Climate change and health needs more investment
Dr. Kristie Ebi on the importance of investing in climate change and health research
By Anna Palmer
Climate change is considered the biggest threat humans have ever faced. The links between climate change and health are increasingly being recognised, yet this recognition has often not been translated into resources and policies.
Dr. Kristie Ebi is a Professor in the Center for Health and the Global Environment at the University of Washington. She has been conducting research on the health risks of climate variability and climate change for over 25 years. Pioneering climate change and health research, she has brought these issues to the forefront of national and global agendas.
Climate change threatens health in a myriad of ways. Extreme weather events, such as heatwaves, storms, and floods, cause significant morbidity and mortality. Increases in temperature and climate variability can change the geographic range, seasonality, and transmission intensity of many vector-borne diseases. Reductions in crop yields, due to changes in temperature, precipitation, and air pollutants, leads to malnutrition and undernutrition. Moreover, climate change is undermining many social determinants of good health, such as individual’s livelihoods and access to health care. The World Health Organisation estimates that between 2030 and 2050, climate change will cause an additional 250,000 deaths per year from a limited set of climate-sensitive health outcomes.
Despite the progress made in climate change and health research, Dr. Ebi emphasises that there are major gaps in all areas of the field, “There are hundreds of vector-borne diseases that are potentially affected by a changing climate, and yet almost all the analyses have been on dengue and malaria. It isn’t because the others are not important. There has just not been any serious investment.”
Investments into climate change and health research have been exceedingly small compared to other areas of health. By the end of 2022, the National Institutes of Health (the United States’ national medical research agency) will spend just under $300 million USD on climate-related exposures and conditions, representing approximately 0.06% of their annual $45 billion USD budget. This is a significant increase in annual research funding over the past 15 years. Investments into climate change and health in Canada are small but beginning to increase.
Dr. Ebi explains that getting funding for climate change and health has been a challenge from the start, “Climate change started as an environmental issue, leading to the perspective in the health sector that it is not their responsibility. It has been very difficult to convince people responsible for health research and implementation budgets how critically important it is to prioritize climate change and health,” she states. “Polarisation of the issue, particularly in the United States, also is a challenge.”
Throughout her career, Dr. Ebi has supported multiple countries in Central America, Europe, Africa, Asia, and the Pacific to assess their climate-related vulnerabilities and prioritize implementation of adaptation policies and programs. She is currently working on a project developing heatwave early warning systems in South Africa and Côte d'Ivoire. “There’s many reasons to be concerned about higher temperatures and growing numbers of heatwaves in Africa,” she explains. “Exposure to high temperatures towards the end of pregnancy results in an increase in low birthweight babies. Further, outdoor workers exposed to higher temperatures have lower productivity. Few poor and marginalised people have protection from higher temperatures.”
To develop a successful early warning system, Dr. Ebi explains that there are many moving parts: “[A heat early warning system] goes beyond the broadcast meteorologist telling us that it is hot. Usually, we know that. But communities need to be prepared for actions needed to protect health and well-being when a heatwave arises. Response plans need to include all actors, not just the meteorological services and the departments of health. They need to include the trusted voices for marginalised communities, and connect with utility companies, the departments that run our infrastructure, and others.” By way of example, Dr Ebi explains how a failure to consider the impact of heat on the transportation network had detrimental consequences during the heat dome in the pacific northwest. “Portland assumed that a fair number of people would travel to their cooling shelters on their light rail system. But the temperatures were too hot for the trains to run safely. Advance preparation means heatwave early warning systems can function effectively.”
Dr. Ebi says that resources, both human and financial, are the biggest barriers to implementing climate adaptation plans. Every three years, the World Health Organisation surveys countries on their progress in addressing the health risks of climate change. Of the 95 countries that participated in 2021, only 52% reported that they have a national health and climate change plan/strategy in place, with the majority of those countries reporting they have insufficient resources to implement their plans/strategies. Dr. Ebi explains, “Climate change is something new and different for the health sector, and very few health professionals are trained in climate change and health. In addition, health systems are not resilient or sustainable, and need more investments.”
The global effects of climate change are not equally distributed, and often countries most vulnerable to climate change have contributed the least to greenhouse gas emissions. The most affected countries often have insufficient resources to deal with its impacts. Consequently, intensifying climate change will only increase global health inequities. Dr. Ebi explains, “Climate change is a stress-multiplier that will increase current and create new inequities.”
The COP27 agreement on loss and damage funding was a major advancement to helping the most vulnerable countries affected by current climate change. The aim of the fund is to provide monetary assistance to nations most vulnerable, and most affected, by climate change. Dr. Ebi states, “the agreement to have a fund is a critical step forward. There’s still a lot that needs to be done to operationalise this fund, but that was a major outcome from COP27.”
As climate change continues to worsen, more research and implementation will be needed to combat current and future health risks. Awareness of climate health risks are growing, as are the resources needed to tackle them. Dr. Ebi says, “It’s very exciting to see that climate change and health is finally a career path for early career researchers with promise of much more funding in the future. There will be significant opportunities to make advances in the next decade. It’s a good moment to enter the field.”
Dr. Kristie L. Ebi is Professor in the Center for Health and the Global Environment at the University of Washington. She has been conducting research and practice on the health risks of climate variability and change for 25 years, focusing on understanding sources of vulnerability; estimating current and future health risks of climate change; designing adaptation policies and measures to reduce risks in multi-stressor environments; and estimating the health co-benefits of mitigation policies. She has supported multiple countries in Central America, Europe, Africa, Asia, and the Pacific in assessing their vulnerabilities and implementing adaptation policies and programs. She has edited four books on aspects of climate change, has more than 200 publications, and has been an author on multiple national and international climate change assessments, including the fourth U.S. National Climate Assessment and the IPCC 6th Assessment Report and Special Report on Global Warming of 1.5°C.