table of content - limun · 2016-12-16 · zz 3 london international model united nations 2017...

ZZ

1

LONDON INTERNATIONAL MODEL UNITED NATIONS 2017

Table of Content

World Health Organisation London International Model United Nations 18th Session | 2017

ZZ

2


Table of Contents

Introduction Letters 3

Introduction to the Committee 6

Topic A:

Introduction 7

History of the Problem 8

Statement of the Problem 10

Current Situation 12

Bloc positions 14

Questions a Resolution Should Answer 15

Sources 16

Topic B:

Introduction 19

History of the Problem 20

Statement of the Problem 21

Current Situation 25

Bloc Positions 28

Questions a Resolution Should Answer 28

Sources 29

Conference information 30

ZZ

3


Introduction Letters

Evangelos Chalatsis, Director

Dear delegates,

It is my distinct pleasure to welcome you all to the World Health Organization

of the 18th Session of LIMUN. My name is Evangelos and I will be serving as

the Director of the committee.I am originally from Greece but I am currently

living in London where I am a 3rd Year Medical Student at Queen Mary

University. This is the 9th year that I have been participating in UN

simulations with something close to 30 conferences on my back, but most

importantly the 3rd year in a row to be part of the great LIMUN family.

When it comes to LIMUN, you will see for yourselves that there is more to it

than just reputation and prestige. Although being the biggest conference of

Europe makes it sound daunting, it offers the unique chance of meeting people

from any part of the world you can think of while improving your public

speaking skills through debating top-priority topics that form the actual agenda

of major real-life bodies and organizations. My Deputy Directors and myself

are always at your disposal should you have any concerns or questions. Feel

free to email us at [email protected] to pass any of those to us or even to just

introduce yourselves!

Looking forward to meeting every single one of you in February!!

mailto:[email protected]

ZZ

4


Shubhangi Karmakar

Assistant Director

Hello, delegates! I’m thoroughly excited to be your WHO Assistant Director,

in my first university MUN chairing role, at LIMUN 2017.

I’m a British SF Medicine student at Trinity College Dublin, in Ireland. My

experience of MUNs has been in a delegate and training capacity, attending nearly 20

MUNs, with commended, highly commended and best delegate awards, as well as

helping develop the inaugural Trinity MUN later this year.

I take a keen interest in encouraging debate on Public Health, and breaking

barriers of access to healthcare. In my spare time, I am the Treasurer General of the

Association of Medical Students Ireland (AMSI), where we implement suggestions in

the WHO’s Sustainable Development Goals to improve healthcare education and

provision. I'm also Pro Debates Convenor for the College Historical Society (the

Hist), the oldest student society in the world, where we debate international affairs of

current importance. Having lived in several countries, including India, the topic of

Epidemic Control this year is of particular interest to me, and I can’t wait for your

creative collaboration on one of the most diplomatically sensitive and critical subjects

of our time!

Nil Bozkurt

Assistant Director

Hello delegates and welcome to yet another session of WHO, LIMUN 2017. I am

very much looking forward to being your Assistant Director for this weekend!

I am currently studying Biochemistry in Imperial College London and have the

honour of representing the Imperial College Model UN Society as its President.

Being one of the many individuals devoted to MUN, I have participated in 10

conferences within Europe to this date and have had the chance to take on the role of

Chair 3 of such experiences. Having had a chance to explore all aspects of MUN, I

am delighted to be able to now guide you through a weekend of debate which

revolves around the subject area I study.

WHO is one of the most important committees under the UN. Its mandate includes

ensuring the health and wellbeing of all individuals on the planet, which is further

echoed in the 2030 Sustainable Development Goals. Unlike other committees, all

nations in the WHO work for a common aim of universal health. Thus, as a Chair, I

am expecting to see outstanding diplomacy and creativity during the conference

weekend. Working together is key to successful changes in our world and I am

excited to witness this first hand in the resolutions which this committee will

propose!

ZZ

5


Introduction to the Committee Established in 7 April 1948, the World Health Organisation is a sub-body of the

United Nations, which is mainly concerned with public health. It is the successor to

the Health Organisation, which made part of the previously established League of

Nations. Every year in the month of May, all 194 Member States meet at the WHO

headquarters in Geneva, Switzerland to discuss pressing health issues.

The World Health Assembly is the main decision-making body for the WHO

and determines the policies for the organisation1. Under its mandate, the WHO is able

to provide assistance to Governments on public health issues whilst also being able to

act independently to lead global action during emergencies such as epidemics. Since

its establishment, the WHO has played a key role in the eradication of contagious

diseases such as smallpox as well as intervening in conflicts to provide humanitarian

aid to regions such as South Sudan and Syria.

Amongst other work, the WHO has recently delved into developing plans to

kick start the action towards achieving Universal Health Coverage as directed by the

newly adopted Sustainable Development Goals2.

1Wikipedia

2 Chan, 2016.


ZZ

6


Source: http://www.who.int/csr/disease/yellowfev/yellow-fever-vaccines.jpg

Topic A: Creating International Standards

for responding to

health concerns/epidemics

Introduction

In this era of technology, communication and travel, the global population lends itself

more susceptible to the spread of diseases than ever before. As global transport links

and networks expand, so do the routes of transmission for micro-organisms such as

bacteria and viruses.

Some micro-organisms can mutate quickly to acquire fast transmission rates whilst

also causing diseases with high mortality rates. As it is difficult to control such novel

strains of micro-organisms, diseases may potentially have the power to wipe out a

large population of people. One example of this case was seen in the 1918 H1N1 Flu

Pandemic, also termed as the ‘Spanish Flu’, which killed around 50 million people

across the globe3.

It is imperative that under such circumstances the international community recognise

the epidemic quickly and act in a timely manner, in order to provide the appropriate

material needed to contain the disease within confined borders whilst ensuring its

eradication. After having seen examples such as the Ebola and Zika outbreaks, the

3 Jeffery K. Taubenberger&David M. Morens, 2008.

ZZ

7


WHO must learn from its past mistakes and successes in order to improve

their actions to counter future epidemic cases.

