Building a global community in support of health delivery and improved outcomes in a changing climate
Climate services for the health sector are increasingly discussed as a possible contribution to improving climate-sensitive health outcomes and as a means to support climate change adaptation. However, unlike sectors such as agriculture or water management, climate information is rarely used in health decision making. An important limitation in reducing climate-related risks to health is that few health policy makers or practitioners have access to relevant and actionable climate information services. Little evidence exists in the literature relating the benefits of climate information services to the health sector.
While our discussions were global, the African continent was noted as a region of particular focus. While many African countries have seen significant economic growth since the millennium, poorer income groups (disproportionately women and girls) still remain substantially reliant on rain-fed agriculture and seasonal water resources. Their consequent vulnerabilities to inter-annual climate variability and climate change have far-reaching implications for food security, water, sanitation, communicable diseases and even hydrometerological disasters in the more extreme years. The well-being and livelihoods of many are therefore highly climate-sensitive and better information may help reduce climate-related risks. Our Colloquium prioritized the interaction of climate with malnutrition and infectious diseases, such as malaria, as well as the public health outcomes of weather disasters, such as heatwaves.
The purpose of the Colloquium was to help build a global community of health practitioners and policymakers that can use climate information as a means to support health delivery and improved outcomes in the context of a changing climate.
The meeting was sponsored by the World Health Organization, including WHO – Special Programme for Research and Training in Tropical Diseases, the World Meteorological Organization, the Global Framework for Climate Services, the World Bank Group, the Nordic Development Fund, the International Development Research Centre, the CGIAR research programs on Climate Change, Agriculture and Food Security and Agriculture for Nutrition and Health, and the Earth Institute. It brought together experts from governments, humanitarian agencies, development organizations, U.N. agencies, research centers and universities. Â We are exceedingly grateful to all who contributed and participated in the meeting for sharing resources, expertise, ideas and, most of all, passion to making a difference to the lives of individuals around the world who suffer from climate-sensitive health issues, such as malaria in Tanzania, Zika in Brazil, micronutrient malnutrition in Bangladesh or heat stress in India.
Madeleine C. Thomson
International Research Institute for Climate and Society
The Earth Institute, Columbia University
Patrick L. Kinney
Mailman School of Public Health
Wednesday, June 8, 2016 (Day 1) – Climate Information to the Serve the Health Community
9:00am – 9:45am Setting the Scene
9:00 – 9:15 Welcome: Lisa Goddard, Director, International Research Institute for Climate and Society (IRI)
9:15 – 9:30 Welcome Address: Linda Fried, Dean, Mailman School of Public Health (MSPH)
9:30 – 9:45 Keynote Address: Keith Hansen, World Bank Group (WBG)
9:45am – 10:30am Opening Remarks
9:45 – 9:50 Sponsor Agencies Introductions: Madeleine Thomson, IRI
9:50 – 10:00 Video Address: David Nabarro, United Nations
10:00 – 10:08 Climate information needs of the Health Sector: Diarmid Campbell-Lendrum, World Health Organization (WHO) and Daniel Buss, Pan American Health Organization (PAHO)
10:08 – 10:16 Climate information needs of the Agriculture and Nutrition Community: John McDermott, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)
10:16 – 10:22 Climate information needs in the context of EcoHealth: Bernadette Ramirez, World Health Organization â€“ Special Programme for Research and Training in Tropical Diseases (WHO-TDR)
10:22 – 10:30 Climate services for health WMO/WHO: Joy Shumake-Guillemot, WHO/WMO-Global Framework for Climate Services (GFCS) and Anahit Hovsepyan, WMO
11:00am – 11:15am Climate Information for Public Health Action: Madeleine Thomson, IRI
11:15am – 12:30pm Climate Observations and Monitoring Products
11:15 – 11:20 Moderator: Brad Lyon, University of Maine
11:20 – 11:35 Chris Hewitt, U.K. Met Office
11:35 – 11:50 Tufa Dinku, IRI
11:50 – 12:30 Panel and audience discussion with Adugna Woyessa, Ethiopian Public Health Institute (EPHI); Rene Salgado, President’s Malaria Initiative (PMI); Patrick Kinney, MSPH
2:00pm – 3:30pm Seasonal and Sub-Seasonal Climate Prediction Products
2:00 – 2:05 Moderator: Joy Shumake-Guillemot, WHO/WMO-GFCS
2:05 – 2:25 Carlos Perez, NASA Goddard Institute for Space Studies (NASA GISS)
2:25 – 2:45 Simon Mason, IRI
2:45 – 3:30 Panel and audience discussion with Peter Dazsak, EcoHealth Alliance; Perry Sheffield, Mount Sinai; Susan Rumisha, National Institute for Medical Research (NIMR-Tanzania)
4:00pm – 6:00pm Near-term and Long-term Climate Scenarios
4:00 – 04:05 Moderator: John McDermott, CGIAR A4NH
4:05 – 4:20 Lisa Goddard, IRI
4:20 – 4:35 Radley Horton, NASA GISS
4:35 – 4:55 Brad Lyon, University of Maine
4:55 – 5:40 Panel and audience discussion with Kristie L. Ebi, University of Washington; Bruce Wilcox, Global health Asia and Mahidol University; Peter McElroy, Centers for Disease Control and Prevention (CDC)
5:40pm – 07:30pm Reception and Book Launch – Featuring Book Launch: Joy Shumake-Guillemot, WHO/WMO-GFCS
Thursday, June 9, 2016 (Day 2) – Case Studies and Tools
9.00am – 10.30am Modeling Methodologies/Case Studies: Climate and Nutrition, Disasters and Infectious Diseases – Part 1
9:00 – 9:05 Moderator: Juli Trtanj, National Oceanic and Atmospheric Administration (NOAA)
9:05 – 9:25 Lisa van Aardenne, Climate System Analysis Group, University of Cape Town
9:25 – 9:45 Ãngel Muñoz, NOAA Geophysical Fluid Dynamics Laboratory (GFDL)/Princeton University & Anna Stewart, State Universirty of New York (SUNY) Upstate Medical
9:45 – 10:05 Jeff Shaman, MSPH
10:05 – 10:25 Ruth Defries, Dept. of Ecology, Evolution and Environmental Biology (E3B), Columbia University
11.00am – 12.30pm Modeling Methodologies/Case Studies: Climate and Nutrition, Disasters and Infectious Diseases – Part 2
11:00 – 11:05 Moderator: Moses Bockarie, Liverpool School of Tropical Medicine
11:05 – 11:25 Paul Simon Gwakisa, Nelson Mandela African Institute of Science and Technology (NMAIST)
11:25 – 11:45 Delia Grace, International Livestock Research Institute (ILRI)
11:45 – 12:05 Mary Hayden, National Center for Atmospheric Research (NCAR)
12:05 – 12:25 Kim Knowlton, Natural Resources Defense Council (NRDC)
2:00pm – 3:30pm Integration of Tools
2:00 – 2:05 Moderator: Pietro Ceccato, IRI
2:05 – 2:20 Pietro Ceccato, IRI
2:20 – 2:40 Allison Lieber, Google Earth Engine
2:40 – 3:00 Matthew R. Lamb, MSPH
3:00 – 3:30 Panel and audience discussion with Wafaa El-Sadr, MSPH; Kacey Ernst, University of Arizona; Alex de Sherbinin, Center for International Earth Science Information Network (CIESEN), Columbia University
3:30pm – 4:00pm Rapid Fire Presentations
4:30pm – 6:30pm Poster Session & Reception w/ Videos from the TDR IDRC Research Initiative
Keynote Address by Jeffrey Sachs, Earth Institute
Friday, June 10, 2016 (Day 3) – Training and the Donor Perspective
9:00am – 11:00am Education and Training
9:00 – 9:05 Moderator: Patrick Kinney, MSPH
9:05 – 9:20 Kim Knowlton, NRDC / MSPH
9:20 – 9:35 Gilma Mantilla, Pontificia Universidad Javeriana, Colombia
9:35 – 9:50 Ana Bucher, World Bank Group
9:50 – 10:30 Panel and audience discussion with above speakers
11:00am – 12:30pm The Changing funding Landscape for Health and Climate
Moderator: Madeleine Thomson, IRIPanelists: Sarah Molton, Wellcome Trust; Monserrat Meiro-Lorenzo, WBG; Thierry Baldet, International Development Research Centre (IDRC)
12:30pm – 1:00pm Concluding Perspective
Patrick Kinney, MSPH and Madeleine Thomson, IRI
Video Interviews with Conference Organizers and Attendees
What’s the Biggest Issue at the Intersection of Climate and Health?
Why Did People Attend the Colloquium?
The Evolution of Climate and Health
Where Do We Go from Here?
