This project supported the development of effective plans for climate change adaptation in the health sector in low and low-middle income countries. Bangladesh, Ethiopia, Nepal and Tanzania were selected as pilot countries. Criteria for selection included: (i) high burden of disease from water and sanitation; (ii) evidence of climate-sensitivity of water-related health risks and iii) a diversity of mechanisms through which climate change is expected to affect water and sanitation, and consequently health.
The problem
Climate change is exacerbating the environmental determinants of health; WHO conservatively estimates that the climate change that has occurred since the 1970s already causes over 140,000 excess deaths each year. Evidence from previous work by the UK Department for International Development (DFID) and WHO highlights the risk to water and sanitation infrastructure from climate change and unless infrastructure and management systems are made more resilient to future climate change, the impacts on health, social and economic will be significant, and achievement of the Sustainable Development Goals (SDGs) will be undermined.
Water, sanitation and hygiene (WASH) have a significant impact on health and, of particular concern as described in the recent Intergovernmental Panel on Climate Change Special Report on Extreme Events, are the risks of more frequent and intense extreme weather events such as floods, cyclones and droughts, alongside increasing temperatures. Such extremes pose particular challenges to the capacity of WASH programmes to protect health, and there is accumulating evidence that climate change is worsening these risks.
A joint DFID/WHO review provided strong qualitative evidence that climate change will compromise the effectiveness of a significant proportion of both existing and planned water and sanitation services in many parts of the world, putting at risk human lives, economic investments, and progress towards and sustaining the achievements of the related SDGs. Despite the accumulating evidence of the cost-effectiveness of pre-emptive disaster risk management, many countries continue to fail to prioritize WASH investments as a means of increasing resilience. The international community is already investing significantly in WASH development assistance, but climate change puts the value of this investment at risk. Ensuring that current and new investments take into account the risks posed by climate change will be critical in ensuring a real and lasting difference to people’s lives and will serve as an opportunity to provide leadership in defining and implementing climate-resilient health programming.
The goal
The main outcome of the project was the creation of a clear framework for protecting health and reducing the risk of disease as a consequence of climate change in 4 pilot countries. This was achieved through transforming the way these countries integrated climate change into health programming, and now serves as the foundation to target risk reduction of climate-related disease and reduce the vulnerability of the poor in a wider set of low and low-middle income countries.
The project
DFID provided £6,850,000 to the World Health Organization over 4 years (2013-2016) from the International Climate Fund to support the development of effective plans for climate change adaptation in the health sector in low and low-middle income countries. Bangladesh, Nepal, Ethiopia and Tanzania were selected as pilot countries. Criteria for selection included: (i) high burden of disease from water and sanitation; (ii) evidence of climate-sensitivity of water-related health risks and iii) a diversity of mechanisms through which climate change is expected to affect water and sanitation, and consequently health.
The project combined both international and country-level work, where there is a greater potential to develop effective guidance based on real-world experience. Work at an international level was targeted at generating coherent climate resilient international health policy with common operational frameworks, and mechanisms for policy and technical support to health actors to engage in the definition of the health components of National Adaptation Plans under the UN Framework Convention on Climate Change.
At a national level, technical work defined and guided the implementation of: (i) a set of revised national policies on climate-resilient and health promoting policies for water management, and WASH, (ii) climate –resilient water safety plans, (iii) household interventions to enhance health resilience to climate change. Iterative monitoring and reporting of the population coverage of evidence-based and field tested packages of interventions was compared to the cost of the programmes.
Partners
The project was funded by DFID through the International Climate Fund and coordinated by WHO. Within the UK government, the programme was managed by the WASH Team in Policy Division. National agencies took ownership to ensure coherence with national policy goals, deliver on the programme outcomes, and mainstream into sustained changes in policy and practice beyond the timeframe of the programme.
The future
The project laid the groundwork for scaling up investment into climate-resilient WASH programmes that will improve and protect health. A target was set to have health adaptation plans and policies in place in 25% of LICs and LMICs by 2016.
Read More