Paz s 20150709_1500_upmc_jussieu_-_room_107
Post on 20-Jan-2017
93 Views
Preview:
Transcript
Impacts of Climate Change on Vector Borne Diseases
in the Mediterranean Basin -
Implications for Preparedness and Adaptation Policy
2, Manfred S. Green2Maya Negev ,1Paz Shlomit
1Department of Geography and Environmental Studies
2School of Public Health
University of Haifa, Haifa, Israel
The Mediterranean is: • a transition zone between different climate types
• a bridge (for humans, birds and other organisms) between
continents
• populated by over 500 million people and includes 27 countries
in North Africa, western Asia, and southern Europe
• characterized by gaps in the socio-economic levels among countries
Climate Change and Vulnerability
in the Mediterranean Basin
The Mediterranean basin is a main climate change hotspot and one of the most responsive areas to global warming.
Since the 1960s, the region has become warmer, with a significant increase in the frequency, intensity and duration of heat waves.
In addition, the basin is characterized by changes in rainfall patterns and a decrease in the total amount of precipitation.
With significant gaps in the socio-economic levels among the Mediterranean countries, particularly between the North (Europe) and South (Africa), together with population density, increased water demand and political conflicts, the vulnerability of the region under changing climatic conditions is increasing.
Vector (Insect)-Borne Diseases and Climatic Factors
The ecology, development, behavior, and survival of insects and the transmission dynamics of the diseases they transmit are strongly influenced by climatic factors. Temperature, rainfall, and humidity are especially important, but others such as wind can also be significant. The same factors also play a crucial role in the survival and transmission rate of the pathogens. The main parameter is temperature. When the temperature increases, it tends to cause an upsurge in the growth rates of mosquito populations, decrease the interval between blood meals, shorten the incubation time from infection to infectiousness in mosquitoes and accelerate the virus evolution rate. Regarding rainfall – the picture is more complex: the response depends on differences in the ecosystems and the ecology of mosquito vectors.
Since the Mediterranean is undergoing a warming trend it is expected that vector-borne diseases (VBD) in the region will be influenced by climate change since extreme weather conditions influence their emergence. For part of VBD, linkages with the recent climatic fluctuations in Mediterranean countries have already been proved. For others, projections indicate that climatic suitability for the vectors will increase in new regions as a result of climate change.
Lelieveld et al., 2012
Linkage with climate change Cases in the Mediterranean
Proved Exist (e.g. Spain, Italy, Greece,
Turkey, Israel)
West Nile
Fever
The vectors exist in the northwestern
basin. Future expansion of the vector
could be further facelifted by climate
change.
Reported in several Mediterranean
countries. Most cases imported, but
local transmission occurred in
Croatia and France.
Dengue
The vectors exist in the northwestern
basin. Future expansion of the vector
could be further facilitated by climate
change.
Imported cases were reported in
several countries.
Chikungunya
Malaria vectors exists in the area.
Climate change creates the potential
for local transmission, albeit relatively
small.
Most cases imported but in 2012,
cases from Greece and France
were reported as ‘not-imported’.
Malaria
Sandflies are especially sensitive to
changes in temperature and
moisture. The potential for impact of
climate change is real.
Cutaneous leishmaniasis (CL) and
Visceral leishmaniasis (VL) exist in
the basin.
Leishmaniasis
The main VBD, transmitted by mosquitoes and potentially
influenced by the changing climate in the Mediterranean basin:
Policy Context
2010 Cancun agreements
18 of 32 European countries adopted a national strategy
90% address heatwaves, 86% address vector, food, water-borne diseases
(Boeckmann & Zeeb 2014)
Significant differences between OECD countries facing similar risks in number and quality of adaptation measures
Also similarities: negligible reference to vulnerable populations, local risks, and implementation aspects: budget and evaluation
(Panic & Ford 2013)
WHO report on implementing European framework for
protecting health from CC
The Study Aims
To analyze and compare adaptation policies in a representative
selection of Mediterranean countries, according to relevant policy
categories.
To identify existing mechanisms for regional collaboration
regarding environmental and health issues.
To suggest recommendations for VBD adaptation in the
Mediterranean, at the national and regional levels.