History of the Problem

In light of the most recent Ebola outbreak in West Africa, many individuals and

organisations have criticized the WHO’s response to epidemic crises. Due to the lack

of appropriate technologies and doctors, the nations which were hit severely with

Ebola, failed to detect the spread of the disease at its early stages. When the outbreak

was finally identified, these same nations did not have the necessary strategy to report

or respond to it. Having spent a significant amount of their GDP and resources, the

most affected nations found themselves with 11,000 deaths at the end of the crisis,

which is six times the number of victims since the discovery of the Ebola virus in

1976 4 . This recent case was the one which pushed the WHO to consider

implementing reforms to its epidemic response system in order to address complex

challenges with which it may be faced in the future.

Besides considering diseases similar to Ebola, the WHO must also consider responses

to other communicable and non-communicable diseases (NCDs). This includes

tackling global health pandemics such as obesity and diabetes as well as diseases

spread by influenza viruses.

Communicable Viral Diseases

Influenza viruses are respiratory pathogens which are responsible for diseases like the

common seasonal flu. Such viruses can pose a great threat to the global population as

mutations accumulated by some viral strains can cause high morbidity and mortality

amongst populations 5 . The numerous deaths incurred by Spanish Flu (H1N1)

Pandemic of 1918 still remains an example of where a novel strain of the Influenza

virus was capable of attaining both high transmission and mortality rates. Under these

circumstances the H1N1 virus was transmitted to 500 million people around the

world, with a case fatality rate of >2.5%, compared to <0.1% presented by other

influenza pandemics6. The aftermath of the epidemic not only induced deaths but also

caused spread of panic, disruption to trade and political instability.

In 1919, the League of Nations recognised the threat of global spread of diseases and

moved to develop an internationally recognized set of regulations to prevent and

control spread of diseases7. Thus, the International Health Regulations were set up

and signed by 191 Member States in order to encourage the use epidemiological tools

to prevent spread of epidemics, especially at national levels. However, such

regulations remained specific to and concentrated on diseases such as cholera and

yellow fever8.

4 BBC, 2015.

5 Padha & Tambyah, 2011. 6 Ibid. 7 WHO/CDS/CSR/2000.2 8 Ibid.

ZZ

8


When H1N1 Swine Flu pandemic emerged in 2009, it was comparatively

milder than the Spanish Flu pandemic with a case fatality ratio of 0.6%, and a

transmissibility rate higher than the common seasonal flu. Even so, having learnt

from the Spanish Flu, the WHO acted quickly to implement mass vaccination

programs. However, the program saw that provision of the H1N1 vaccine for

everyone in both developed and developing nations proved challenging 9 . The

response also outlined the importance of defining pandemics and epidemics as the

media drew a large volume of attention to the epidemic, which resulted in a high

volume of resource spending10.

Non-Communicable Diseases (NCDs)

Obesity is one public health problem which does not fit into a traditional definition of

epidemics. In 2014, obesity affected 2.1 billion people worldwide and claimed lives

of 3.4 million adults annually due to chronic complications11. Besides having the

ability to affect all age ranges and socioeconomic groups in both developing and

developed nations, obesity can also produce social and psychological concerns. Other

diseases such as diabetes also fall under the category of health concerns which are not

outlined in the traditional definition of epidemics.

Since the 1990s, the WHO has taken action to curb the cases of obesity by launching

expert and technical consultations. This project aims to raise awareness of policy

makers, private sector partners, medical professionals and the public as well as

concentrating on promoting healthier choices to the global population12.

Besides raising awareness, the WHO also provides scientific guidelines for the

prevention of major NCDs. Specifically for diabetes, the WHO particularly targets

low and middle income countries to put in place measures of surveillance, prevention

and control.

Interactions between communicable diseases and NCDs can increase the burden on

national healthcare structures. For example infection from the human papilloma virus

can subsequently lead to cervical cancers. Furthermore although beneficial, the

administration of drugs can sometimes make individuals susceptible to NCDs. This

was seen in the case of anti-retroviral treatments of HIV patients who become at risk

to metabolic side effects such as diabetes, lipodystrophy and dyslipidaemia13.

Seeing as different Member States are at different time points of socio-economic

development, it is difficult to establish one single method of tackling NCDs

9 Padha & Tambyah, 2011. 10 Ibid. 11 Dunham, Reuters, 2014. 12 WHO, Controlling the obesity epidemic, 2016. 13 Maher, Ford & Unwin, 2012

ZZ

9


worldwide. However, it is no question that the attainment of the global targets

for reducing NCDs will be beneficial to each country14.

Statement of the Problem

Director General of WHO, Margaret Chan, admits that in evaluating WHO’s recent

response to Ebola, the organization could indeed consider reforms to tackle

epidemics more effectively. 15 In accordance with WHO reforms, the creation of

International Standards should aim to increase coherence in global health through

governance and organisational changes16.

Definitions

No formal definition exists for pandemics and epidemics. However an

epidemiological definition does exist: “an epidemic occurring worldwide, or over a

very wide area, crossing international boundaries and usually affecting a large

number of people”17. However, by this definition the annual seasonal flu of the winter

season should also be considered an epidemic. This definition does not include

population immunity, virology or disease severity.

Furthermore, NCDs such as obesity and diabetes, which affect a large proportion of

the global population, do not come under the traditional definition of an epidemic or

pandemic. Perhaps putting such health concerns under this definition would allow for

the use of novel strategies when tackling such health concerns.

Categorising and prioritizing NCDs can be important for policy makers in national

governments. WHO focuses on ensuring priority to NCDs are given a greater amount

of attention on a global stage. However such categories of prioritization remain

indefinite.

Nations Lacking Adequate Health Framework

In particular, some low-income nations do not have an adequate healthcare

framework to tackle epidemics. Cost of essential medication and diagnostics for both

communicable and non-communicable conditions can be high under resource limited

conditions18. Even though national governments commit to establish a well-structured

framework under the International Health Regulations, this endeavour is impeded by

limited funds and limited external investments.

Furthermore, it can be difficult for such nations to prioritize tackling NCDs such as

diabetes, chronic respiratory diseases, and cancer. Recently, HIV, malaria and

tuberculosis were made the focus of ‘priority diseases of poverty’, which enabledsuch

14 WHO, Global status report on non-communicable diseases, 2014 15 Chan, WHO, 2016. 16 WHO, WHO reform, 2016. 17 Kelly, WHO, 2011. 18 Maher, Ford & Unwin, 2012

ZZ

10


diseases to benefit from international funding collected from subsequent

agencies which were set up, such as the Global Fund to Fight AIDS, Tuberculosis

and Malaria19.

