The UK government's chief scientist, David King, has said that “climate change is the most severe problem we are facing today—more serious even than the threat of terrorism.” Yet terrorism continues to dominate the world's news media and preoccupy the thoughts of many people. James Wolfensohn, president of the World Bank, recently told an audience of representatives of business and civil society groups that the environment was on the back burner of international discussions on development.
Figure 1.
Eds A J McMichael, D H Campbell-Lendrum, C F Corvalän, K L Ebi, A K Githeko, J D Scheraga, A Woodward
World Health Organization, SFr20 (SFr14 in developing countries)/$18, pp 322 ISBN 92 4 156248 X
Email: publications@who.int
Rating: ★★★
It is perhaps time to be reminded of Hippocrates, suggests Tony McMichael, one of the editors of Climate Change and Human Health. Hippocrates related epidemics to seasonal changes in weather, writing that physicians should have “due regard to the seasons of the year, and the diseases which they produce, and to the states of wind peculiar to each country and the qualities of its waters.”
The central tenet of this book is that we must rapidly reacquaint ourselves with global environmental systems and how we depend on them. The long term good health of populations depends on the continuing stability and functioning of the biosphere's ecological and physical systems. The book is a timely reminder that the debate on global warming is shifting from a “will it or won't it happen” question to a recognition that some effect is inevitable. Even if substantial reductions in greenhouse emissions were to be made the planet would continue to warm for at least the next 50 years and sea levels continue to rise for hundreds of years, because of the time it takes for basic global systems to reach a new equilibrium. Now we urgently need to understand what the likely impacts of climate change will be and which populations are most at risk, so that global society can respond appropriately.
It is clear from the efforts of meteorological scientists, epidemiologists, and others reflected in this book that the likely impact on health of climate change is a hugely complicated and uncertain business. Much of the evidence presented is based on the third assessment report of the International Panel on Climate Change, which reported in 2001. Important influences on health will include extreme weather, changes in the transmission of infectious diseases, food production, air pollution, population displacement, and civil strife.
The people who will be hit first and hardest by climate change are, by and large, already among the poorest on the planet. For example, the panel concluded with “medium confidence” that, because of the effects on crop yields, climate change will increase the number of hungry and mal-nourished people in the 21st century by 80 or 90 million. The consequences of extreme weather differ vastly, according to populations' ability to cope. For example, cyclones in Bangladesh in 1970 and 1991 caused an estimated 300 000 and 139 000 deaths, respectively. In contrast Hurricane Andrew caused 55 deaths when it struck the United States in 1992.
Clearly, the world's poorest people are also the least able to adapt to climate change. An equitable agenda for climate change is also an agenda for development that has as a top priority the reduction of socioeconomic vulnerability.
This book has a long shopping list, much focused on research and data needs. However, the authors call clearly for adoption of the precautionary principle whereby policy makers do not wait for all the data to be in before acting to limit adverse impacts. Excellent though this book is, do not expect to be provided with a menu of actions. Although it sets out some guiding principles the difficult choices that must now be made and the “missing action” are down to all of us.