This WHO project supports the four Pacific Least Developed Countries (LDCs) – Kiribati, Tuvalu, Solomon Islands and Vanuatu – to enhance the capacity of national and local health system institutions, personnel, and local communities to manage health risks induced by climate variability and change.
The problem
The Pacific LDCs are among the countries most vulnerable to climate variability and change. A common problem is that existing climate-sensitive diseases are exacerbated by climate change causing high rates of illness and death.
Vulnerability assessments in these countries highlighted how climate variability and change was affecting vector/food/waterborne diseases, malnutrition and noncommunicable diseases. Disease incidence, geographic distribution and seasonality are affected by temperature, rainfall and extreme weather events.
The majority of people and health care facilities (such as hospitals and community health centres) are located near low-lying coastal areas making them highly vulnerable to cyclones, floods, storm surges, sea level rise and disturbances in water supply caused by drought or salination of aquifers.
Damage to these facilities - buildings and essential supplies/amenities including interruptions to access to water, sanitation and energy – affects their capacity to provide health care when they are most needed in emergency situations. Due to the lack of capacity and resources in the health sector, the majority of health facilities are not resilient to climate-induced pressures in terms of structural, non-structural and functional safety.
The goal
The goal of the project is to enhance the capacity of national and local health system institutions, personnel and local communities to manage health risks induced by climate variability and change in four Pacific LDCs – Kiribati, Solomon Islands, Tuvalu and Vanuatu. This goal will be achieved through on-the-ground interventions and policy-level actions, under four outcomes, as described below.
The project
The project will be implemented in the four Pacific LDCs with activities leading to four key outcomes:
Outcome 1. Governance of health system and institutional capacities strengthened by mainstreaming climate-related risk and resilience aspects into health policy frameworks
This project will support healthcare institutions and health personnel to have the capacity to fully integrate climate risk and resilience considerations into national and subnational policies, plans and regulations, and cross-sectoral coordination mechanisms related to health care.
Outcome 2. Capacities of health system institutions and personnel strengthened in managing health information and weather/climate early warning systems
This project will enhance information and early warning systems to be operated in collaboration with national meteorological services and line ministries. It will apply modern health surveillance and database management techniques, based on digitized medical records, with information overlaid with hydro-met, sectoral and spatial data.
Improved integrated surveillance and monitoring systems will be supported through training of health professionals to enable detection of trends in climate-sensitive diseases and health impacts and to identify outbreaks early enough for effective interventions.
Surveillance systems with integrated climate early warning functions will serve for carrying out preventive measures for impending health emergencies; documenting the results of interventions; and for monitoring the epidemiology of health problems. This will be key to informing public health policies and strategies. These will be pursued through innovative approaches and the application of modern technologies, such as eHealth and telemedicine, tailored to the setting of remote islands and communities of the participating Pacific LDCs.
Outcome 3. Improved coverage and quality of health services addressing climate-sensitive diseases, and reduced climate-induced disruptions in the function of health care facilities
This outcome will allow for more effective disease control practices (including disaster preparedness and response) at the community level. As an expected result, the project will help enhance health services delivery in selected high-risk communities, incorporating effective prevention and control of climate-sensitive diseases, management of disaster risks, and environmental determinants of health (such as water and food supply).
Healthcare facilities, including national referral hospitals and health centres in vulnerable communities on outer islands, related infrastructure and services, and their personnel, will be better equipped to cope with potential climate-induced hazards, undertaking preparedness and response measures.
The project will provide technical assistance for detailed and site-specific vulnerability assessments and the establishment of technical design and business/investment plans (involving cost benefit analysis ) for implementing ‘climate-proofing’ measures to enable healthcare facilities to continue to function during events such as flooding, strong winds, and storm surges affecting facilities, access, electricity and water supply functions; drought affecting water supply and quality; and extreme events causing contamination through spreading inadequately disposed hospital waste. These measures will be closely supported by enhanced information services, along with a strengthened enabling environment (policies, plans, regulations, guidelines) pursued under Components 1 and 2.
Outcome 4. Enhanced cooperation between countries to foster knowledge exchange, the provision of technical assistance and scientific advisory, and the integration of national health policy frames and related adaptation plans
The first three components of the project will be supported by this regional component coordinated through WHO and UNDP. WHO will coordinate the facilitation of exchange between countries and harmonized technical assistance and scientific advisory to allow the effective uptake and replication of the latest techniques, technology and good practices. UNDP will provide technical assistance to governments to ensure effective linkages between health sector climate change mainstreaming processes (under Component 1 and 2) and overall National Adaptation Planning processes in the countries to ensure climate change is integrated into planning across economic sectors. This outcome will also ensure the continuity of cooperation between countries on advancing the National Adaptation Plan process in LDCs.
Regional knowledge exchange is expected to result from a range of activities: i) definition of normative aspects related to climate-resilient health systems by developing regional-level guidelines, manuals and other relevant technical documents in the priority areas of intervention, as determined by countries; ii) regional capacity-building events for technical aspects of components 1-3; and iii) systematization of regional experiences and promotion of country cooperation and knowledge exchange (which may include virtual communities of practice and platforms). Country cooperation events can also serve to create catalytic partnerships and shine a light on best practices from each country in order to mobilize additional sources of financing (domestic and international) for replication and sustainability.
Partners
This project will be funded from the Global Environment Facility Least Developed Countries Fund with co-financing from the four LDC National Governments, WHO and UNDP.
WHO is the implementing agency for this project, in cooperation with Ministries of Health and Medical Services.
The future
The long-term solution for the governments of these Pacific LDCs is to have enhanced national health system and institutions with climate change risk and resilience aspects integrated into health governance, health information management and the delivery of health services. This would enable them to respond effectively to climate change impacts on health in vulnerable population groups.
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Publication - Climate change and health in small island developing states