Timely Sharing of Information

Some reports argue that the connection between national governments and the WHO

can sometimes be insufficient when facilitating sharing, validating and responding to

information on outbreaks20.

Previous pandemics, particularly of the influenza disease, have shown that the nature

of viruses can be unpredictable. Epidemiological patters can vary within and amongst

Member States during different waves of the pandemic or epidemic21. Under such

circumstances it is difficult for the global community to adapt and respond to the ever

changing epidemic.

Furthermore, national governments need to have sufficient information on how to

contain the virus after the infection of an individual. In the case of Ebola, this lack of

knowledge made the containment of the virus difficult as traditional cultural

practices, such as funeral customs, aided the propagation of Ebola.

Travel Restrictions

Although beneficial for quarantine purposes, imposed travel restrictions can be

detrimental to the affected area. This severely limits the supply of resources needed

to control the outbreak whilst slowing down the mobilisation of personnel and

funding on site.

It is important to also consider the attitudes to national and international health

workers on site. In the case of the Ebola epidemic, international health workers were

supplied with experimental treatments and were able to be evacuated, whereas their

national counterparts did not receive the same benefits22.

Biosafety Measures

The Severe Acute Respiratory Syndrome (SARS) epidemic of 2003 in Asia showed

the world that we can never predict when and where the next SARS outbreak may re-

emerge from23. It is possible that the original animal reservoir of the virus may be a

source of re-emergence of the disease. After SARS was contained in 2003, new cases

in China were thought to be due to animal-to-human transmission. Moreover, some

cases found after 2003 in Singapore and Taiwan seemed to be laboratory-acquired,

suggesting a need for more stringent biosafety precautions24.

19 Ibid. 20

Ibid. 21 WHO, New influenza A (H1N1) virus: global epidemiological situation, June 2009. 22

Moon, Suerie et al., 2015. 23 Prashar, 2004. 24 Ibid.

ZZ

11


Confusion Between new and pre-existing UN Agencies

Some reports provide scepticism towards the creation of new agencies for health

emergencies, fearing that they may create confusion when it comes to sharing

responsibilities25. During the Ebola outbreak, the UNMEER (UN Mission for Ebola

Emergency Response) was created to exist besides already established agencies such

as UN body for emergency coordination and the Office for the Coordination of

Humanitarian Affairs26.

Information to the Public & Media

Other factors which can contribute to the escalation of the epidemic lies in

information diffused by national governments to the general public. In the case of the

Ebola epidemic, in order to prevent panic, the public was not well-informed about the

virus and was encouraged to continue its economic activity. In addition, some

governments in the affected are even failed to call for international help to further

avoid any spread of panic.

Current Situation

As of 28 May 2016, at the close of the 69th General Assembly, the WHO has taken

multiple steps, and laid out plans and the framework for several more, in order to

control outbreaks and epidemics on the global scale.27 The relevant steps outlined in

the press release are briefly discussed here.

The WHO has duly recognised the vast contribution of organisations such as

Medecins Sans Frontieres (MSF) in limiting the damage done by outbreaks and

pandemics such as the Ebola and Zika viral crises. It has also acknowledged the

conflicts of interest which may arise when working with a plurality of non-

governmental, philanthropic, or other academic and charitable organisations which

may or may not each act in cooperation with individual international governmental

organisations. In doing this, it adopted the WHO Framework of Engagement with

Non-State Actors (FENSA). This is to provide them with “comprehensive policies”

for collaborating with such organisations to improve healthcare in the face of

outbreaks, also minimising the need for new organisations to be set up at every

instance of a new epidemic. FENSA is also to provide “a standardized process of due

diligence and risk assessment”, and “an enhanced level of transparency and

accountability” on their actions, with publicly available information on all their

engagements.

Further, they agreed on new Sustainable Development Goals (SDGs), with intentions

to “prioritize universal health coverage, and to work with actors outside the health

25

Roland, Denise. 2015. Wall Street Journal. 26

Ibid. 27

World Health Organisation, 2016

ZZ

12


sector to address the social, economic and environmental causes of health

problems, including antimicrobial resistance.” Antimicrobial resistance is a vital

issue targeting both developed and developing nations, and a significant barrier to the

efficient global control of outbreaks and epidemics.

The Health assembly were also called to evaluate the report of the Review

Committee on “the Role of the International Health Regulations (IHR) (2005) in the

Ebola Outbreak and Response.”. While the work on the report was commended, and

the IHR were found to have had no direct detrimental effect on the Ebola outbreak,

there was instead a call for better universal implementation of the IHR and of a “new,

intermediate level of public health alert and recognition of external assessment of

country core capacities.” The terms of this are yet to be elaborated on.

Some other steps taken are:

● Improving global access to healthcare and vaccines, especially for children, by

“improving affordability through price negotiations and voluntary or

compulsory licensing of high-priced medicines”;

● Agreeing to accelerate the WHO Global Observatory, to “identify gaps in

R&D, especially for diseases that disproportionately affect developing

countries and attract little investment”, with 6 demonstrations projects on

Neglected Tropical Diseases (NTDs);

● Moving towards Integrated Healthcare Services, where the focus lies on

“putting people and communities, not diseases, at the centre of health systems,

and empowering people to take charge of their own health rather than being

passive recipients of services.” This concept may improve the communication

and propagation of healthcare best practice, especially in culturally isolated

communities.

ZZ

13


Bloc positions

African Bloc: Nations such as Guinea, Liberia and Sierra Leone, amongst others.

Issues they need to address are providing basic public healthcare measures such as

improved sanitation, access to clean basic necessities such as water, and wider

healthcare accessibility. They require primarily monetary and secondarily technical

aid from blocs, in improving sanitation programs, healthcare awareness and

professional training, and developing their own sustainable advancements. The latter

is crucial, as it will allow them to wean themselves off support in a sustainable

manner over time.

Western Bloc: The USA, and Western European nations such as Spain, United

Kingdom, and Italy, due to their proximity to the affected African bloc, or their

experience with implementing strategic public health responses to control epidemics,

are best situated to provide rudimentary medical training, and monetary and

technological aid. They have often provided developing nations with skilled

healthcare professionals during crisis situations, such as during the Ebola outbreak.

They have historically assisted in this manner, especially financially, for the

alleviation of 7 prior epidemics and pandemics.