A series of introductory addresses set the stage for the colloquium
Welcome: Lisa Goddard, Director, International Research Institute for Climate and Society (IRI)
Lisa Goddard welcomed the participants to the colloquium and IRI, giving a brief background on IRI’s mission and making note of the institution’s 20th anniversary. She emphasized that IRI exists to help society better understand, anticipate and manage the impacts of climate in order to improve human welfare, prioritizing developing countries and vulnerable populations. Goddard also highlighted the need for continued, international collaboration in order to drive practical innovations that support better health outcomes in the context of increasing climate-related risks.
Welcome address: Linda Fried, Dean, Mailman School of Public Health (MSPH)
Linda Fried joined Goddard in welcoming participants to the colloquium. She presented a brief history of the School of Public Health, highlighting its 100-year existence and its programs and curricula on Climate and Health, while drawing attention to its mission of protecting and promoting the health of populations. She also emphasized the need for continued collaboration, research and practice with IRI and other like-minded organizations in order to mitigate, adapt to and build resilience against the health effects of climate change. She called upon the audience to remember when the journal Lancet deemed climate change as the biggest global health threat of the 21st century. Dean Fried noted that the growing number of health consequences of climate change (e.g. asthma, infectious disease, food insecurity, etc.) are driving an urgency to act; but she also acknowledged the challenges institutions will face in order to mobilize, gain understanding and prepare solutions through the nexus of climate and public health science and research.
Dead Fried concluded her address by underscoring the importance of President Obama’s First Summit on Climate and Health in 2015, Mailman’s new National Institutes of Health-funded training on Climate and Health, the Global Consortium of Health Professionals and Students—a legacy of the 21st Conference of the Parties meeting (COP21) and outcome of the summit—and the Health and Climate Colloquium.
Keynote address: Keith Hansen, Vice President for Human Development, World Bank Group (WBG)
Keith Hansen began his address by also drawing attention to the landmark climate agreement of COP21. He stressed the World Bank Group’s priority in addressing climate change through climate-smart development and the newly adopted Climate Change Action Plan for 2020. In addition to increasing financing to deliver climate benefits, the WBG plan aims to expand access to high-quality hydro-meteorological data and early warning systems and improve climate and epidemiological data collection for planning in the health sector. After providing some examples of the extreme weather events associated with climate change, Hansen stressed the importance and relevance of the colloquium in building the bridge between the climate and health communities. He continued by affirming the need to train a new generation of health decision-makers who could be as comfortable with climate data as with epidemiological data. He concluded his address by emphasizing how transformational a climate-smart movement within the health community could be.
Sponsor Agency Remarks
Madeleine Thomson briefly introduced David Nabarro, anecdotally calling on her memories of him as a lecturer when she attended Liverpool University, and highlighting his accomplishments which include his various roles as advisor to the United Nations including Special Envoy of the Secretary-General on Ebola (2014-present); Senior Coordinator for Avian and Pandemic Influenza (2005-2011); Coordinator of the Movement to Scale Up Nutrition (2011-2015); Special Representative of the Secretary-General for Food Security and Nutrition (2009-present). He is also currently the Special Advisor to the United Nations on 2030 Agenda for Sustainable development.
Video address: David Nabarro, United Nations
David Nabarro began his address by hailing 2015 as a historic year of successes for multilateralism, citing the adoption of the Sendai Framework for Disaster Risk Reduction, the 2013 Agenda for Sustainable Development (SD) and the Paris agreement on climate change. He explained that the adoption of the SD agenda by UN member states equated to the recognition of the sustainable development goals as universal, indivisible and interlinked. Nabarro asserted that the linkage between climate change and health was vital and demanded urgent attention. In particular, he called attention to three key areas of concern: (1) air pollution, (2) vector-/water-borne and zoonotic diseases and (3) food security and nutrition. He later referred to the 2015 Lancet Commission on Health and Climate Change by stating that tackling climate change could be the greatest global health opportunity. But he immediately acknowledged that this could only be accomplished with accurate data to understand the nature, scope and complexity of the problem. Since 2015, the World Health Organization has been collaborating with the UN Framework for Climate Change Secretariat to prepare climate change and health country profiles. He ended his keynote by asking participants to engage in constructive discussion to raise the profile of climate and health. He also stressed the need for accurate and comprehensive climate information to inform global and national health policies.
Climate information needs of the health sector: Diarmid Campbell-Lendrum, World Health Organization (WHO) and Daniel Buss, Pan American Health Organization (PAHO)
Diarmid Campbell-Lendrum explained that WHO has been active in the climate change space for some time, producing the first report on Climate Change and Health 27 years ago. Since that time, there has been rapid expansion in collaborations and partners. Campbell-Lendrum also referenced the Paris Agreement and celebrated it as the most important public health agreement of the century, with “The Right to Health” displayed on the first page of the document and with health being integrated into climate action. Yet, he was dismayed in the small amounts of climate funding that is currently allocated to health, especially given that environmental impacts are not seen as public health crises. Campbell-Lendrum then spoke about WHO’s 3-tiered action play that included (1) raising awareness in climate and health; (2) building evidence for promoting health by reducing risks (e.g. country profiles) and assessing whether interventions are working and (3) implementing action and systematic climate resilience. He closed his speech by speaking about the timeliness and relevance of the colloquium, but spoke of the constraints the WHO faces in implementation due to a lack of capacity development in using climate information.
Having just joined PAHO four months prior as Advisor on Global Environmental Changes, Daniel Buss admitted he was still learning PAHO’s comprehensive and expansive agenda, including the three last COP conventions, biodiversity and health with the United Nations Development Corporation, and various topics related to the sustainable development goals. However, he stressed the need for PAHO to work in an intersectoral way and beyond the health sector (i.e. health with all policies approach vs. health in all policies approach). Buss stated that PAHO is currently working to rebuild and redesign its plan of action on climate change (next five years) around (1) the root cause of climate change related to emissions and pollution; (2) the direct effects of climate change (e.g. heat and cold waves); (3) vector ecology and distribution, prioritizing Zika and (4) disaster mitigation and adaptation plans. He concluded by expressing his excitement for the colloquium while hoping to gain best practices and more insight for regional intersectoral work.
Climate information needs of the agriculture and nutrition community: John McDermott, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)
John McDermott took a moment to explain that that CGIAR is comprised of a network of donors who support 15 research centers around the globe, promoting sound research within the nutrition and health space. He also emphasized that the CGIAR could have a unique position to work with the climate and health community to build long term research agendas and partnerships, as well as leverage already established infrastructures in Africa, Asia and other countries. McDermott mentioned that in the last five years, A4NH had starting looking at research in climate change, nutrition and health and asked themselves what agriculture systems could do to support the research. He also spoke about A4NH’s interests in attending this colloquium to begin conversations in (1) the convergences between agriculture and infectious diseases, (2) how to shape agricultural intensification in order to manage water and livestock and (3) closing the gap between predictions and forecasting to improve preventions and responses.
Climate information needs in the context of EcoHealth: Bernadette Ramirez, World Health Organization: Special Programme for Research and Training in Tropical Diseases (WHO-TDR)
Ramirez described the current joint effort between WHO-TDR and Canada’s International Development Research Centre that supports research and capacity building towards understanding the population health vulnerabilities to vector-borne diseases, with the expectation of increasing resilience under climate change conditions in Africa. She highlighted that the research initiative is committed to an ECOHEALTH approach, that is holistic, intersectoral and transdisciplinary. The WHO-TDR/IDRC research initiative is expected to contribute to the development and strengthening of stakeholder capacity and ownership, cross-sectoral dialogue and coping mechanisms to assess and mitigate population health vulnerabilities to vector-borne diseases in the context of climate change in Africa. She concluded by recognizing the strong link between health and climate. But, she also noted the challenges related to accessing appropriate climate services and raised the question, “How can we expect to adapt to climate change without understanding climate?”
Climate services for health: Anahit Hovsepyan, WMO and Joy Shumake-Guillemot, WHO/WMO-Global Framework for Climate Services (GFCS)
Anahit Hovsepyan of the World Meteorological Organization firstly expressed her thanks to IRI and the Mailman School of Public Health for inviting her to speak and for hosting the colloquium. She then affirmed that WMO was pleased to help fund the colloquium due to the importance of climate and health. In addition to the numerous examples of WMOâ€™s multilateral activities, she explained that the vision and mission of WMO is to provide world leadership and expertise in international cooperation in the delivery and use of high-quality, authoritative weather, climate, hydrological and related environmental services by its members, for the improvement of the well-being of societies of all nations.
Joy Shumake-Guillemot, who leads the WHO/WMO joint office for Climate and Health in Geneva, started with an overview of the Global Framework for Climate Services, explaining that the WMO created the GFCS in 2009 after the World Climate Conference. The mission of GFCS is to bring the partners together under a common agenda to help improve the availability, access and use of climate and weather information in the five climate-sensitive areas of water, energy, agriculture and food security, disaster-risk reduction and health. And although WMO spearheads GFCS, the initiative is implemented by the UN, World Bank, WHO, government agencies such as NOAA and technical institutes such as the IRI. She emphasized that by implementing a common agenda and coordinating the investments for climate services, GFCS strives to accelerate and improve the use of climate information for society in developing countries.
