deviation From Trend in Malaria Cases (%)Bouma et al. Tropical Medicine and International Health 1997;2:1122-1127

Disease DeterminantsClimate change is one of many factors influencing human health and social well-beingPublic health challenges presented by climate change need to be addressed within the context of issues such as inadequate nutrition, access to clean water and sanitation, and diseases such as HIV/AIDSPoverty a major underlying factor

Campylobacteriosis Notifications, New Zealand

Campylobacteriosis in New Zealand (Weinsten & Woodward 2005)Campylobacteriosis is an emerging human gastrointestinal disease, with a dramatic increase in cases in the last few decades In New Zealand, natural vegetation was replaced with pastoral farmingThis increased sources for disease (animal waste) and reduced the ability of natural vegetation to remove the wastes from runoffThis has resulted in contamination of half of New Zealands rivers and streams

Multiple Political, Social, Economic, Technological, and Human Factors Determine Whether Measures Are EffectiveEffective interventions are embedded in an understanding of human factors and are tailored to address local situationsAlso, maladaptation and unintended consequences of interventions can occur in many different ways

Or -Differences in culture, education, knowledge, availability and affordability of technology, and other factors means that a one size fits all approached is likely to fail

Surveillance and Early Warning Systems Can Reduce VulnerabilityMaximum Temperature 10 August 2003

Heat Watch/Warning Systems Save Lives: Estimated Costs and Benefits for Philadelphia 1995-1998 Ebi et al. BAMS 2004Heatwaves defined as days categorized as maritime tropical or dry tropicalIncluded 3 days following a heatwave day45 days included in analysis; 21 warning days and 24 days following a warningMortality for 65 and older age group Analysis based on excess mortalityDifference between reported mortality and underlying mortality trend estimated from years prior to 1995 (1964-66, 1973-76, 1968, 1980-88)Data analyzed using linear regression

ResultsExcess Mortality = 3.27 0.05*Time of Season 2.6*Warning IndicatorWhen a warning was issued, assuming no mortality displacement, 2.6 lives were saved, on average, for each warning day and for the three following daysTherefore, PWWS saved an estimated 117 lives over the period 1995-1998Net benefits around $468 million over the three-year periodEstimated the value of a statistical life at $4 millionMost of the actions undertaken by city of Philadelphia do not have direct costs; they include actions taken by city employees as a normal part of their jobs, actions taken by volunteers, and delayed actions; estimated costs of $10,000 per day

Collaboration and Coordination is Required: Potential Transmission of Schistosomiasis, Jiangsu ProvinceYang et al., 2005

Underlying ThemeThere is a need to establish an institutional structure with the responsibility to maintain vigilance in responding to climate variability and change, and to commit sufficient resources on an ongoing basis to identify and respond to problems Effective interventions rarely result from a one-off solutionThe consequences of a less than effective intervention can be severe in terms of human disease and death

Adaptations ShouldMake sense anywayAnd make even more sense considering climate changePolicies that reduce vulnerability to climate variability will generally reduce risk to climate changeBe flexibility and efficiencyPerform well under a variety of climates (current climate, hotter and drier, hotter and wetter)Consider benefits under current climate and timing of climate change benefitsBe efficient (have marginal adjustments and low cost)No regrets

Pohnpei 1997-98

Thank You

Source: Van Leishout et al., 2004. Based on the MIASMA model (V2.2) developed by Martens and colleagues. The model links GCM climate scenarios with an impact module that applies the formula for the basic reproduction rate to calculate the transmission potential of the malaria mosquito population, and to estimate the population at risk. The population at risk was defined as the total population living in an area where conditions were suitable for malaria transmission as defined by the transmission potential, and an average monthly precipitation of 80 mm. The reference scenario included population growth and kept the climate conditions the same as in the baseline climatology of 1961-1990. The model estimates climate suitability for an average year and the suitability for stable or annual transmission. The model assumes the current level of adaptation to malaria (countries were classified into one of six groups based on expert judgment).Estimates of the additional population at risk for more than 1 consecutive month of transmission by the 2080s ranged from more than 220 million (A1) to over 400 million (A2) when climate factors and population growth are considered in the model. The figure shows, under each scenario, the change in risk classified by the changes in the number of consecutive months of transmission (> +2, +2, -2, < -2).