Latin and Caribbean Bloc: A bloc comprising Brazil, Colombia, Argentina and

Chile, among others. They harbour serious concerns over epidemic control, with the

current problem of developing their own financial sustainability over time. Gaining

access to up-to-date vaccinations and healthcare provisions that could combat a

pandemic emergency are huge concerns here. Lack of finances and medical

technology, as well as medical training, especially afflict rural regions in this bloc.

Asia-Pacific Bloc: This bloc, inclusive of China and India, primarily seeks specialist

training for dealing with imminent threats of epidemics, with some request for

monetary assistance. They strive to acquire medication and medical technology of

objectively better quality which could assist in tackling such threats - as the Western

bloc holds about 67% of such sensitive, quality-assured and widely distributed

medication and technology, cooperation and provision of tools to self-sustain medical

development will be key to addressing the bloc’s needs.

Questions a Resolution Should Answer

● What specific measures must be developed to counter emerging epidemics?

● How able is your nation to harness emerging social and scientific technologies

to improve healthcare awareness and epidemic controls?

ZZ

14


● How should nations in afflicted blocs structure this to a uniform

standard? How can these standards address the needs of countries in different

stages of socio-economic development and environment?

● What can be done to ensure congruity in the implementation of public health

measures in the urban and rural areas of your nations?

● In what way can international cooperation lead to the establishment of

improved global “standards” for the quality of public health strategies across

nations? What might these “standards” be?

● How can public awareness and systematic preparation for potential outbreaks

be facilitated in afflicted nations? Consider the input of skills and resources

from more developed nations in this.

● Ultimately, how can crisis intervention and management during such health

concerns/epidemics be improved by their global standardisation?

ZZ

15


Sources

Anon (2016) World Health Organization. [Online]. 2016. En.wikipedia.org. Available from:

https://en.wikipedia.org/wiki/World_Health_Organization [Accessed: 27 November 2016].

Chan, Margaret (2016) Closing remarks at the Sixty-ninth World Health Assembly. [Online].

2016. World Health Organization. Available from:

http://www.who.int/dg/speeches/2016/wha69-closing-remarks/en/ [Accessed: 30 October

2016].

Anon (2016) Ebola global response was 'too slow', say health experts - BBC News. [Online].

2016. BBC News. Available from: http://www.bbc.co.uk/news/health-34877787

[Accessed: 2 November 2016].

Anon (2016) Sixty-ninth World Health Assembly closes. [Online]. 2016. World Health

Organization. Available from: http://www.who.int/mediacentre/news/releases/2016/wha69-

28-may-2016/en/ [Accessed: 31 October 2016].

Goliber, Thomas (2016) The International Response to HIV/AIDS. [Online]. 2016. Prb.org.

Available from:

http://www.prb.org/Publications/Articles/2002/TheInternationalResponsetoHIVAIDS.aspx


Anon (2016) WHO | Origins of the 2014 Ebola epidemic. [Online]. 2016. Who.int. Available

from: http://www.who.int/csr/disease/ebola/one-year-report/virus-origin/en/ [Accessed: 31

October 2016].

Anon (2016) WHO's Governing Bodies. [Online]. 2016. World Health Organization. Available

from: http://www.who.int/governance/en/ [Accessed: 4 November 2016].

Anon (2016) World Health Organization. [Online]. 2016. En.wikipedia.org. Available from:

https://en.wikipedia.org/wiki/World_Health_Organization [Accessed: 30 October 2016].

Moon, S., Sridhar, D., Pate, M. & Jha, A. et al. (2015) Will Ebola change the game? Ten

essential reforms before the next pandemic. The report of the Harvard-LSHTM

Independent Panel on the Global Response to Ebola. The Lancet. [Online] 386 (10009),

2204-2221. Available from: doi:10.1016/s0140-6736(15)00946-0.

Roland, D. (2016) Experts Criticize World Health Organization’s ‘Slow’ Ebola Outbreak

Response. [Online]. 2016. WSJ. Available from: http://www.wsj.com/articles/experts-

criticize-world-health-organizations-slow-ebola-outbreak-response-1431344306


World Health Organization. (2016). Sixty-ninth World Health Assembly closes. [online]

Available at: http://www.who.int/mediacentre/news/releases/2016/wha69-28-may-2016/en/

[Accessed 10 November 2016].

Taubenberger, J. & Morens, D. (2008) The Pathology of Influenza Virus Infections. Annu. Rev.

Pathol. Mech. Dis.. [Online] 3 (1), 499-522. Available from:

doi:10.1146/annurev.pathmechdis.3.121806.154316.

Pada, S. & Tambyah, P. (2011) Overview/reflections on the 2009 H1N1 pandemic. Microbes and

Infection. [Online] 13 (5), 470-478. Available from: doi:10.1016/j.micinf.2011.01.009.

ZZ

16


Anon (2016) Weight of the world: 2.1 billion people obese or overweight. [Online]. 2016.

Reuters. Available from: http://www.reuters.com/article/us-health-obesity-

idUSKBN0E82HX20140528 [Accessed: 22 November 2016].

Anon (2016) WHO | Controlling the global obesity epidemic. [Online]. 2016. Who.int. Available

from: http://www.who.int/nutrition/topics/obesity/en/ [Accessed: 22 November 2016].

Maher, D., Ford, N. & Unwin, N. (2012) Priorities for developing countries in the global response

to non-communicable diseases. Globalization and Health. [Online] 8 (1), 14. Available from:

doi:10.1186/1744-8603-8-14.

Anon (2016) Global status report on noncommunicable diseases 2014. [Online]. 2016. World

Health Organization. Available from: http://www.who.int/nmh/publications/ncd-status-report-

2014/en/ [Accessed: 22 November 2016].

Anon (2016) WHO reform. [Online]. 2016. World Health Organization. Available from:

http://www.who.int/about/who_reform/en/ [Accessed: 22 November 2016].

Kelly, H. (2011) WHO | The classical definition of a pandemic is not elusive. [Online]. 2016.

Who.int. Available from: http://www.who.int/bulletin/volumes/89/7/11-088815/en/ [Accessed:

22 November 2016].

Anon (2016) New influenza A (H1N1) virus: global epidemiological situation, June 2009. [Online].

2016. WHO. Available from: http://www.who.int/wer/2009/wer8425.pdf [Accessed: 22

November 2016].