Shumake-Guillemot stated that the GFCS Health Programme responds to a series of priority needs to bring climate and health communities together via partnerships, connecting experts to national-level needs, linking research with operational needs, increasing learning and capacity, sharing experiences and merging technical and research needs for climate services to the health sector. She stressed that the GFCS Health Programme is helping to mainstream climate information, products, and services (e.g. early warning systems and climate-informed integrated surveillance systems) to improve the core business of the health sector, detect diseases, prepare for emergencies and ultimately save lives.
Climate information for public health action: Madeleine Thomson (IRI)
Madeleine Thomson offered an introduction to climate information for public health action in order to frame the discussions and presentations of the colloquium. To start, she provided past and present global examples of the threat that climate poses to health. She then explained how this accounts for public health professionals being justly and increasingly concerned about the potential impact of climate variability and change on health outcomes. Protecting public health from the vagaries of climate requires new working relationships between the public health sector and the providers of climate information. She explained that the Climate Information for Public Health Action initiative at the IRI was designed to increase the public health community’s capacity to understand, use and demand appropriate climate data and climate information to mitigate the public health impacts of the climate. She then spoke briefly about engaging the health sector and climate community in the creation of evidence for policy and practice. Thomson concluded her presentation by highlighting how health outcomes could be improved through climate information.
Session: Climate Observations and Monitoring Products
Chris Hewitt: Global climate observations and monitoring products
Abstract: Climate information is increasingly being used to aid decision-making, and climate services are being actively developed by a range of organizations for a growing number of users and applications worldwide. Climate observations and climate monitoring products are an essential component of most, if not all, climate services: they are essential for assessing climate vulnerability and for scenario planning, as a baseline for assessing any changes in the future, for developing and evaluating climate models used in predictions and projections and for initialising climate predictions. This talk will introduce the global climate observing system, highlighting the mix between new technology (such as satellites) that provides a relatively global picture but only for the past few decades, compared with much longer records from in-situ observational systems which are not global in coverage. The discussion will provide example sources of information and describe measurements from weather stations, estimates from satellite data and gridded products, including global reanalyses blending observations with state-of-the-art weather forecast models. Finally, international data exchange policies will be briefly described, with a move towards making more data more freely available.
- Climate observations and monitoring are essential components of climate services for a range of sectors
- For the health sector, there are potentially useful global records from a range of sources (long weather records, satellite measurements, gridded products, re-analyses)
- There is a growing movement towards making more data more freely available
Tufa Dinku: Enhancing National Climate Services for use in health decision-making
Abstract: The Enhancing National Climate Services (ENACTS) effort focuses on the creation of reliable climate information that is suitable for national and local decision-making. Data availability is improved by blending national observations with satellite and other proxies. Data access and use is improved by providing online tools which allow for data visualization, downloading data and training users; the online tools are also integrated into the National Meteorological Services’ web pages. The ENACTS approach has five major components:
- Building technical capacity at the National Meteorology Agency to generate and use climate information;
- Generating time series of at least 30 years of rainfall data and 50 years of temperature data for every 4 km grid across each country;
- Customizing and installing the very powerful IRI Data Library at the National Meteorology Agencies;
- Developing an online mapping service providing user-friendly tools for the analysis, visualization, and download of climate information products and
- Facilitating engagement with stakeholders on the use of new products and services, training them on available tools, as well as incorporating their feedback and requirements into further product development.
The ENACTS approach overcomes traditional barriers in data quality and access. The spatially and temporally continuous datasets allow for characterization of climate risks at a local scale, and offer a low-cost, high impact opportunity with major potential to support climate-resilient development. Making this type of climate information available to the health community supports a suite of solutions that can shore up development gains and improve the lives of the most vulnerable in the face of climate variability and change.
- Climate data collected by national meteorological agencies are the foundations for all kinds of climate services.
- There have been significant challenges to availability of and access to climate data, particularly in Africa.
- ENACTS helps national meteorological agencies overcome these challenges by combining all available national observations with globally available proxies.
Panel: Climate Observations and Monitoring Products
Moderator: Brad Lyon, University of Maine
Additional panelists: Adugna Woyessa, Ethiopian Public Health Institute (EPHI); Rene Salgado, President’s Malaria Initiative (PMI); Patrick Kinney, Columbia University Mailman School of Public Health (MSPH)
The speakers and panelists highlighted the importance of data availability, noting that the lack of weather stations and full-time series data in developing countries poses challenges. Patrick Kinney commented that in developing countries, where data analyses can have the most impact, the data are not available. There is also a need for cross-collaboration with respect to acquiring and making historical data accessible. Currently, evaluating the climate impacts at the national level is extremely difficult due to limited data availability.
The importance of communicating climate information was also an emergent theme of this session. To communicate this information to a broader audience, there needs to be a common language and a simple medium of presenting evidence. A simplified, common language will facilitate fluid communication between providers of climate products and users. A shift in the mindset is required to embrace the epistemology of climate. Rene Salgado noted that climate tools need to be made simple for non-technical users to make use of such tools.
Questions from the audience concerned the number of weather stations, data availability and quality, low-cost technology, as well as engagement with the private sector. With respect to weather stations, audience members were interested in the cost of expanding the network of weather stations in Africa as well as tradeoffs between expanding the network of low-cost weather stations versus having a high-quality data network in which data can be automatically uploaded. Tufa Dinku pointed out that it is not a matter of just installing more weather stations in Africa but that the countries have to have the capacity to maintain the stations. Further, installing more weather stations does not address the issue of data gaps in historical data. Chris Hewitt noted that there are data in non-digital formats (e.g., paper records) that can be used to fill in gaps in the historical data. Brad Lyon highlighted the importance of identifying the questions that need to be answered and the data needed to answer those questions when considering relying on weather stations or a data network that automatically uploads data. Chris Hewitt noted the challenge of being able to use data that varies in method of collection and quality in forecast models for reanalysis. Engaging with the private sector was noted as an opportunity, although it raises concerns regarding data ownership, costs to access data depending who owns the data, and data sharing practices, all of which need to be examined and addressed.
Session: Seasonal/Sub-Seasonal Climate Prediction Products
Joy Shumake-Guillemot: How to get reliable and fit-for-purpose information about the seasonal climate?
Abstract: Once we know what problem we are trying to solve, its timescale and its spatial dimensions, it is often difficult to locate the right forecasting product. In addition, knowing how to trust the product and tailor it sufficiently to be useful to operational health program managers needing to plan ahead (up to several months in advance) is a challenge. The session will explore experiences using extreme heat forecasts for health action plans, how the 2015 El Niño was used to inform malaria control in Tanzania and the use of environmental information in addition to climate information.
- Climate forecast products are rarely useful straight off the shelf—a partnership to tailor products to the right variables and formats is often needed.
- Sometimes technically feasible forecast products are not yet available simply because they haven’t been requested.
Carlos Pérez García-Pando: Informing public health decisions with weather and climate information and forecasts
Abstract: The goal of disease early warning systems (EWS) is to provide health authorities and the public with information on the likelihood of an outbreak in a particular location, with the additional aim to enable actions that mitigate potential harm. While surveillance of early cases can provide predictive certainty for many diseases, typically it does not allow enough lead-time to undertake relevant mitigation actions.
The feasibility of disease EWS partly depends upon reliable weather and climate forecasts, whose inherent characteristic is the increase of predictive uncertainty with lead-time. During the first part of my talk I will give a basic introduction on the current status of forecast products for lead times of a few hours to several weeks. Longer prediction horizons are addressed in other talks.
The implementation of EWS for many diseases is also challenged by uncertainties in the relationship between climate and disease, the relative influence of other factors and the lack of observational data (both epidemiological and environmental). I will use the second half of my talk to illustrate some of these challenges using the case of meningococcal meningitis in Sub-Saharan Africa, where response to meningitis epidemics is based on weekly incidence thresholds at the district level. I will review recent research and practice seeking to improve the epidemic response strategy of national ministries of health in the meningitis belt of Africa.
- Better understanding and managing the increase of weather/climate predictive uncertainty with lead-time is key to develop disease early warning systems.
- Sub-seasonal climate forecasts are operationally available and have potential for health decision making over the next decade. Because this time scale is relatively unexplored, uncertainty is large and products may evolve rapidly, a strong and constant interaction between the climate and health communities is required.
- The case of meningococcal meningitis epidemics in sub-Saharan Africa illustrates many of the challenges that hamper the implementation of operational disease early warning systems. These challenges include gaps in knowledge, lack of data, interventions changing over time and institutional misalignments.