Typology of Health Adaptation Measures
1. monitoring and surveillance
2. Environmental management
3. Health systems preparedness
◦ infrastructure, capacity building, interventions
4. Public education
adapted from Balbus et al. (1998), in: UNEP handbook on methods
for CC impact assessment and adaptation strategies
Country
Surveillance & monitoring Environmental management Health system preparation Public education
Spai
n
Climate modeling &
future scenarios
Surveillance of VBD &
climate data
Prevention system with
vector-control programs
Quarantine of products
from endemic zones
Early warning systems
Practitioners' training
including medical
entomology, tropical
medicine, global perspective
Prevention campaigns
Inform public & tourists
on preventive
measures they can
take
Italy Constant monitoring of
population at risk
Survey & monitor increase
of vectors
Regional programs for co-
infection of HIV/leishmania
Environmental
interventions
coordinated with early
warning systems
Quarantine of imported
goods
Risk-based, early warning
systems
Preparedness & response plan
Train health professionals in
identifying priority prevention
Communication of
adaptation policy to
public
Information campaigns
Malt
a
Strengthen surveillance
Link data: environmental
& epidemiological
Further assessment of
climate change impacts on
vectors
Improve early
identification & response Risk assessment
Plan for control during
outbreaks
Address gaps in entomological
expertise
Enhance diagnostics
Education campaigns
to focus on health
impact of climate
change & aim at
changing behavior
Turk
ey
Strengthen surveillance
Identify areas at risk,
screen populations &
plan monitoring
Forecast changes in
disease patterns
Strengthen vector
control Form regional laboratories
Develop emergency response
plans
Research effectiveness
Increase capacities of health
organizations in risky areas
Guides & training to
citizens
Publishing the
adaptation plan
nationally
Isra
el
Monitoring vectors and
morbidity
Monitoring at border areas
Forecast which vectors &
hosts may pose risk due to
climate change
Strengthen local
authorities regulations
for vector control
Treat & prevent
"standing" water
Monitor vector control
Prepare for outbreaks:
identifying early symptoms,
treating diseases
annual exercise
Guidelines for professionals,
including medicine & nursing
students
Public alerts in case of
outbreaks
Public notification
regarding prevention
Guide public to spray
and report vectors and
habitats
Egy
pt
Develop a surveillance
system
Develop early detection
Establish an accessible
integrated database
Ongoing control of
mosquitoes Develop early warning systems
& control programs
Improve access to health
services
Develop research:
epidemiological, vectors
migration, prevention, vector
control, monitoring
Raise awareness on
pro-active health
measures & on
vectors and parasites
Key Findings
Many Mediterranean countries do not have adaptation plans
Of those that have a plan:
◦ All major aspects of VBD-related adaptation measures are
present in the plans
◦ Practicalities differ greatly
◦ Limited reference to the public
◦ Limited inclusion of responsibilities, regulation,
implementation, evaluation, budget
◦ There is limited adaptation in all countries, albeit the
emerging threat and lack of vaccinations
The Cross-Border Aspect
Importance in regions with diversity and political conflicts
Combating vectors
◦ VectorNet, ArboNet, WHO Western Pacific Project
Mitigating and adapting to CC
◦ Climate-ADAPT, ClimaSouth
Environmental management
◦ Mediterranean Action Plan (MAP)
Public Health
◦ EpiSouth
Lessons from MAP and EpiSouth
Enable regional cooperation and networking of experts, including countries in conflict
Improve monitoring and surveillance, policy, capacities and data-sharing
Limited capacity to decrease gaps between countries in
infrastructure, preparedness etc.
Limited consideration of needs and characteristics of Non-European countries
Recommendations - Part 1:
national levelfor the recommendations Basic
Monitoring and surveillance:
◦ Emergence, density and distribution of vectors
◦ Systematic collection of epidemiological data
Environmental management
◦ More detailed, including responsibilities and public aspects
Health systems preparedness
◦ Annual exercise and evaluation, diagnostic capacities, training, risk assessments, vulnerable populations
Public education
◦ Strengthen, involve public
Evaluation and assessment
Adopt the ecosystems approach
(Millennium Assessment, 2005)
Integrated vector management
◦ Including biological pesticides and technologies
Public participation
◦ Local knowledge
◦ Community based vector control and surveillance
Trans-disciplinary work
◦ Inter-sectoral cooperation, multilevel governance
Recommendations - Part 2:
recommendations for the national level Advanced
Recommendations - Part 3:
Regional level: The Mediterranean
Adaptation under an international, permanent and neutral body
◦ Utilization of existing frameworks
Emphasis the characteristics and needs of African, Asian and European countries in the Mediterranean
Equal accessibility and relevancy to all parties, in terms of existing infrastructure, capacities, culture and language
Conclusions
In order to deal with these potential health threats and
before the VBD develop into regional outbreaks, since
vectors may spread easily across political borders,
Mediterranean countries must develop national adaption
policy, which include strategic response.
Such policies should be geared towards both the prevention
of the disease and the management of the events that may
arise.
The unique characteristics of the Mediterranean require
developing a stable cross-border cooperation, oriented
towards building capacity in Southern and Eastern countries.
For more details:
Negev, M., Paz, S., Clermont, A., Groag Pri-or, N., Shalom, U.,
Yeger, T., Green, M.S., 2015. Impacts of Climate Change on
Vector Borne Diseases in the Mediterranean Basin –
Implications for Preparedness and Adaptation Policy.
International Journal of Environmental Research and Public
Health, 12: 6745-6770.
Thanks!
top related