Parashar, U. (2004) Severe acute respiratory syndrome: review and lessons of the 2003 outbreak. International Journal of Epidemiology. [Online] 33 (4), 628-634. Available from: doi:10.1093/ije/dyh198.

ZZ

17


Topic B: The WHO response to

climate change

Introduction

Climate change has been an alarming issue that has been troubling the

international community for many years now. Although experts have been issuing

continuous warnings, particularly during the last decade, it seems that governments

of member states have not been doing much progress in tackling this major

problem. As a result, not only has the deterioration of climate change effects not

been halted, but on the contrary, studies have shown that it has taken a turn for the

worse. The United Nation’s Intergovernmental Panel on Climate Change (IPCC)

has estimated in a recent report that global temperature will rise by 1.4-5.8oC until

2100i. The same report, acknowledges with less accuracy that similar changes are

to occur for factors such as precipitation, sea levels and wind speeds. Lately, the

UN and its subsequent bodies have attempted to re-spark the interest in the

landslide of events that climate change can lead to: dislocation of great population

masses due to sea level rises, contributing to the already existing refugee problem,

extreme weather events (EWE) due to alterations in the atmosphere and huge

financial implications are only a few of the predicaments humanity is bound to face

due to climate changeii.

Health is another major sector that climate change is predicted to affect

and it is surprisingly neglected when compared to others. With many

organizations such as the American Heart association pointing out the cost

climate change is to have on people’s health, the real questions is how the

international community should try to prevent the effects of climate change

and start preparing for the aftermathiii.

ZZ

18


History of the Problem

The first links between climate-change and health

The impact of climate change of health is not a recently discovered

issue. Ever since its creation, the WHO has strived towards upgrading health

systems towards dealing with environmentally borne problemsiv. When climate

change first became a known threat to the world and the first ideas for

alterations in energy usage were heard, governments were reluctant to any

policy reconsiderations with the sole argument that no evidence has shown that

climate change will impact people’s health. Even when the first reports

showing links between climate change and health were published, there was a

lot of uncertainty around experts’ estimations about those and thus little

argumentation to change governmental policiesv. It was only until recently

(roughly the past decade) that research methods of measuring climate change

effects have evolved. The WHO published its first evidence-strong study in

2002 that thoroughly listed all the potential impacts that climate change can

have on health, with a 10 page Appendix explaining how the methods (like

correlation studies between two factors) used to measure those effects had an

insignificant uncertaintyi.

After that first credible report from the WHO, the international

community entered serious discussions about addressing all the problems listed

and eventually the World Health Assembly (WHA) managed to issue the

“Resolution on Climate Change and Health” in May 2007vi . Among other

recommendations, this resolution acknowledged the fact that raising public

awareness and health promotion in terms of climate change is a needed but not

sufficient measure on its own to countering the problem. The 193 member

states signing the resolution agreed that climate change is happening whether

or not prevention measures are taken and that efforts should made towards the

creation of stress mechanisms and adaption measures rather than towards a

total revolution in energy usage. The 2007 Resolution triggered a reaction of

environment experts that reaffirmed the sad but inevitable conclusion that it is

perhaps too late to prevent climate change and that funds should be directed

towards to either delaying it at the best or to find ways to minimize its impact

on people’s healthvii. So far other major bodies and organizations of the UN

have not succeeded in passing resolutions specifically addressing the impact of

climate change on people’s health. The United Nations Environment

Programme (UNEP) has simply issued a Ministerial Report where the issues

that public health faces through Climate Change are only acknowledged and

sadly no specific solutions were proposed during the meetings of the

Programme towards this topicviii.

The Millennium Development Goals (MDGs) that were reviewed in

2015 have failed to address the issue of climate change and health, and the part

concerning the WHO only included aspects relating to availability and prices

ZZ

19


of essential medicines ix. This clearly shows how the interest in this

important global issue has again declined and how the international community

has to be reawakened towards a real threat.

Statement of the Problem

When reading about the effects of climate change on health, it is best to

address each section separately and understand how each aspect of climate

change affects the different areas of human health. In this guide, we will be

focusing on four main areas as pointed out by the 2002 WHO report on Global

Climate Change and addressed by the 2007 Resolution on Climate Change and

Health.

The effect of temperature on Cardiovascular and Respiratory Disease

The most prominent part of climate change is probably the one of global

temperature rise. Although changes in temperature have been proven to affect

health in many different ways, most evidence is gathered around

cardiovascular disease. It has been shown that there is a positive correlation

between heat levels and blood viscosity, meaning that increasing temperatures

make ones blood thicker, rendering it tougher to pump across vesselsx. This in

turn worsens the efficacy of the organism in renewing its fluid stock and

contributes to the occurrence of a condition known as heat stroke. Heat stroke

has been listed as one of the most serious medical emergencies and it occurs

particularly in the elderly population, as age is known to cause impaired body

temperature regulation, and in people whose work involves significant physical

exertion such as athletes, outdoor workers, military personnel etc. xi Heat

strokes occur mostly during EWE like heat waves and although such events are

considered rare at the moment, experts claim that even slight variations in

temperature can lead to an increase in the incidence of heat waves. The

relativity of this temperature increase is also important here, as people who live

in already warm climates are thought to have developed a higher temperature

threshold. This may potentially act as defense mechanisms for these

populations and although one might think that tropical areas are at more risk

due to severe spikes in temperature, it is colder areas that will be affected the

most as their people will experience more abrupt changes to which they will

ZZ

20


not have enough time to adapt. Cardiovascular disease is already the

leading cause of death in the world and despite the medical progress in tackling

it, the rates do not seem to be decliningxii. Apart from heat strokes that appear

to be less common, heart attacks are of big concern as well. The rising trends

in hypertension and subsequent coronary artery disease render temperature

rises even more threatening, as heat increases dehydration and lipid deposition

in vessels making a heart attack event more likely.

The demographic changes currently observed worldwide are also a poor

prognostic feature for the effects of climate change on health. The main two

problems associated with this is an increase in the aging population and

urbanization. As explained earlier, elderly are more at risk during heat-related

EWE as they deal with such changes less efficiently. Population growth is also

a linked problem as it is said to lead to more people living in urban areas,

increasing the number of people exposed to the urban island effect. This refers

to all the factors that make cities red zones of heat-related events such as heat

retention from buildings and streets, higher CO2 emission rates that worsen

cardiovascular and respiratory health etc. Last but not least, this correlation

between cardiovascular risk and rising temperatures will affect labor as well

and will have a landslide of impacts on sectors such as infrastructure,

administration etc. If working conditions of individuals worsen and put a major

risk to their health, they will be more likely to miss working days, exert poor

quality of work and lead to a decline of overall services provided.