Panel: Seasonal and Sub-Seasonal Climate Prediction Products
Moderator: Joy Shumake-Guillemot
Additional panelists: Peter Dazsak, EcoHealth Alliance; Perry Sheffield, Mount Sinai; Susan Rumisha, National Institute for Medical Research (NIMR-Tanzania)
The panelists were unanimous in considering data availability and quality to be a priority issue, as the effectiveness of climate services depends on the quality of the data that underpin them. Better data availability and a commitment to understanding past data are crucial both to improving climate forecasting capabilities and understanding health risks. In many countries, data exist on paper records and must be digitized. Susan Ramisha highlighted a digitization program for malaria data which is currently underway in Tanzania. Simon Mason pointed out how the IRI’s ENACTS program is helping to complete historical climate data series in Africa.
The panel also emphasized that there are still many aspects of the relationships between climate and health outcomes that are not well understood, and that more research is needed to explore these. Perry Sheffield stressed the importance of basic analyses to demonstrate where climate drivers are adversely affecting health, before any preventive action can be taken. Susan Ramisha cited another example from Tanzania, where historical analyses of rift valley fever and rainfall data in Tanzania, completed in 2014, were used to issue health warnings in 2015. She emphasized that much can be built from a basic understanding of these linkages. Peter Dazsak pointed to research opportunities to exploit the relationship between climate drivers and wildlife behavior to improve our understanding of diseases like Ebola.
Downscaling vs. “right-scaling” was a topic of some debate among the panelists and the audience. The initial premise of the discussion, that there is a mismatch between the coarse scale of available seasonal climate forecasts and the fine local scale at which health related decisions are taken, was put forward by the moderator, Joy Shumake-Guillemot and reiterated by Susan Ramisha. This was picked up by Simon Mason, who encouraged representatives from the health community to consider the full range of spatial and temporal scales at which decisions are taken. Peter Dazsak asserted that the onus was on the health community to find where the available climate information could be useful to them. From the audience, Adrian Tompkins (ICTP) asserted that the apparent mismatch of information need not be an impasse. He advocated for combining available seasonal climate information, to provide general guidance on regional decisions, with local health data to target specific interventions in places where analyses have shown that risk is likely to be elevated.
The discussion about the scale of climate information highlighted a persistent communication problem regarding the uses of seasonal forecast information. Adrian Tompkins challenged the panel to suggest what needs to be done to close this information gap. This turned the conversation towards partnership building, a key priority area highlighted by moderator Joy Shumake-Guillemot. For Peter Daszak asserted that it is about ensuring that the right people are at the table. Trying to communicate details about forecast skill to a stakeholder who is unconvinced that climate information could be useful or relevant to them will lead nowhere. Where there is motivation to act, there is interest in learning and the challenges of communicating complex scientific information are greatly reduced. This brought the discussion back to the importance of data availability and analysis, and of building the case for action by demonstrating the linkages between climate and health.
Session: Near-term and Long-term Climate Scenarios
John McDermott: Introduction to session on near-term and long-term climate scenarios
- Infectious disease emergence and change associated with climate will increase. In low- and middle-income countries, much of this will be associated with agriculture.
- Dietary transition and food system change in low- and middle-income countries will be major drivers of health status and climate in the coming decades.
Lisa Goddard: Climate time scales: What’s all that noise? And, why is it getting louder?
We experience the climate year by year, as a single entity, but that climate is influenced by a collection of phenomena. Those all come together in the climate we experience, much like different beats within a song. Climate change and decadal and longer-scale natural variability together are both perceived as trends, and together yield periods of accelerated, decelerated, or even sign-changing trends. One example of this is the expectation of wetter conditions in eastern Africa, which has experienced frequent drought conditions since the late 1990s—droughts that research has tied to decadal-scale natural variability.
Year-to-year variability on top of slower climate change can lead to the more extreme seasonal conditions. For most parts of the world it is this interannual climate variability that dominates what we experience. We have seasonal forecasts to predict year-to-year conditions, but those only go out a few seasons. We have climate change projections for the end of the 21st century, but those are of limited value on timescales of 5-20 years. Decadal-scale predictions currently constitute a gap. However, considerable research is underway in the international climate research community to make those predictions better and more useable. In the meantime, statistical methods that can characterize interannual-to-decadal scale climate may provide useable information to aid resiliency and planning efforts.
Several opportunities are identified for research and development of appropriate climate information that can help the health community better plan, prepare and build resilience within the communities where they work. These include: (1) consideration of the timescales of decisions and plans, and the magnitude of shocks that could hit over that time span; (2) examination of the “recent trends,” which may be over just the last decade or last several years, and how those compare to expectations and (3) work across disciplines to identify what information can be brought in to address needs and expectations.
Radley Horton: Climate Change, Extreme Events, and Human Health
- Quick mention of emerging/important topics related to extreme temperatures, like joint correlation with humidity, air quality, risk of power failure, urban heat island, etc.
- A couple of degrees of warming can mean huge changes in many types of extreme events of relevance to the health community.
- A brief temperature mortality case study from the climate projections perspective. Description of typical GCM methods, and an explanation of how temperature extremes at the far tails could end up looking quite different than the GCM projections that underpin these types of analyses.
Brad Lyon: What Question, Which Data, Why it Matters to Ask
Abstract: Connecting health outcomes to climate variations and climate change is best handled by an interdisciplinary team of investigators. Examples of some of the challenges in making such linkages are provided by considering some seemingly straightforward health-related questions and the different approaches and climate data used in attempting to address them. These examples revolve around the malaria community and are focused on the region of Eastern Africa, but the implications are applicable regardless of the health question considered or geographic location to which it applies. In addition to issues surrounding data and analysis approaches, the examples highlight inherently different time and spatial scales of climate variability and connections between local changes in a global context.
- Know thy data: if it involves climate, involve a climate scientist.
- Consider the dimensions of the question being addressed in time and space.
- Be cognizant of the actuality that the climate varies on multiple time scales simultaneously.
Panel: Near-term and Long-term Climate Scenarios
Moderator: John McDermott, CGIAR A4NH
Additional panelists: Kristie L. Ebi, University of Washington; Bruce Wilcox, Global Health Asia and Mahidol University; Peter McElroy, Centers for Disease Control and Prevention (CDC)
The speakers highlighted that climate variability works across various timescales (i.e., sub-seasonal, interannual, decadal, climate change) and that all of these timescales should be considered together. However, Lisa Goddard stressed that interannual variability is by far the most important scale with respect to decision-making as it is the year-to-year variability that is important for what people experience. Thus, it is important to consider the timescales of decisions to identify the climate information most appropriate for the questions and decisions of interest. Radley Horton discussed the importance of small shifts in mean conditions. He noted that small shifts in average conditions can have profound impacts with respect to the frequency of extreme events, with increasing frequencies and non-linear impacts that present greater risks. He also stressed that the impacts of extreme events operate over multiple timescales and thus there may be longer-term health impacts in addition to the more immediate impacts. Brad Lyon discussed the importance of matching data to the questions being asked with respect to timescales and also spatial scales. He called for cross-disciplinary collaboration to address challenges at the health-climate interface, taking advantage of an “unprecedented opportunity” to link weather and climate data to information in the health community.
The panelists, both in their discussion and response to audience questions, acknowledged the link between climate and health, but also explained that climate impacts on health may act secondarily to other issues such as development, population growth and urbanization. Kristie Ebi stressed that uncertainty in the development sector presents a major challenge and that thinking about different development pathways may help decision-makers manage the health impacts of these various processes. Thus, while development, population growth and urbanization both impact and are impacted by climate change, it is important to consider whether climate is a necessary variable to consider when addressing challenges in the health sector (e.g., malaria, disease emergence).
The need for transdisciplinary work involving climate and health and the need for climate scientists to work with health practitioners both domestically and internationally was also highlighted. Bruce Wilcox asserted that we need to revise how we think about health and the climate-health nexus and frame problems from a systems perspective since health issues are ultimately complex systems. Audience members, however, expressed concern that such transdisciplinary work and complexity could make it challenging to act. Finally, the need for funding was identified as an obstacle to the continuing and scaling up work in the field of climate and health.
A special event to launch “Climate Services for Health-Case Studies”
Photographs of the launch party for Climate Services for Health: Improving public health decision-making in a new climate
Thursday, June 9, 2016: Case Studies and Tools
Session: Modeling Methodologies/Case Studies
Nutrition, Disasters & Infectious Diseases – Part 1
Lisa van Aardenne: Climate and Tsetse – Exploring the effect of climate variability and change on vector biology, population dynamics and distribution in the Zambezi Valley
Abstract: The vector of African trypanosomiasis is the tsetse fly (Glossina spp). There is strong evidence that temperature influences key aspects of the biology and population dynamics of the tsetse fly, such as the rates of larval production, pupal development, abortion and mortality among young and mature adults. The Rekomitjie research station in the Zambezi Valley, Zimbabwe has recorded data on past changes in tsetse abundance along with daily weather values over the last 50 years. These two datasets provide evidence on how gradually increasing temperatures influence the tsetse fly population size and highlight the role of extreme season or weather events in causing the tsetse fly population to crash. These datasets, along with climate change information, also makes it possible to move towards the development of models that predict how tsetse distribution and abundance might be affected under various climate change scenarios.
