Creating ‘health resilience’ in the face of climate change

San Francisco -- When Sir Richard Feachem posed a question about the relationship between universal healthcare coverage and climate change, he brought the least discussed climate-related topic at a global climate summit here into spotlight.

Universal health care (UHC) could play a big part in creating “health resilience” in the face of a changing climate, said Feachem, director of the Global Health Group at the University of California San Francisco Institute for Global Health Sciences.

A baby receives a polio vaccine at a community hospital in Ranong, a province on the border with Myanmar. Under Thailand's universal healthcare coverage plan, all children are eligible to receive vaccinations / Credit: Paritta Wangkiat

But as the impacts of climate change become more acute, with diseases spreading faster and more extreme weather posing a greater threat to communities, they healthcare system will need to come up with more responsive emergency care and be better prepared to face financial constraints.

"We're talking about healthcare resilience -- a healthcare system that can still do a good job in the face of climate change," Feachem said. That means in the face of more intense heat and more extreme weather events, such as storms, heavy floods and droughts.

Feachem spoke during a climate and health forum ahead of of the Global Climate Action Summit, an event in San Francisco that brought together international politicians, business leaders and civil society groups to discuss ways that states, cities and the private sector can work together to reduce their carbon emissions, a major factor contributing to global warming.

The impacts of climate change on human health have materialized at an alarming rate. This year is set to be the fourth-hottest year on record worldwide, with deadly heat waves across the globe forcing many people to seek hospital treatment.  

According to the World Health Organization, climate change affects air and water quality, it impacts crop growth and food sufficiency and threatens secure shelter. The WHO predicts that between 2030 and 2050, climate change will cause about 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress.

Further, the WHO estimates direct costs to health at between US$2 billion and US$4 billion (65-130 billion baht) per year by 2030.

Universal health care does not yet exist in the United States, and many patients there have to pay high fees for health care coverage. But developing countries with weak health infrastructure are often the ones most vulnerable to changing climate patterns and are likely to feel the affects more greatly.

To strengthen healthcare access, the United Nations set a goal of achieving universal health care coverage as part of its sustainable development goals. It targets low- and middle-income countries to launch UHC by 2030. The aim is to ensure healthcare access and equity for all.

“UHC can be an agent of change for climate mitigation," and an important player in climate adaptation and resilient healthcare systems, Dr. Srinath Reddy, president of the Public Health Foundation of India, said at the forum. “The healthcare system should become a very important player in providing good primary healthcare.”  

Thailand is among the developing countries that have achieved UHC, he noted. 

Introduced in 2002, tax-funded universal health care has provided free health coverage to 48 million people, accounting for 70 percent of the Thai population.

Thailand's experience in launching universal health care has led to visits by several representatives from developing countries -- India, in particular -- to learn about the scheme.

But Thailand is also highly vulnerable to extreme weather and storm surges because the majority of its population still relies on agriculture and its major cities, such as Bangkok, are located in coastal zones. The 2018 Global Climate Risk Index produced by non-governmental organization Germanwatch, ranks Thailand among the top 10 countries most affected by extreme weather events from 1997 to 2016.

The whole health system must be able to predict the health consequences of climate change country by country so they're ready to cope with the challenges, said Feachem. 

At the same time, the health care industry also adds to the problem of climate change by using electricity to power its facilities 24 hours a day. In the United States, healthcare contributes to 10 percent of all carbon emissions.

Some rural hospitals in Thailand are experimenting with the use of more energy-efficient options. In Songkhla Province in southern Thailand, Chana Hospital installed 20-kilowatt solar panels on the roof and replaced old light bulbs with LEDs. Those changes reduced the hospital’s electricity costs by one-third, encouraging some other rural hospitals to follow a similar energy-saving path.  

Investing in UHC and energy savings in health facilities in the long term would outweigh the short-term economic costs, said Natalie Linou, from the United Nations Development Program’s Bureau for Policy and Program Support.

This story was supported by the 2018 Climate Change Media Partnership, a collaboration between Internews’ Earth Journalism Network and the Stanley Foundation.