Advances in health at risk from our sick planet


OPINION:Climate change is in fact the greatest health challenge in the coming decades, outstripping bogeys such as cancer, writes JOHN GIBBONS

HOW CAN you maintain a healthy population on a sick planet? The answer is: not for very long. A report published last year by the UK’s Faculty of Public Health cautioned that all the advances in population health and increases in life expectancy achieved in the developed world over the last century are now in jeopardy.

The culprit is climate chaos. This now threatens the basic elements of human existence – access to safe water, food production and land use. “We’re facing a global health catastrophe,” faculty president Prof Alan Maryon-Davis stated bluntly. Ahead of World Health Day next Tuesday his warning needs to be taken seriously.

Though rarely addressed in mainstream media coverage of health, climate change is in fact the most acute challenge in the decades ahead, outstripping any of the 20th century’s great bogeys, such as cancers and heart disease. The key to planning for the future may lie in better understanding the past.

Up until the late 19th century, death rates in cities were so high that only the constant influx of people from the countryside prevented urban population collapse. A breakthrough in public health occurred in 1855, thanks to the observations of a London doctor, John Snow, during a cholera epidemic.

He drew detailed maps identifying clusters of the disease, and by a process of elimination, Dr Snow traced the source of the epidemic back to a public water pump in Broad Street. This was at the time a revolutionary conclusion; the pump handle was removed and the epidemic subsided.

This is widely seen as the founding event in the science of epidemiology – the study of the health and illnesses of populations. At the time of Dr Snow’s epiphany, global population was a little over one billion, with a range of deadly pathogens keeping our numbers firmly in check. Since then, largely due to dramatic improvements in public health, the worlds population has expanded more than five-fold.

As our numbers approach seven billion, humanity faces a convergence of crises.

From a public health perspective, none is more pressing than water. Every great civilisation in history has stood or fallen on its ability to access reliable sources of fresh water. Today global water systems are under severe pressure from a combination of overextraction, climate change and widespread pollution.

The Intergovernmental Panel on Climate Change (IPCC) warned that climate change is “likely to affect the health status of millions of people across the globe”. Specific risks include increased rate of heat-related and respiratory deaths and the greater spread of diseases such as malaria and dengue in a warming world.

Water and food-borne diseases, as well as deaths and displacement arising from flooding and other severe weather events are also slated by the IPCC as our constant companions in the decades ahead. The vulnerability of populations to extreme weather events is not restricted to the developing world. The 2003 heatwave in France alone caused 11,500 premature deaths. Even Ireland is becoming vulnerable to the hazards of a warming world; scientists at NUI Maynooth have mapped out how our entire eastern seaboard is facing water shortages in the next decade or two.

Already, the World Health Organisation estimates that one third of the global burden of ill health comes from environmental sources. Every year in the EU a third of a million people die prematurely as a result of air pollution.

The good news is that by tackling pollution, which is driving dangerous climate change, we will also yield dramatic improvements in health, as well as huge benefits to both industry and healthcare systems.

Achieving a 30 per cent emissions cut within the EU by 2020 could yield health savings of some €76 billion a year, a major study found. Cars, for instance, exact a massive annual health toll in accidents and air pollution, as well as enabling the sedentary lifestyle that is fuelling the obesity epidemic. Cutting car dependence means fewer accidents, cleaner air and healthier populations; the roads might even be safe enough to let your children cycle to school.

Ironically, health systems can also be a significant part of the problem. The NHS is Britain’s largest public sector polluter, producing the equivalent of 18 million tonnes of CO2 a year. It has now committed to making 60 per cent savings in its emissions (the HSE failed to respond to queries as to whether they had any similar initiatives in train).

Maintaining a functioning health system in the face of growing threats and a shrinking revenue base is a monumental challenge. To date, the people to whom you might expect to look for leadership – our senior doctors – have collectively seemed more focused on their own narrow self-interest. Given the enormous investment by the Irish taxpayer in financing doctors’ medical education in the first place, this is disappointing, to say the least.

To see how this small nation has completely lost the plot, you need only consider that almost every one of Ireland’s thousands of hospital consultants is now in receipt of in excess of the €220,000 salary paid to German chancellor Angela Merkel for the responsibility of running Europe’s largest economy. As the man in the radio ad used to shout: Dis madness must end soon!

The Age of Stupid, a film dramatising the dangers of climate collapse, premieres in the IFI, Dublin, tomorrow night