Ãngel Muñoz and Anna Stewart: Towards a ZIKV climate-health service at the Latin American Observatory
Abstract: After Zika virus (ZIKV) was declared a Public Health Emergency of International Concern by the World Health Organization in February 2016, the Latin American Observatory, an informal regional partnership aimed at improving climate- informed decision-making services, joined efforts with allied research institutes to design and co-produce a set of tools that (a) fully considers the contribution of climate as a partial driver of the disease seasonality, (b) uses the most updated health and socio-economic information relevant to the problem, and (c) integrates these different components in an action-oriented, easy-to-use and freely-available web interface that permits the users to assess both present and expected conditions that could affect ZIKV-sensitive populations in the Americas. Here we introduce and discuss the already online first version of this novel climate-health service.
Jeff Shaman: Forecasting infectious disease outbreaks
Abstract: Dynamic models of infectious disease systems abound and are used to study the epidemiological characteristics of disease outbreaks, the ecological mechanisms affecting transmission and the suitability of various control and intervention strategies. The dynamics of disease transmission are non-linear and consequently difficult to forecast. Here, we describe combined model-inference frameworks developed for the prediction of infectious diseases. We show that accurate and reliable predictions of seasonal influenza outbreaks can be made using a mathematical model representing population-level influenza transmission dynamics that has been recursively optimized using ensemble data assimilation techniques and real-time estimates of influenza incidence. Operational real-time forecasts of influenza and other infectious diseases have been and are currently being generated.
- Forecast of influenza and other infectious diseases is possible with leads of up to 10 weeks.
- The methods used for generating these forecasts are analogous to the methods used for generating numerical weather predictions.
- There are many potential public health applications for infectious disease forecast.
Ruth DeFries: Climate-resilience and nutrition from cereal crops: Case study in central Indian Highlands
Abstract: This case study examines the trade-offs and synergies between climate-resilience and nutritional yields for monsoon cereal crops in the central Indian Highlands. We estimate nutritional yields for protein, energy and iron and examine the sensitivity of yields to monsoon rainfall and temperature. Rice, the dominant crop in the region, is the least land efficient for providing iron and most sensitive to rainfall variability. Sorghum and maize provide high nutritional yields while small millet is most resilient to climate variability. Multiple climate data sets provide fairly consistent results. No single crop is superior for all objectives (climate resilience, nutrition, and price) in this region. Instead, understanding which crops, or combinations of crops, are most suitable requires identifying household-, community- and region-specific priorities coupled with empirical analysis that considers multiple objectives.
- Climate-resilience and nutrition are both components for healthy agriculture.
- Rice, the most dominant crop, is less resilient to variability in monsoon precipitation and provides less nutrition per hectare than other cereals (millet, sorghum, maize) in this study area.
- No single cereal crop provides highest nutritional yield and climate resilience. Choices involve trade-offs.
- Empirical analysis with multiple climate data sets is needed to support planting decisions and agricultural investments.
Panel: Modeling Methodologies/Case Studies: Nutrition, Disasters & Infectious Diseases – Pt. 1
See the video embedded at the top of this page.
Session: Modeling Methodologies/Case Studies
Nutrition, Disasters & Infectious Diseases – Part 2
Paul Simon Gwakisa: Predicting vulnerability and improving resilience of the Maasai communities to vector-borne infections: an ecohealth approach in the Maasai Steppe ecosystem
Abstract: Distribution of tsetse flies is profoundly affected by changes in climate and land use/cover. These changes are exacerbated in the Maasai steppe by close interactions between humans, domestic and wild animals. We have shown that tsetse fly abundance varies with season and temperature, with G. swynertonni and G. m. morsitan abundance peaks differing from G. pallidipes peaks. Further, there was limited relationship between fly species abundance and temperature variation. The generalised linear mixed (GLMM) effect model indicated significant negative relationship between maximum temperature and vector abundance across habitats. The highest tsetse catches were recorded in the woodland-swampy ecotone habitat and lowest in riverine, where G. pallidipes was significantly abundant. Molecular analysis of over 4500 tsetse flies over a period of 15 months revealed a 5.6% overall prevalence of trypanosome infections, which varied by season and location. The most prevalent trypanosome species was T. vivax while T. congolense and T. brucei were least abundant. DNA sequencing of blood meals from caught tsetse flies revealed a diversity of hosts including ostrich, buffalo and humans. Further analysis of 1002 cattle DNA samples revealed a prevalence of 17.2%, with 5% of these being T. brucei infections, which could be human infective. We are currently developing an ecohealth partnership on trypanosomiasis control through collaboration with Maasai opinion leaders and early adopters in order to reduce vulnerability and enhance community resilience.
- We show temporal and spatial variations of tsetse flies and trypanosome infections. The results allow simulation of tsetse fly abundance for future predictions and designing of appropriate vector control regimes.
- Tsetse fly distribution amongst habitats and different land cover allow us to designate potential hotspots of infection and hence targeted control for African Trypanosomiasis in the Maasai steppe.
- Three trypanosome species, T. vivax, T. congolense and T. brucei were found in that order of abundance in both tsetse flies and cattle. Although no human-infective trypanosomes (T. b. rhodensiense) were detected in over 4,000 tsetse flies (and 1,000 cattle), presence of human DNA in blood meals from tsetse flies suggests that Maasai communities in Simanjiro district are vulnerable to African Trypanosomiasis. Human activities and social and ecological factors may be confounding reasons for this finding in the Maasai ecosystem.
Delia Grace: Climate change, animal infectious disease, and poverty
Abstract: Livestock are extremely important to the global economy and to rural livelihoods. There are an estimated 38 billion livestock in the world, most (81%) in developing countries. Around one billion poor farmers keep livestock, many of them women. Livestock disease probably kills 20% of ruminants and more than 50% of poultry each year. Climate change can exacerbate disease in livestock, and some diseases are especially sensitive to climate change. Among 65 animal diseases identified as most important to poor people, 58% are climate sensitive. Climate change may also have indirect effects on animal disease, and these may be greater than the direct effects.
Moving from general to specific we present a case study from south-east Asia. The Mekong is a hotspot for human, animal and plant disease, and some of the most important are highly sensitive to climate and climate changes. Better tackling climate-sensitive disease requires better information and tools. We have identified a portfolio of climate-based information systems that target important diseases and are used successfully in other countries, and we are conducting action research to adapt them for Vietnam/Laos and ensure delivery through partnerships.
Working in a one health paradigm, the project targets human, animal and plant diseases:
- Developing and piloting a real-time prediction system for leptospirosis and Japanese encephalitis in people and animals in Vietnam and Laos.
- Adapting weather-based forecasting for aflatoxin mitigation in Vietnam.
- Climate service and early warning system for rubber plantations in northern Laos.
- Extremely poor availability of epidemiological (and ecological) data in LMIC and lack of laboratory and epidemiology capacity hinders control.
- Numerous pathways through which climate can influence disease, and numerous other factors some more important than climate.
- Most climate-sensitive diseases are multi-host so transmission dynamics are stable and control difficult.
- Joint occurrence of climate sensitive diseases in common landscapes makes control difficult.
- Some of the most promising opportunities are:
- Invest in “no regret” adaptation responses.
- Improve disease surveillance and response in order to detect changes in disease in a timely way, thus dramatically reducing the costs of response.
- Increase the capacity to forecast near-term occurrence of climate sensitive diseases, and to predict longer-term distribution of diseases
- Improve animal health service delivery
- Support eradication of priority diseases where economically justified
- Increase the resilience of livestock systems by supporting diversification of livestock and livelihoods, and integrating livestock farming with agriculture
- Adopt breeding strategies focused on identifying and improving breeds that are better adapted to the environment and disease
- Manage land use changes in climate-sensitive way
Mary Hayden: Enhancing Surveillance for Plague in NW Uganda
- Plague is a highly virulent zoonotic disease that can be treated successfully with inexpensive antimicrobials.
- Although plague occurs worldwide, the overwhelming burden is in rural, impoverished areas of sub-Saharan Africa where the case fatality rate is high and access to health care is limited.
- Interdisciplinary collaborations among climate scientists, epidemiologists and behavioral scientists are necessary to reduce the burden of disease.
- In northwest Uganda, an ongoing interdisciplinary project is aimed at reducing risk of plague through use of ensemble weather and climate data coupled with epidemiological data and a successful training module bringing together traditional healers and clinicians.
Kim Knowlton: Building Climate Resilience in Indian cities with heat action plans
Abstract: Extreme heat and reducing heat vulnerability has been an entry point for further discussions of how to enhance climate resilience. Sharing international experiences and best practices helped change the initial perception among project stakeholders that heat was not a significant health threat, along with building a local evidence base on heat’s effects on health.
Engaging with local public health and medical practitioners to build the evidence base and raise awareness was invaluable, providing trusted messengers who could engage a wide network of government stakeholders to create a coordinated response when heat waves are forecast. International knowledge exchange forums have proven essential to build trust, gain familiarity with issues and methods, and to share ideas about how to overcome challenges to implementation of heat early warning systems.
