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This book focuses on the risks that climate change poses for the health sector. It discusses the current vulnerabilities to climate-sensitive diseases, the resultant mortality and morbidity in human populations, the projected risks in connection with increasing global warming, and the options for tackling the adverse impacts of climate change. Adapting to climate change so as to effectively address the risks for and adverse impacts on the health sector requires an in-depth understanding of current deficits in health sector preparedness for climate-sensitive illnesses, as well as future plans and programs for increasing adaptive capacity and building resilience.
The book situates climate and health adaptation concerns in the broader context of developing countries, providing insights that can be useful for other countries as well, helping them further their health adaptation efforts. In India, poverty and inadequate access to basic water, health and sanitation services combine with climate-related events to adversely impact health outcomes. Three case studies on the occurrence of heat stress, flooding, and extreme cyclonic events in India are presented along with a critical assessment of the level of preparedness and capacity of healthcare facilities to respond to the threats posed by climate change. The book presents the key challenges faced in reducing the risks posed to the health sector by climatic factors, and highlights the most important opportunities for promoting resilience and adaptation to achieve sustainable development.

Dr. Dasgupta’s excellent book reviews the health risks of climate change, outlines an operational framework for health adaptation, and describes the socioeconomic context for adaptation in India. - Kristie L. EbiProfessor, Departments of Global Health, and Environmental and Occupational Health Sciences, University of Washington, USA
This pioneering work contributes to an the understanding of the preparedness in India to manage health risks from such (climate) change on the basis of detailed data analysis, both from large national surveys and contextualized field based surveys.- Kanchan ChopraFormer Director and Professor, Institute of Economic Growth, New Delhi, India



Chapter 1. Introduction: Climate Risks in the Health Sector

This chapter details the structure of the book, and introduces relevant terminology and concepts used in it. The first section describes the scope of the book while the second section presents the conceptual framing in terms of risks to the health sector and adaptation for managing the risks from climate change. It presents the current evidence on climate change and projected risks for the health sector, the association between different climate drivers and prevalence of selected diseases, and concerns of exposure and vulnerability across regions of the world.
Purnamita Dasgupta

Chapter 2. Climate Change Adaptation: The International Experience in Health

This chapter presents the current understanding on adaptation needs and its rationale for public health planning. Evolving criteria for guiding adaptation responses and developing an understanding of the economic basis for adaptation decisions are essential for effective adaptation. Historical experiences in adapting to hazards, standard protocols and consensus based international guidelines and learnings from country specific experiences are brought together to frame the domains of an effective adaptation strategy that can address ongoing and new challenges. The role of socioeconomic and technological factors, awareness, political will and institutional capacity in determining the effectiveness of any desired response to vulnerabilities is discussed.
Purnamita Dasgupta

Chapter 3. Developing Economy Context for Adaptation Decision-Making

This chapter discusses the wider context of developing economies with particular emphasis on the challenges of sustainable development faced by them. It presents a comparative picture of country profiles in health status, vulnerability to climate sensitive diseases and economic development. The chapter also discusses the important issues in economic decision-making for adaptation, with special reference to concerns and challenges that arise with regard to economic valuation and costing. Challenges in measuring and assessing adaptation in developing economies, available tools and methods, ancillary and externality effects, and distributional issues are considered. The Indian context is used to highlight some of the issues. This is of interest since India represents a country of paradoxes to some extent. Although its economic profile is much better than several others, it continues to face many challenges with regard to poverty alleviation and meeting basic needs including public health.
Purnamita Dasgupta

Chapter 4. Understanding Associations: Health, Socio-economic Wellbeing and Climate

Reducing risks from current and projected threats from climate change in a developing economy requires an in depth understanding of the associations between health status, climatic events and development. This is particularly important since up to mid Century, climate change is expected to act mainly by exacerbating health problems that already exist. Adaptation under these circumstances, especially for populations that do not have access to health care and public health services, is as much a question of responding to an amplification of existing threats to public health as of new strategies for managing new threats. To illustrate the point, an analysis of secondary data for one state in India is undertaken. The risk posed by climate events to mortality and economic losses, are statistically analysed. District level indices of health care provision and socio-economic status are constructed for 18 districts of the state over a period of 12 years from 2002–03 to 2013–14. The statistical associations between risk of mortality from climate events, health sector preparedness and socioeconomic wellbeing are subsequently highlighted.
Purnamita Dasgupta

Chapter 5. Analysing the Interface in Indian Plans and Policies

This chapter analyses the extent and adequacy of the Indian health programmes and the state action plans on climate change in tackling issues of adaptation, in achieving the ultimate outcomes of reducing the burden of disease and building resilience to future adverse impacts on health. The chapter begins with a critical review of the current evidence on the prevalence of what are scientifically established to be climate sensitive illnesses in India including malaria, diarrhoea and dengue among others. Subsequently a critical analysis of the current plans and programmes in terms of the capacity to address these climate related illnesses is conducted, and lessons drawn from the historical experience in tackling illnesses with these programmes. The way forward poses both challenges and offers opportunities as the analysis reveals.
Purnamita Dasgupta

Chapter 6. Criticality of the Field: Three Case Studies

The evidence on occurrence of climate sensitive diseases is mounting. The detection and attribution of diseases to climate change has also improved, with epidemiological studies to support such claims. This chapter will specifically consider three important types of climatic events that have had serious consequences for India in the past, and are likely to persist and even increase in the years to come given the threat of climate change. These are heat stress, flood and cyclone related threats posed to the health sector. The three case studies have been done in three different districts of a state in India, which have been experiencing these climate events. The case studies bring out the vulnerabilities that become specific to the Indian situation, taking on the complexity posed by socioeconomic factors that are co-associated with adverse health outcomes. The detailed analysis brings out the major domains of relevance to analyzing the Indian context within which adaptation is to be addressed. The criticality of good research through field work in furthering the understanding of how climate sensitivity can add to lowering both the existing burden of diseases and managing future risks is brought out with illustrations from the case studies.
Purnamita Dasgupta

Chapter 7. Conclusion: Integrating Sustainable Development and Health Adaptation

This chapter summarises the key understandings developed in the book, in terms of the key challenges and efforts made so far to address these. Effective adaptation in the near term includes meeting the basic public health measures such as clean water, sanitation, vaccination and child health services, just as much as increasing capacity for disaster preparedness. A two pronged strategy is advocated—in terms of what can be done within existing programs and policies to reduce climate related impacts and what new areas deserve focus in an interface between health and climate change to reduce the adverse impacts. The current approaches for achieving sustainable development and the processes for adaptation, concerns of resource availability, information, and guidelines is discussed along with learnings from the historical experiences of the world in addressing health sector challenges in the past. Building institutional capacities, training and knowledge transfer, being inclusive in targeting vulnerable populations, awareness creation and budgeting for resources for these are as crucial as getting in place the right infrastructure. The chapter makes key recommendations for adaptation actions and opportunities in the specific context that developing economies find themselves in today.
Purnamita Dasgupta
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