Climate change is affecting Pakistan's healthcare system

A dengue outbreak in Pakistan has infected more than 10,000 and killed 20 people in recent months.

 Waqar Mustafa

Published: Sat 28 Sep 2019, 8:00 PM

Last updated: Sat 28 Sep 2019, 10:22 PM

I suffered from dengue about a decade ago. At that time, people struggled to rightly pronounce the name of the mosquito-borne viral disease. Yet whoever fell ill with the disease dreaded it: it caused high fever, nausea, vomiting, swollen glands, severe headaches, pain behind the eyes, muscle and joint pains, and rashes. Untreated, it could even be deadly. It is so even now.
A dengue outbreak in Pakistan has infected more than 10,000 and killed 20 people in recent months. It commonly affects people in hot, wet regions of the tropics and subtropics during the rainy months. The disease was endemic in only nine countries in the 1970s, but has now spread to more than 100, putting more than half the world's population at risk, according to the World Health Organization.
In Pakistan, the first case of dengue was reported in 1994. Now hotter, wetter weather brought on by climate change has created ideal conditions for female mosquitoes to lay their eggs. Pakistan, one of the most climate-vulnerable countries in the world, is one of the least equipped to adapt to it with the most marginalised groups bearing its brunt. Besides facing more mosquitoes because of change in seasonality, people living in closer contact with disease-carrying insects because of rapid urbanisation are increasingly at a risk of falling ill and adding immensely to the country's disease burden of more than Rs250 billion against a very low outlay for health.
The situation is likely to worsen as global warming is posing a greater challenge than before. It is threatening to undermine the achievement of universal health care. According to a study titled Climate change and water-related infectious diseases, which focuses on the diseases associated with predicted anthropogenic climate changes, a number of pathogens are likely to present risks to public health. "The risks are greatest where the climate effects drive population movement and where drinking water supply infrastructure is poor."
As extreme weather events become a norm in Pakistan, so does the risk of deadly epidemics and endemic disease outbreaks. A year after floods devastated Pakistan in 2010, there were 37 million reported cases of malaria, diarrhoea, and acute respiratory, and skin infections. Climate change continues, and so it will. Urbanisation will compound the trend with poverty aggravating the risk of both epidemics and endemic disease. Higher population density aids contagion and increased pollution and pressure on public sanitation can cause respiratory disease (such as pneumonia) and diarrhoeal disease (like rotavirus and cholera).
Pakistan needs to integrate its climate change and universal healthcare agenda to improve health and achieve health equity. The agenda should work to improve the understanding of climate change, use novel climate sensitive financial frameworks, and incorporate the mitigation of greenhouse gases. The system should seek to protect health and prioritise health system climate resiliency.
A country's heath system is the first to take any environmental shock. Pakistan needs to build a resilient primary health-care system to detect and respond to a disease outbreak instead of one that is reactive, costly, and inefficient. In the absence of such a system, it's the poor - making a major part of the population - who suffer.
Policymakers should prepare for the consequences of climate change and its effect on the spread of infectious diseases. Last week, Amnesty International warned that not prioritising climate action could amount to the greatest intergenerational human rights violation in history. "Our rights to life, food, housing, water and a healthy environment are all threatened by climate change, which also compounds and magnifies existing inequalities," said the human rights campaigner. "While the Government of Pakistan has spearheaded an ambitious afforestation drive, it must make a concerted effort to reduce emissions, phase out fossil fuels and protect the most climate-vulnerable communities."
If temperatures continue to rise, their impact on the current and future health of populations can be unacceptably bad. A lack of progress in reducing emissions and building adaptive capacity will put human lives and the national health systems they depend on in great danger. Ensuring a widespread understanding of climate change as a central public health issue, Pakistan should act, independently and help regionally in South Asia and internationally, to avoid catastrophic health outcomes of the climate change. Bold, innovative, and multidisciplinary action can help the country tackle climate-induced health challenges and ensure a healthier world for its people.
Waqar Mustafa is a journalist and commentator based in Lahore, Pakistan

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