The development of Ahmedabad’s Heat Action Plan (HAP) created demand in other cities for similar, tailored plans. Seeing the demand in the public health user community for longer-term met/climate forecasts then fostered collaborative dialogue between the health and climate/met communities that has proven essential to scaling HAPs to other cities. Deep engagement around the HAPs by city and state leaders has built health capacity, increased government coordination, raised public awareness, helped establish a stronger climate-met-health dialogue and created new opportunities for improving municipal health and resilience to climate change.
Panel: Modeling Methodologies/Case Studies: Nutrition, Disasters & Infectious Diseases – Pt. 2
See the video embedded at the top of this page.
Session: Integration of Tools
Pietro Ceccato: Integration of Tools
- Ministries of health need to integrate different data sources on climate, environment, population, infrastructure and epidemiological data in order to create evidence showing the interactions between diseases and external factors that influence diseases.
- Tools already exist to access different data sources, but there is a need to create a framework that will help national ministries of health to integrate the different data sources and help them improve their decisions based on informed evidence.
Allison Lieber: Google Earth Engine: Health applications of Google’s Cloud Platform for big earth data
Abstract: The volume of satellite and other Earth data is growing rapidly, as is the urgent demand for information that can be derived from such data to inform decisions in a range of areas including food and water security, disease and disaster risk management, biodiversity and climate change adaptation. Google’s platform for planetary-scale geospatial data analysis, Earth Engine, grants access to petabytes of continually-updating Earth and climate data, programming interfaces for analyzing the data without the need to download and manage it, and mechanisms for sharing analyses and results for data-driven decision making. This talk will describe Earth Engine and other Google tools and planetary-scale examples such as global monitoring of forest loss and gain and global surface water availability. On a more local scale, multiple sources of data can be combined and deep stacks of temporal imagery analyzed to estimate crop yield, malaria risk and street-level air pollution.
- Earth Engine is a cloud-based data warehouse for massive Earth observation and derivative data such as environmental, climatic and demographic data.
- Earth Engine performs parallelized computations for quick global-scale analysis.
- Earth Engine integrates with existing tools and can power new decision support tools.
Matthew R. Lamb: DHIS-2 Opportunities Combining Health Systems Information with Global Measures
- DHIS-2 is an open-source, flexible database platform in use by many ministries of health and international NGOs to collect health services information at the facility level.
- DHIS-2’s flexibility can enable health facility information to be combined with global information at the national or subnational level to assess relationships between environmental indices and health outcomes.
- ICAP extensively uses DHIS-2 in our capacity as a President’s Emergency Plan for AIDS Relief (PEPFAR) implementing partner, to assist country programs and ministries of health to collect health information among patients seeking HIV care services.
Panel: Integration of Tools
Moderator: Pietro Ceccato, IRI
Additional panelists: Wafaa El-Sadr, MSPH; Kacey Ernst, University of Arizona; Alex de Sherbinin, Center for International Earth Science Information Network (CIESEN), Columbia University
The speakers in this session presented various tools and platforms to access climate, environmental, population and epidemiological data that can be used to inform and improve decision-making with respect to health. Pietro Ceccato discussed, within the context of both malaria and the Zika virus, how a decision-maker needs access to climate, environmental population, and infrastructure data as well as an integrating method or tool to be able to make informed decisions. He also stressed that epidemiologists have a key role to play in analyzing the available data to assist in the decision-making process. He highlighted the IRI Data Library and Google Earth Engine as two tools that can serve to integrate across these various data types.
Allison Lieber further described Google Earth Engine’s capabilities with respect to health applications, such as malaria risk mapping and analyses of global surface water (important with respect to vector breeding habitat). The purpose of Google Earth Engine is philanthropic in nature and the tool is intended not only to accelerate science but also to support decision- and policy-making. Matthew Lamb discussed the DHIS-2 open-source software platform for managing health information. The database system allows users (e.g., ministries of health) to integrate and visualize data and provides a pathway for moving information from the patient interface up to the national level where decisions are made.
The speakers all highlighted the opportunities that these tools provide for integrating climate and health data, but they also noted challenges to designing and using these tools such as access to data, reliability and accuracy of data, getting users to trust the data, ensuring that the appropriate infrastructure is in place to make sure the data is continually updated and ensuring that countries have the capacity to use the tools. The panel members continued this thread, discussing both the opportunities and challenges to using tools that integrate climate and health data. Kacey Ernst discussed the challenges of data acquisition in designing a community-based participatory surveillance app for monitoring diseases transmitted by Aedes mosquitoes. However, she recognized an opportunity to use the application to link climate and health by both receiving and providing climate data (e.g., precipitation or water storage) to inform decision-making, inform communities of climate-related health risks and reduce the spatial patchiness of precipitation data.
Wafaa El-Sadr expressed sentiments similar to those in other panels regarding the importance of identifying what data is telling us, why we need a given set of data and how the data can be used to inform decision-making, resource allocation and responses to health threats. She also highlighted an additional intersection of climate and health beyond immediate impacts, indicating that information on weather events (e.g., floods) could be useful in examining access to health facilities during such events and the associated health outcomes.
Alex de Sherbinin explained that all of the tools and applications discussed rely on openly accessible data and that there needs to be education on data sharing and its benefits, particularly given that there are confidentiality concerns with respect to health data. He also noted that there are questions of uncertainty, indicating that the number of groups developing data integration tools is expanding and the number of estimates resulting from data analyses is increasing. Thus, there is a need to be able to compare these estimates, verify the results and ensure that decision-makers understand and can use the data. This point was further stressed by noting the need for training, capacity building and empowering in-country decision-makers to access information and take action.
Twenty-three posters presented
Twenty-three posters were presented during the reception and poster session on Day 2. Those that are available online are linked below.
Vector: virus-microclimate surveillance and research platform for dengue control in Machala, Ecuador. Mercy J. Borbor-Cordova, Efraín Beltrán Ayalab, Washington B. Cardenas, Timothy Endy, Julia L. Finkelstein, Christine A. King, Renato Leoni, Ángel G. Muñoz, Raúl Mejía, Mark E. Polhemus, G. Cristina Recalde-Coronel, Sadie J. Ryand, Anna M. Stewart-Ibarra
Weather and climate change impacts on human mortality in Bangladesh. Katrin Burkart, Corey Lesk, Daniel Bader, Radley Horton, Patrick Kinney
Mapping Climatic and Non-Climatic Determinants of Malaria in Malawi for Designing Transmission Reduction Tools. James Chirombo, Rachel Lowe, Dianne J. Terlouw, Jonathan M. Read, Pietro Ceccato, Madeleine C. Thomson, Peter J. Diggle
Optimized and Scalable Climate Data Services. John del Corral, M. Benno Blumenthal, Michael Bell, Remi Cousin, Haibo Liu
Enhancing National Climate Services to Support Climate-Resilient Development in Africa. Tufa Dinku, Remi Cousin, John Del Corral, Rija Faniriantsoa, Madeleine Thomson, Igor Khomyakov, and Audrey Vadillo
CHICAS: Geospatial Health Informatics Capability. Emanuele Giorgi
Predicting Vulnerability and Improving Resilience of the Maasai Communities to Vector-Borne Infections: An Ecohealth Approach in the Maasai Steppe Ecosystem. Paul S. Gwakisa, Mary Simwango, Happiness Nnko, Anibariki Ngonyoka, Linda P. Salekwa, Moses Ole-Neselle, Anna Estes, Isabella Cattadori, Peter Hudson, CoFRSE
Vulnerability and Resilience to Malaria and Schistosomiasis in the Northern and Southern Fringes of the Sahelian Belt in the Context of Climate Change. Brama Kone, Mouhamadou Chouaïbou, Sid’Ahmed Dahdi, Dieudonné K. Silue, Emmanuel L.J-C. Esso, Yves N. Tian-Bi, Gilbert Fokou, Hampaté Bâ, Moussa Keita, Ousmane Bâ, Ibrahima Sy, Grégoire Y. Yapi, Emmanuel Tia, Mohamed Dosumbia, Tanoh A.S.R. Nkrumah, Constant Gbalegba, Richard K. M’bra,, Jeanne-d’Arc Koffi, Aboudramane Kaba, Honorate Ballé, Moussokoro Sidibé, Cheikh M. Seyed, Giovanna Raso, Benjamin G. Koudou
Towards a ZIKV Climate-Health Service at the Latin American Observatory. Ãngel G. Muñoz, Xandre Chourio, Madeleine C. Thomson, Anna Stewart, Patricia Najera-Aguilar, Rémi Cousin
The Impact of Climate on the Current and Future Prevalence of the Ae. aegypti Vector in Brownsville, Texas. Kelly L. Neel and Jennifer Vanos
TDR-IDRC Research Initiative: Population Health Vulnerabilities to Vector-Borne Diseases: Increasing Resilience under Climate Change Conditions in Africa. Vectors, Environment and Society, Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, SWITZERLAND; and the International Development Research Centre, Ottawa, Ontario, CANADA
TDR-IDRC Two Worlds Divided: Bridging the Gap between Research and Policy. Vectors, Environment and Society, Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, SWITZERLAND; and the International Development Research Centre, Ottawa, Ontario, CANADA
The WWRP/WCRP Sub-Seasonal to Seasonal Prediction Project (S2S). Andrew Robertson
Climate Variability and Malaria: A case of Punjab, Pakistan. Sobia Rose, Muhammad Faisal Ali, Muhammad Ashfaq
Long-Lead El Niño Forecast Information to Support Public Health Decision Making. Desislava Petrova, Rachel Lowe, Anna Stewart-Ibarra, Joan Ballester, Siem Jan Koopman, Xavier Rodo, Xavier Rodo