Precipitation and its effect on water sanitation and incidence of disease

Another major consequence of rising temperature is its effect on water

temperature and precipitation frequency and intensity. The state of water-based

ecosystems greatly impacts people’s health in many ways, not solely due to the

biologically invaluable nature of water but also due to the fact that its

sanitation affects other health areas such as spread of disease and pollution.

Decreased precipitation is bound to directly affect individuals’ health, as

it will build up on the already established problem of drinking water shortages.

Developing countries will be particularly at risk from this climate change

consequence, as most already experience limited access to clean, drinking

water facilities and face all co-morbidities associated with this: i.e.

dehydration, low sanitation levels, malnutrition etc. Experts warn that people,

in attempt to find better access to water sources, will begin urbanizing virgin

coastal regions, something that will deteriorate the problem in the long-term as

it will eventually lead to subsequent pollution of the newly inhabited area’s

water as wellxiii.

An indirect impact that water temperature and precipitation frequency

might have on people’s health is a change in the population of pathogens and

their spread. Although the evidence on a clear link between climate and

pathogen behavior is not sufficient, changes in water ecosystems is bound to

ZZ

21


affect the numbers of bacterial, protozoan and fungal populations as

conditions like droughts and increased acidity (through increased CO2

emissions) are thought to be thriving ones for such organisms xiv . This

combined with the already discussed decrease in levels of sanitation, will lead

to outbreaks of water-borne diseases and potentially an increase in mortality

due to already fatal conditions in developing countries such as cholera, West

Nile Disease etc.

Climate change and malnutrition

Both of the two already addressed impacts play a combined role in the

incidence of malnutrition. High temperatures and low precipitation frequency

and intensity along with increased CO2 levels, contribute to poor crop

cultivation conditions. This will in turn lead to a decrease in yields of organic

foods that have a great nutritional value especially in areas where food is

scarce and malnutrition rates are highi. A low crop yield will also indirectly

contribute to reduced food resources, as it will cause issues with livestock,

leading to more severe nutrient depletions (e.g. protein deficiencies leading

towards life-threating conditions like Kwashiorkor, a state of malnutrition

characterized by swelling of the abdomen due to fluid leak in body tissues).

A decrease in food sources poses many indirect threats to people’s

health as well. An increase in food prices due to lower availability but

increased demand will have people making poor food choices, something

known as food insecurityxv. In an attempt to endure hunger, people will be

turning towards cheap, calorie-rich but nutrient-poor products contributing to

an elevation of medical problems such as obesity, type II diabetes etc. As

discussed earlier, climate change will contribute to an increase in the

population of pathogens, leading to agriculture professionals using more and

more pesticides and other similar chemicals to secure plantations, thus entering

a vicious cycle of worsening the rate at which climate change effects appear.

The effect on vector-borne diseases

Apart from favoring the growth of pathogens, the imminent climate

change effects are most likely going to affect the rate of incidence for diseases

transmitted by vectors such as insects. Currently there is a clearly defined

seasonal period in different parts of the world, something that helps experts

identify key period during the year, when vectors are more likely to be present

and contribute to disease transmission. An alternation in those patterns will

mean irregularities in the demographics and behavior of such vectors leading

ZZ

22


to unpredictable disease outbreaks not only in areas where such

conditions are known to thrive but also in areas where the vectors in questions

were not inhabited. For example, conditions like dengue fever and malaria are

fairly localized and medical professionals are able to diagnose such conditions

in travellers based on their travel history or originsxvi. This process will be

hindered as a consequence of climate change as these conditions might spread

to new, unexpected places of the world as a result of vector relocation.

The areas covered above are not the only ones that climate change is bound to

affect in relation to public health. During your own research you may find

other ones that are also of significant importance. The above ones are classified

as top-priority and hence they were discussed in detail to ensure your clear

understanding of them.

Current Situation

The WHO and other related bodies have identified some possible ways of

tackling and/or preparing for the adaption towards the issues discussed earlier.

Below are some key of those solutions that have already started to be

implemented or that they will need to be so as soon as possible to minimize the

effect of climate change on health. Again you are advised to not limit your

research in those solutions and use the links provided at the end to enrich your

knowledge in those and other possible solutions.

Reducing the burden of heat waves

When it comes to the incidence of EWE related to heat, the best way of

reducing their effects has proven to be the use of the so-called Early Warning

Systems (EWS). History teaches us that identifying and predicting the

incidence of a heat wave, way in advance and allowing enough time for the

preparation of masses, greatly reduces the number of emergencies and life-

threating situations as well mortality. The most severe heat wave event to have

occurred was the one in Russian Federation in 2010 where a temperature

record of 44oC occurred in the region of Yashkul in July (when normal

temperature levels were maximum 32oC in previous years) xvii . The local

weather authorities failed to predict the incidence of this event and seriously

underestimated the role pollution played in intensifying the heat wave.

Evolving weather forecast systems and studying the shifting patterns in

temperatures could help create new maps of where EWE are to occur.

Increasing public awareness with regards to adverse effects prevention is key

in the meantime between events while at the same time creating facilities for

rehydration and shelter. Long-term adaptation measures should also include

increasing green infrastructures and urban green spaces, improving the design

ZZ

23


of social care facilities, schools, other public spaces, and public

transport to be more climate-responsivexviii.

Increasing Food Security

With food demand constantly increasing as a result of population

growth, the imminent low crop yield as a result of a warmer world has to be

dealt with as a matter of priority. As measures to deal with food insecurity are

primarily of a long-term nature, member states are advised to begin investing

in such actions as early as possible, in order to ensure that appropriate stress

mechanisms and facilities are completed well in advance before adverse

situations cannot be dealt with.

As it was mentioned earlier, the existence of healthy ecosystems is vital

towards the appropriate culture of crops and thus sufficient yield of food

sources. Henceforth, experts advise member states that appropriate

management and –if needed- restoration of ecosystems should be one of the

key actions towards increasing food securityxix. This has been attempted in the

past through actions such as collaborative management of mangrove forests to

promote conservation, mitigation of climate change and alleviation of poverty

among people dependent on the mangroves and adjacent marine ecosystemsxx.

