Review of research and policies for climate change adaptation in the health sector in Southern Africa
The impact of climate change is being felt across the globe, including in Southern Africa, exemplified by increased incidence of extreme events such as flooding and prolonged drought. These changes, which are partly attributable to anthropogenic activities, will have major implications on human health, ecosystems and the economies of various countries and regions.
In Southern Africa, most of the models project drier conditions as a result of increased warming. Extreme events are also projected to occur with greater incidence in some parts of the region, such as flooding in the Mozambican floodplains. The impact of climate change in the health sector in the region is projected to increase the disease burden by changing the transmission patterns of some diseases as habitat suitability for vectors changes. The incidence of food and water borne infectious diseases is also projected to increase.
This synthesis report was conducted in order to advance our understanding of progress in responding to the threat of climate change in the Southern African region, through a review of policy development and implementation, and our understanding of the linkages between climate change and health. Within the region, particular focus was on South Africa, Zimbabwe and Malawi.
The scope of the review was on three key issues: firstly, it explored the current understanding of climate change in the region and its linkages with human health, specifically focusing on the spread of food, water and vector borne diseases, as well as HIV/AIDS. Secondly, the policy response to the climate change threat in the Southern African Development Community (SADC) region was assessed, looking at the degree to which climate change policies incorporate health issues and vice versa. The third and final section of the report is a gap analysis of both information and policy responses to the role of climate change in the health sector.
This review was a desktop study that relied on extensive literature search of both peer review literature and grey literature by key institutions in the region and globally such as government ministries, the World Bank, the United Nations, the SADC Secretariat and others. Information from online sources was retrieved using keyword search terms linked to climate change and health.
The current evidence shows that the SADC region is experiencing significant impacts on health from incidences of droughts and flooding. However, there is no conclusive evidence that the recent incidences of flooding and drought are due to climate change, even though the projected impact of climate change is significant in the region.
In relation to health, there is some evidence base linking health with climate change and variability. For example, there is significant evidence that shows changes in the distribution patterns of malaria in the region. Projections show that the suitable habitat for the mosquitoes that transmit malaria will extend further south from their current geographic distribution. Incidences of water borne diseases are also on the rise, with evidence from Zambia showing an increase in incidences of diarrhoeal infection as a result of water contamination. The burden of disease due to HIV/AIDS will also increase, as exposure to some opportunistic diseases will be more prevalent in people with compromised immune systems.
The review showed that major knowledge gaps still exist in our understanding of how specific diseases will be impacted by climate change. In addition, most of the research work linking health to climate change has been conducted outside the Southern African region, so there is need for locally driven initiatives that integrate local context in understanding the impact of climate change on the health sector.
Significant progress in responding to climate change is being achieved, with various countries having developed policies and strategies. However in relation to health, the policy responses are still relatively inadequate compared to other sectors such as agriculture and water.
Most countries in the region have health policies but have not adequately incorporated climate change considerations in their implementation. In some cases climate change is recognised as a threat to the health sector, but no comprehensive strategies for managing the health impact of climate change have been developed.
The overall conclusion is that even though the issue of climate change in the health sector has become increasingly important in the region, more work still needs to be done to develop the knowledge base, mainstream health considerations into climate change policy and vice versa. Specific recommendations arising from this review include the need to improve the evidence base, the need to remove barriers to research uptake by policymakers and the need for a more coordinated approach to addressing the risks of climate change on the health sector in the region.