Malaria Early Warning System for Uganda using ECMWF weather forecasts to drive a dynamical malaria model. Adrian M Tompkins, Felipe Colon Gonzalez, Francesca Di Giuseppe, and Didas Namanya
Constraining the Relative Uncertainty of Malaria Simulations due to Climate Spatial Heterogeneity and Dynamical Malaria Model Parameter Specification. Adrian M Tompkins and Madeleine Thomson
Use of Vectorial Capacity in Describing and Forecasting of Malaria Cases in Kericho, Kenya. Israel Ukawuba, Madeleine C Thomson, and Peter J Diggle
Population Vulnerability, Ecological Risk Factors And Resilience To Climate Sensitive Vector-Borne Diseases In Baringo County, Kenya. B. Estambale, I.K. Nyamongo, S. Bukachi, G. Ong’amo, F. Oyieke, M. Nanyingi, C. Oludhe, D. Olago, J. Oyugi, F. Amimo, E. Juma, C. Loye, C. Omondi, D. Kobia, A. Ochieng, I.M. Ondiba, E. Mutua
Research Uptake in Support of Outcomes: How five projects analyzing the impact of climate change in vectors disease epidemiology have used their finding to influence change. Julius Nyangaga, Salafina Nyagah, and Simran Dhadialla
Trypanosomiasis: Modeling the Effects of Increasing Temperatures on Tsetse Population Dynamics and Distribution. John Hargrove, Glyn Vale, and Lisa van Aardenne
Social, Environment and Climate Change Impacts on Vector-Borne Diseases in Arid Areas of Southern Africa. MU Chimbari, S. Mukaratirwa, P. Furu, and Mabisa Researchers
by Jeffrey Sachs, Earth Institute, Columbia University
Jeffrey Sachs gave his last speech as Director of the Earth Institute in the informal setting of the Colloquium’s poster session. He spoke at length about the significance of the sustainable development goals, their emergence from the millennium development goals and the new challenges posed to development by a more difficult political and economic climate. The audience was highly engaged and asked a number of challenging questions. Dr. Sachs was able to draw on his extraordinary breadth of experience and knowledge to respond in detail to the questions posed.
Friday, June 10, 2016 “Training and the Donor Perspective”
Session: Education and Training
Kim Knowlton: Building a global consortium on climate and health education
Abstract: Health professionals need to connect with experts from the climate sector to become familiarized with the data tools that are available at appropriate time and spatial scales. Inter-sectoral training between health and climate practitioners is essential. Creating hubs of combined research, educational training and practice can establish arrays of global climate-health centers of excellence. Key areas of overlap in which public health practitioners apply climate data include heat-health early warning systems, air pollution alerts and planning responses to storms, among others. These events have enormous public health impacts that are likely to worsen under climate change.
The Mailman School of Public Health at Columbia University is taking the lead in organizing the Global Consortium on Climate & Health Education, a network of schools of public health that will serve as an international forum to share model curricula and best scientific practices to assess the health impacts of climate change. The Consortium will provide climate-health information via:
- free MOOCs to reach wider audiences;
- short courses on health and climate change for mid-career professionals and
- academic curricula for public health and medical schools that bridges the climate data/health application divide.
Mitigation of climate change provides substantial health benefits today through reduced air pollution, physically active lifestyles and healthy diets. Public health considerations need to be built into climate mitigation and urban planning systems. With leaders and practitioners who understand how climate services and health communities interact, we can build global capacity to create a healthier, more climate-secure future worldwide.
Gilma Mantilla: In-country training and education
Abstract: When addressing topics as interdisciplinary as climate and public health, it is important that all stakeholders understand each other’s needs. Those working on the climate side need to have an understanding of the types of information and products that the public health sector needs, and try to tailor information accordingly. Similarly, public health workers must have a basic understanding of climate science and its implications for their field, as well as the various types of climate information available and how it can be applied.
To address these challenges, there is a need for greater integration across the field of climate and public health, supported by enhanced education and training, and access to the data, methodologies and tools that are necessary to bridge this gap.
In this presentation we will focus to understand that in order to put together a training course you need to know what knowledge you want to deliver, to whom, when, where, why and how. Based on this scheme we will present the experience of in-country training developed by IRI and how some universities in Colombia are incorporating climate as an issue in their undergraduate and graduate programs of medicine and public health.
- Putting together a training course is a process which requires to know in advance what knowledge you want to deliver, to whom, when, where, why and how to do it.
- It is critical to develop more local climate and public trainers to build local evidence of how climate influences public health outcomes
- Incorporating climate into undergraduate curricula could help universities to provide a more holistic and systematic approach when developing a degree.
- It is important to move from research to implementation of best practices in undergraduate and graduate courses. This will require students to focus on problem analysis, knowledge applications and cooperative work around real-world and relevant issues.
Ana Bucher: Innovation in training and capacity building for Climate Services
Abstract: Under its new Climate Change Action Plan, the World Bank is committed to increase climate-related lending activities in an effort to integrate climate resilience in development operations. A successful integration requires increased sharing of evidence-driven knowledge and capacity building activities in relation to climate change. Several initiatives have been developed to facilitate the outreach and uptake of existing climate related knowledge with the objective of raising awareness and supporting decision making processes. Examples of successful engagements include the use of online tools that facilitate the outreach to thousands of practitioners. The use of Massive Open Online Courses (or MOOCs) in the World Bank was tested with the release of the flagship “Turn Down the Heat” Series report which helped bring important climate related issues, including health, to policy makers and concerned citizens. The course reached to nearly 39,000 people in more than 180 countries worldwide. Through the course, development practitioners reached out to renewed climate scientists and policy-makers.
The online course allowed the creation of discussion forums and stimulated collaboration via interactive learning experiences. In addition, another initiative is underway with the development of e-learning modules to promote the development and understanding of weather and climate services that support climate-smart development. The course, which depicts a value chain approach for such services, will be launched soon. The use of online tools and MOOCs represents great opportunities to elevate the climate change and health agenda and ensure evidence-based and actionable knowledge is at the fingertips of decision makers.
- The use of online tools and MOOCs represents a great opportunity to elevate the Climate Change and Health agenda with development practitioners.
- Online tools allows the creation of discussion forums and stimulates collaboration via interactive learning experiences.
- Climate change and health education/capacity building activities need to ensure evidence-based and actionable knowledge is shared and made available at the fingertips of decision makers.
Panel: Education and Training
Moderator: Patrick Kinney, Columbia University Mailman School of Public Health (MSPH)
Patrick Kinney initiated the session on education and training by discussing the need for training a new generation of practitioners in both climate science and public health who understand each other’s language, who can work with each other’s data, and who can advance the evidence and knowledge base underlying interventions and informing decision-making and research.
The session highlighted various models of education and training, from more traditional graduate-level training to short courses to Massive Open Online Courses (MOOCs). Kim Knowlton discussed scaling up MSPH’s graduate global training in public health via a global consortium on climate and health. The consortium will consist of a global network of educational hubs with the purpose of sharing knowledge with communities outside of MSPH and IRI and creating an environment of sustained support and investment for research, transdisciplinary work, and practice. She highlighted the outreach potential of such a consortium as a means to inform policy-making and decision-making with respect to the benefits and consequences of projects and programs designed to address the nexus of climate and health (e.g., health impacts, adaptation, mitigation). Knowlton also discussed the importance of mainstreaming climate and health into planning efforts (e.g., energy, community, urban) to create climate-resilient communities and advance community health and well-being.
Gilma Mantilla described an in-country, short course education and training program developed with IRI for a range of audiences including professionals, decision-makers, students, the general public, and communities. When designing a short course or training, Mantilla stressed the importance of clarity with respect to what is being taught (content), why it is being taught (framework), identifying the target audience, identifying the scale of interest (e.g., global, regional, local), the format of the education and training (e.g., face-to-face, online, combined format) and the resources available to support the training. The short course Mantilla described, which has been used in Colombia, Ethiopia, Madagascar, Uruguay and Ecuador, consists of core lectures, practical sessions, short reports and evaluations. The objectives of the course are for students to understand the role of climate in public health outcomes, learn how to use tools for accessing climate and epidemiological data that can be used for analyses and mapping, and understand how the integration of management and data can inform and improve public health decision making.