In addition to that, improving infrastructure in terms of food supply in key,

especially at times of EWE to ensure that resource deficiencies are avoided.

Other measures to increase food security may include using, eco-friendly

pesticides for the shifting populations of insects and considering alternative

energy on nutrition and foodborne illness. Such measures though call for a

combined increase in funding research and development in the agriculture

sector

Response to infectious disease risks

The measures around minimizing the effects of increased vector-borne

and other infectious diseases should focus around areas such as lowering the

exposure of individuals to vectors and sites of infection, studying and

documenting the shifts in demographics of the vectors and strengthening the

stress mechanisms during outbreaks.

Recent studies have shown that the use of air-conditioned facilities as a

measure against heat waves also plays a role in reducing vector-borne disease

incidents, probably due to decreased exposure of individuals to vectorsxxi .

Using this as a principle, member states in red-zone areas should invest in

creating appropriate facilities for endangered population to seek shelter to and

thus tackle two major problems of climate change at once.

As previous disease outbreaks show, appropriate communication

between healthcare authorities is vital when dealing with such diseases. This

requires and accurate documentation of disease patterns, for healthcare

ZZ

24


professionals to suspect and diagnose them as well as up-to-date IT

systems to ensure that international collaboration between member states is

present during pandemics. Although disease pattern recognition can be a

shifting and time-consuming process, adequate communication between

authorities can help achieve that measure faster and more efficiently.

Bloc positions

Although all member states have signed the 2007 Resolution on Climate

Change and Health and are expected to be “supporters” of measures towards

tackling climate change, it is true that priorities will vary between states. For

instance certain states will question shifting towards a non-fossil fuel energy

system due to the high cost of the alternatives and the statement of previous

reports that climate change effects are not written on stone. Developing

countries are expected to look towards several measures in terms of upgrading

and modernizing healthcare systems as well as dealing with all the issues in the

previous sections. Developed states who are not at risk of the majority of the

effects will probably not be willing to invest in the same areas like Developing

states and thus conflicts of interest and priority may appear

Questions a Resolution Should Answer

What methods of prevention can be used to mitigate the negative effects

of climate change on the health of the population

What solutions have member states already implemented when dealing

with this topic? Have those solutions proven to be effective? How can

they be improved?

What new measures need to be taken in the short- and long-term in order

to ensure the effects of climate change on health be dealt with as

successfully as possible?

ZZ

25


SOURCES

I McMichael, A. (2014). Global climate change. [online] Geneva, Switzerland: World Health Organization. Available

at: http://www.who.int/publications/cra/chapters/volume2/1543-1650.pdf?ua=1 [Accessed 13 Nov. 2016].

ii Friends of the Earth, (2013). Extreme weather events and climate change. [online] New York, New York: Friends of

the Earth. Available at: https://www.foe.co.uk/sites/default/files/downloads/extreme_weather_cc.pdf [Accessed 13 Nov.

2016].

iii Heart.org. (2016). Number of strokes increase as pollution levels rise - News on Heart.org. [online] Available at:

http://news.heart.org/number-of-strokes-increase-as-pollution-levels-rise/ [Accessed 13 Nov. 2016].

iv World Health Organization. (2016). What we do. [online] Available at: http://www.who.int/about/what-we-do/en/

[Accessed 13 Nov. 2016].

v Schneider, S. (2002). Science and Impacts. 1st ed. Washington, D.C.: Island Press, p.Chapter 2: Uncertainty and

Climate Change Policy.

vi World Health Assembly, (2007). Resolution on climate change and health. [online] Geneva, Swizterland: World

Health Organization. Available at: http://www.who.int/globalchange/climate/EB_CChealth_resolution/en/ [Accessed 13

Nov. 2016].

vii Davies, M. (2008). Climate Change Adaptation, Disaster Risk Reduction and Social Protection. [online] Brighton,

UK: The University of Sussex. Available at:

https://www.ids.ac.uk/files/IDS_Adaptive_Social_Protection_Briefing_Note_11_December_2008.pdf [Accessed 13

Nov. 2016].

viii UNEP.org. (2016). MINISTERIAL DECLARATION ON “HEALTH, ENVIRONMENT AND CLIMATE CHANGE”.

[online] Available at: http://web.unep.org/climatechange/cop22/ministerial-declaration-%E2%80%9Chealth-

environment-and-climate-change%E2%80%9D-0 [Accessed 2 Dec. 2016].

ix United Nations Development Programme, (2015). MDG Gap Task Force Report. [online] New York, New York:

United Nations, pp.4-5. Available at: http://www.un.org/millenniumgoals/pdf/MDG_Gap_2015_E_web.pdf [Accessed

13 Nov. 2016].

x Song, C. (1989). Effects of temperature on blood circulation measured with the laser doppler method. International

Journal of Radiation Oncology*Biology*Physics, 17(5), pp.1041-1047.

xi Pascal, M. (2005). France’s heat health watch warning system. Int J Biometeorol, 50(3), pp.144-153.

xii World Health Organization. (2016). Cardiovascular diseases (CVDs). [online] Available at:

http://www.who.int/mediacentre/factsheets/fs317/en/ [Accessed 13 Nov. 2016].

xiii Dwight, rH, et al., american Journal of Public Health, 2004. 94(4): p. 565-567, Dwight, rH, et al., Water

environment research, 2002. 74(1): p. 82-90, semenza, Jc, et al., lancet infectious Diseases, 2009. 9(6): p. 365

375. xiv http://www.niehs.nih.gov/, (2016). A Human Health Perspective On Climate Change. [online] Environmental Health

Perspectives and the National Institute of Environmental Health Sciences. Available at:

http://www.niehs.nih.gov/health/materials/a_human_health_perspective_on_climate_change_full_report_508.pdf


xv Cdc.gov. (2016). CDC - Climate Change and Public Health - Health Effects - Food Security. [online] Available at:

http://www.cdc.gov/climateandhealth/effects/food_security.htm [Accessed 13 Nov. 2016].

ZZ

26


xvi Douglass, rJ, et al., Vector Borne Zoonotic Dis, 2005. 5(2): p. 189-92, costello, a, et al., The lancet, 2009.

