We need to act on climate change immediately if we are to avert a human and environmental crisis in the near future, writes Prof Bob Mash of the Faculty of Medicine and Health Sciences at Stellenbosch University in an opinion article published in the Cape Times on Thursday, 26 February 2015. The same article also appeared in the Mercury under the heading Time to act on climate change is now.
The complete article, as it was published, follows below:
Two responses needed to climate change: Time for mitigation and adaptation
Imagine you take your 3-week old baby to the doctor with a suspected infection and fever of more than 38°C. Would you want the doctor to take specimens and then wait days for certainty before treating your child or would you want treatment immediately?
Most doctors would treat immediately because they know that the risk of calamity is real and if they wait it may be too late. This type of decision making, familiar to all health professionals, is what is required if we are to avert a human and planetary crisis in the coming decades.
Late last year, the Intergovernmental Panel on Climate Change (IPCC) of the United Nations (UN) published a report spelling out the expected impact of climate change on human health and social wellbeing. The Panel found that "climate change is a severe threat to future sustainable development."
We should pay attention and act right away. After all, the report represents the consensus of hundreds of scientists who have appraised the work of thousands of their colleagues from around the world.
It is expected that climate change will affect human health in three different ways. First, an increase in such extreme weather events as heat waves and storms will lead to heat stress, drought, fires, flooding and storm damage. These will have direct consequences for people's health, as well as disrupt such infrastructure as roads, power supply and health services.
Second, our natural systems will be negatively affected. There will be more allergens and air pollution, decreased food production, an increase in diseases borne by food and water, and changes to the patterns of infectious diseases.
Third, our social systems will suffer because of societal disruption, forced migration, conflict and mental stress. If we unpack these three categories, a scary picture emerges.
Access to safe water supplies for drinking and irrigation is predicted to become more difficult. This goes for both urban and rural communities. And Southern Africa will suffer more because water is already scarce here.
Crop yields in Africa are predicted to be more variable, with a decrease in coarse grains (maize, barley, sorghum) of 17-22% in the near future. The yields of such other major crops as wheat and rice are also predicted to decrease. Changes in crop yield and food prices due to extreme weather events have already been seen in Russia and the USA.
In the context of rapid urbanisation in African cities with large informal settlements that are already at risk of flooding or fire, climate change will further expose large numbers of vulnerable people. Pregnant women, people with chronic diseases, small children and the elderly will be the most vulnerable.
The effect of climate altering pollutants other than CO2, is uncertain, but 7% of the global burden of disease in 2010 was already assigned to respiratory and cardio-vascular illness resulting from such air pollution.
Diseases such as malaria, dengue fever, tick-borne encephalitis, haemorrhagic fever with renal syndrome, Lyme disease and Japanese encephalitis are seen as climate-sensitive infections. Changing climate can lead to a change in the habitat that supports the insect vectors of these diseases, and this could lead to new communities being exposed.
Climate change is just one of many human related impacts on planetary ecosystems. Others include deforestation, agriculture, road building, fishing, mining and the damming of rivers – all affecting our natural ecosystems.
Climate change is expected to have a disruptive impact on many species and their services to the ecosystem. The combination of acidification of oceans and warming of sea water will lead to a loss of fish, coral reefs and associated biodiversity.
From the above description of the risks associated with climate change one can see how these effects could lead to the displacement of populations, conflict over scarce resources and a breakdown in social solidarity.
What to do about it – that is the question. Two of the main responses are adaptation and mitigation.
Adaptation refers to the resilience of communities and their ability to handle the consequences of climate change. The ability to adapt will be related to the magnitude of climate change and its consequences.
The less we are able to mitigate or reduce greenhouse gas emissions, the harder adaptation becomes. And poor, informal and vulnerable communities will be the least able to adapt to the effects of climate change – making this a major challenge in South Africa. Without adequate adaptation, the number of malnourished children globally under the age of 5 years may increase by 20-25 million by 2050.
The health sector has a big role to play. The resilience of communities can be increased by strong primary health care and public health expertise with warning systems that alert us to impending risks. Well-functioning disaster management and emergency medical services will also be important.
Adaptation can only be successful if we are also able to mitigate ongoing greenhouse gas emissions, primarily though reducing our dependence on fossil fuels. In this regard the exploration of new fossil fuel reserves by technologies such as fracking is seen by many as unethical, because the burning of our existing reserves from more conventional sources will already take us way past safe levels of CO2 emissions.
Delays in mitigation now may mean that it is too late to avert worst-case scenarios later on. Unsustainable development is therefore a threat in terms of increased climate change and reduced resilience.
Decision makers have the complex task of shaping policies that integrate sustainability and development. Governments must balance the need for energy security (keeping the lights on), energy access (extending affordable electricity to more people) and environmental impact (avoiding the destruction of ecosystems).
Sadly, after 20 years of global dialogue on climate change, governments and other major players seem unwilling to provide the leadership required to solve this problem. One exception is the Global Green and Healthy Hospitals Network. It unites nearly 500 healthcare structures and organisations on six continents that are committed to reducing their ecological footprint and promoting environmental health.
The Western Cape Department of Health and the Faculty of Medicine and Health Sciences at Stellenbosch University are two of only a handful of African health organisations to join this initiative. This highlights the need for a global movement of professionals concerned for the health of both the planet and its 7 billion people – before it is too late.
* Professor Bob Mash is head of family medicine and primary care at Stellenbosch University's Faculty of Medicine and Health Sciences, and chairs its Green Committee.