Ana Bucher discussed the World Bank Group’s use of MOOCs to train and build capacity with respect to the provision of climate services. The specific MOOC she discussed, From Climate Science to Action: Turn Down the Heat Series, was designed to reach a large number of practitioners and provide them with access to expert- and evidence-based knowledge with the objective of translating information into action. The MOOC was interactive and included sessions with climate scientists, policy-makers, and practitioners as well as discussion forums, Google hangouts, quizzes, and assignments for which feedback was provided by facilitators and peer reviewers. The MOOC engaged participants around the globe who were able to interact and share knowledge via the discussion forums.
Audience members commented on and posed questions concerning the training of climate scientists and meteorologists in learning what the public health community’s priorities and needs are; reaching additional audiences such as communities in low and middle-income countries, advisors to policy-makers, and statisticians; and ensuring that trainings incorporate examples of robust climate and epidemiological data and case studies. While the speakers presented different models of education and learning, a common theme throughout the session was the need to identify what information needs to be provided, as well as how that information should be provided so that users can act on it. The need for funding to continue or scale up education and training programs was also repeatedly noted, as was the need to mainstream the nexus of climate and health throughout public health fields. Overall, the session stressed both the importance of climate and health education and training and the importance of how that education and training is framed.
Session: The Changing Funding Landscape for Health and Climate
Panel Moderator: Madeleine Thomson, IRI
Panelists: Sarah Molton, Wellcome Trust; Thierry Baldet, International Development Research Centre (IDRC); Monserrat Meiro-Lorenzo, World Bank Group
The final session and panel discussion of the colloquium provided perspectives on the investment climate in the climate and health “space” from Wellcome Trust, a UK-based, independent charitable fund, the World Bank Group, and the International Development Research Centre (IDRC), a Canadian government center that funds research in developing countries to support economic and social growth. Sarah Molton discussed Wellcome Trust’s growing interest in the impact of the environment on health and the Trust’s efforts to “map out” the interactions between human physiology and the environment from a both-systems perspective and a transdisciplinary approach. As part of this effort, Molton described the Our Planet, Our Health strategic priority, which allocates funding to support interdisciplinary research, development of cross-sectoral partnerships, policy dialogue and public engagement. She also highlighted several Trust projects that address the climate-health nexus with respect to infectious disease dynamics, nutrition and food availability. Molton further discussed the importance of partnerships, including bringing together climate scientists, economists, the private sector and the food policy sector, as well as the need for public engagement and education.
The IDRC works to support participatory action research and build networks of scientists, academics, decision-makers, community groups, and development organizations, primarily in the Global South. Thierry Baldet explained that IDRC works programmatically in agriculture and the environment, inclusive economies, and technology and innovation to effect large-scale positive change, build leaders and support partnerships to improve the lives of people living in the developing world. With respect to climate and health, Baldet highlighted both the IDRC’s Ecohealth approach and the Centre’s Climate Change Program. The Ecohealth approach takes an ecosystem approach to health, aiming to address human health problems that are linked to the environment. The Climate Change Program funds innovative research and supports partnerships and network-building to advance policies and practical solutions to addressing the impacts of climate on health, focusing on hotspots of vulnerability to climate change.
Monserrat Meiro-Lorenzo of the World Bank provided the Bank’s perspective and approach to facilitating a multi-sectoral dialogue to bring the climate agenda into the health policy discussion, as well as dialogues concerning other sectors such as agriculture and transportation. The idea is to leverage knowledge from financial and intellectual resources for development purposes and identify entry points for integrating the climate message into the health sector. Meiro-Lorenzo noted that an important link that needs to be made with respect to climate and health is that between the energy sector and the health sector—for example, supporting approaches to energy management at small-to-medium health facilities that decrease reliance on fossil fuels and reduce energy costs. She also described the CityStrength Diagnostic Tool, which has been used to assess the health impacts and cost associated with rebuilding plans to address flooding in Can Tho, Vietnam.
Although the panelists presented different institutional perspectives, they all noted that while linking climate and health is gaining traction, convincing funders of the need to mainstream climate into health programming should be a priority. This requires internal institutional negotiating, effective communication strategies, systems thinking and cross-sectoral dialogues. Translation was a key word of the session: the need to translate science and research into meaningful actions, the need to translate science and research into a language that funders and decision-makers can understand and the need to translate the political commitments to the Paris Climate Change Agreement and the 2030 Agenda for Sustainable Development into meaningful actions.
Several audience members contributed to the discussion, highlighting the need for the climate science and health community members to leverage their influence with their individual institutions to continue integrating climate and health, for funding to support projects that integrate climate and health, and the role of the international community in supporting capacity-building and decision-making with respect to climate and health in developing countries.
Madeleine Thomson and Patrick Kinney
Patrick Kinney concluded the colloquium by highlighting his perspective on the overall theme that emerged over the three days dedicated to speaking, thinking and learning about the intersection of climate and health. For Kinney, the colloquium was a “great illustration of the networks that are forming and have been forming in this field for such a long time.” These include 1) networks between academic, governmental, non-governmental and donor organizations, 2) international networks, 3) intergenerational networks, 4) educational networks and 5) research networks. For Kinney, the concept of networks was his take-away point and he expected that new networks would emerge from the colloquium as the institutions and participants continue their efforts to integrate climate and health.
Madeleine Thomson thanked the people and institutions who sponsored, presented and participated in the colloquium. She reminded the audience that “we now need to build on the discussion we had” to overcome the challenges faced by the field of climate and health and clear the way for a path forward.
Which sessions were more impactful to you and for your work?
Note: Participants allowed to make more than one choice.
- What historical climate observations and monitoring products can serve the health community? – 31.6%
- What weather, sub-seasasonal and seasonal climate prediction products can serve the health community? – 52.6%
- What near term and long term climate predictions and scenarios can serve the health community? – 31.6%
- Modeling/ Methodologies Case Studies: â€œClimate and Nutrition, Disasters, and Infectious Diseases – 36.8%
- Integration of Tools – 36.8%
- Education and Training – 47.4%
What was the single most valuable thing you learned at the event?
“The lack of connectedness in the communities sparked thoughts on how communications could bring those worlds together and increase funding.”
“Training must be in the radar of all the people involved with this issue.”
“Overall the event was very informative but the session on methodologies and data problems in health and climate was very fruitful.”
“Communications issues between climate science and health communities.”
Did you have many conversations with people outside of your field and region?
Yes – 88.9% No – 5.6%
Do you think that the colloquium will change or influence decisions your stakeholders will make in the future?
Yes – 72.2%
No – 27.8%
The Health and Climate Colloquium was co-organized by the International Research Institute for Climate and Society and the Mailman School of Public Health.
The organizers are grateful for support given by the World Health Organization, including WHO â€“ Special Programme for Research and Training in Tropical Diseases, the World Meteorological Organization, the Global Framework for Climate Services, the World Bank Group, the Nordic Development Fund, the International Development Research Centre, the CGIAR research programs on Climate Change, Agriculture and Food Security and Agriculture for Nutrition and Health, and the Earth Institute.
Madeleine C. Thomson, International Research Institution for Climate and Society
Patrick L. Kinney, The Mailman School of Public Health, Columbia University
Brad Lyon, The University of Maine
Yohana Tesfarmariam Tekeste, International Research Institution for Climate and Society
Pamela Henderson, International Research Institution for Climate and Society
Francesco Fiondella, International Research Institution for Climate and Society
Elisabeth Gawthrop, International Research Institution for Climate and Society
Aisha Owusu, International Research Institution for Climate and Society
Rapporteurs and notetakers
Dannie Dinh, Andrew Kruczkiewicz, Hannah Nissan, Aisha Owusu, Catherine Pomposi, Laura Scheske, Yohana Tesfamariam Tekeste, Cynthia Thomson, Israel Ukawuba, Cathy Vaughan, Hui Wang
Francesco Fiondella, Elisabeth Gawthrop, Tiff van Huysen, Yohana Tesfarmariam Tekeste, Aisha Owusu
Layout and production
Francesco Fiondella and Elisabeth Gawthrop
Video and photography
Elisabeth Gawthrop and Francesco Fiondella
Permalink to this report: http://features.iri.columbia.edu/healthclimatecolloquium2016
The conference was made possible through partial support provided by the World Health Organization, including WHO â€“ Special Programme for Research and Training in Tropical Diseases, the World Meteorological Organization, the Global Framework for Climate Services, the World Bank Group, the Nordic Development Fund, the International Development Research Centre, the CGIAR research programs on Climate Change, Agriculture and Food Security and Agriculture for Nutrition and Health, and the Earth Institute. The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of these organizations.
IRI 2016. Health and Climate Colloquium. International Research Institute for Climate and Society, Columbia University, New York. Web: http://features.iri.columbia.edu/healthclimatecolloquium2016