373(9676): p. 1693-1733, ebi, Kl, et al., environmental Health Perspectives, 2006. 114(9): p. 1318-1324

xvii Met Office. (2016). The Russian heatwave of summer 2010. [online] Available at:

http://www.metoffice.gov.uk/learning/learn-about-the-weather/weather-phenomena/case-studies/russian-heatwave


xviii Ebi, KL and Burton, I. Identifying practical adaptation options: an approach to address climate change-related

health risks. Environ Sci Policy. 2008; 11: 359–369

xix Watts, N. (2015). Health and climate change: policy responses to protect public health. BDJ, 219(2), pp.67-67.

xx Dulvy, N. and Allison, E. (2009). A place at the table?. Nature Reports Climate Change, (0906), pp.68-70.

xxi Brunkard, Jm, et al., emerging infectious Diseases, 2007. 13(10): p. 1477-1483, reiter, P, et al., emerging infectious

Diseases, 2003. 9(1): p. 86-89.

ZZ

27


Conference Information

When looking for information regarding LIMUN 2017 (and subsequent

editions) your first step should be to visit our website: www.limun.org.uk

LIMUN on social media

Please follow updates from us through our social media channels:

London International Model United Nations (LIMUN)

@LondonMUN

When tweeting about this year’s conference (your preparations, journey

to/from London or when live-tweeting the events during the conference itself)

–

- please use hashtag #LIMUN2017

Agenda & Rules of Procedure

The agenda for the 2017 conference is available online at

www.limun.org.uk/agenda

Since its 17th session last year, LIMUN has introduced changes to its Rules of

Procedure. The revised Rules can be accessed here: http://limun.org.uk/rules i McMichael, A. (2014). Global climate change. [online] Geneva, Switzerland: World Health Organization. Available

at: http://www.who.int/publications/cra/chapters/volume2/1543-1650.pdf?ua=1 [Accessed 13 Nov. 2016].

ii Friends of the Earth, (2013). Extreme weather events and climate change. [online] New York, New York: Friends of

the Earth. Available at: https://www.foe.co.uk/sites/default/files/downloads/extreme_weather_cc.pdf [Accessed 13 Nov.

2016].

iii Heart.org. (2016). Number of strokes increase as pollution levels rise - News on Heart.org. [online] Available at:

http://news.heart.org/number-of-strokes-increase-as-pollution-levels-rise/ [Accessed 13 Nov. 2016].

iv World Health Organization. (2016). What we do. [online] Available at: http://www.who.int/about/what-we-do/en/


ZZ

28


v Schneider, S. (2002). Science and Impacts. 1st ed. Washington, D.C.: Island Press, p.Chapter 2: Uncertainty and

Climate Change Policy.

vi World Health Assembly, (2007). Resolution on climate change and health. [online] Geneva, Swizterland: World

Health Organization. Available at: http://www.who.int/globalchange/climate/EB_CChealth_resolution/en/ [Accessed 13

Nov. 2016].

vii Davies, M. (2008). Climate Change Adaptation, Disaster Risk Reduction and Social Protection. [online] Brighton,

UK: The University of Sussex. Available at:

https://www.ids.ac.uk/files/IDS_Adaptive_Social_Protection_Briefing_Note_11_December_2008.pdf [Accessed 13

Nov. 2016].

viii UNEP.org. (2016). MINISTERIAL DECLARATION ON “HEALTH, ENVIRONMENT AND CLIMATE CHANGE”.

[online] Available at: http://web.unep.org/climatechange/cop22/ministerial-declaration-%E2%80%9Chealth-

environment-and-climate-change%E2%80%9D-0 [Accessed 2 Dec. 2016].

ix United Nations Development Programme, (2015). MDG Gap Task Force Report. [online] New York, New York:

United Nations, pp.4-5. Available at: http://www.un.org/millenniumgoals/pdf/MDG_Gap_2015_E_web.pdf [Accessed

13 Nov. 2016].

x Song, C. (1989). Effects of temperature on blood circulation measured with the laser doppler method. International

Journal of Radiation Oncology*Biology*Physics, 17(5), pp.1041-1047.

xi Pascal, M. (2005). France’s heat health watch warning system. Int J Biometeorol, 50(3), pp.144-153.

xii World Health Organization. (2016). Cardiovascular diseases (CVDs). [online] Available at:

http://www.who.int/mediacentre/factsheets/fs317/en/ [Accessed 13 Nov. 2016].

xiii Dwight, rH, et al., american Journal of Public Health, 2004. 94(4): p. 565-567, Dwight, rH, et al., Water

environment research, 2002. 74(1): p. 82-90, semenza, Jc, et al., lancet infectious Diseases, 2009. 9(6): p. 365

375. xiv http://www.niehs.nih.gov/, (2016). A Human Health Perspective On Climate Change. [online] Environmental Health

Perspectives and the National Institute of Environmental Health Sciences. Available at:

http://www.niehs.nih.gov/health/materials/a_human_health_perspective_on_climate_change_full_report_508.pdf


xv Cdc.gov. (2016). CDC - Climate Change and Public Health - Health Effects - Food Security. [online] Available at:

http://www.cdc.gov/climateandhealth/effects/food_security.htm [Accessed 13 Nov. 2016].

xvi Douglass, rJ, et al., Vector Borne Zoonotic Dis, 2005. 5(2): p. 189-92, costello, a, et al., The lancet, 2009.

373(9676): p. 1693-1733, ebi, Kl, et al., environmental Health Perspectives, 2006. 114(9): p. 1318-1324

xvii Met Office. (2016). The Russian heatwave of summer 2010. [online] Available at:

http://www.metoffice.gov.uk/learning/learn-about-the-weather/weather-phenomena/case-studies/russian-heatwave


xviii Ebi, KL and Burton, I. Identifying practical adaptation options: an approach to address climate change-related

health risks. Environ Sci Policy. 2008; 11: 359–369

xix Watts, N. (2015). Health and climate change: policy responses to protect public health. BDJ, 219(2), pp.67-67.

xx Dulvy, N. and Allison, E. (2009). A place at the table?. Nature Reports Climate Change, (0906), pp.68-70.

xxi Brunkard, Jm, et al., emerging infectious Diseases, 2007. 13(10): p. 1477-1483, reiter, P, et al., emerging infectious

Diseases, 2003. 9(1): p. 86-89.

table of content - limun · 2016-12-16 · zz 3 london international model united nations 2017...

Documents