The world is already witnessing the damaging impact of climate change. Unseasonal floods are devastating countries. Apart from disrupting healthcare services, floods are associated with disease outbreaks accompanied by surges in demand for services. Uncertainty is creeping into food production and security. The burden of malnutrition might increase making the population vulnerable to communicable diseases. The probability of new pathogens emerging is increasing due to the physical and chemical stresses induced by climate change. Rising sea levels make people living in coastal areas and islands highly vulnerable. Extreme temperatures make aging populations most vulnerable to heat-related deaths.
The COVID-19 pandemic demonstrated that the majority of health systems are weak and fragile. While there is a greater policy focus on health, many countries are going through a confluence of crises induced by economic downturns and increasing geopolitical tensions. Countries do not have enough fiscal space to increase their health spending to strengthen their health systems. Even the meager health budgets remain unspent due to poor public financial management. In the absence of priority-setting culture, much of the budget is spent on low-value (unnecessary consults, screenings, tests, treatments, and procedures) and high-cost hospital-based care. Hence, the countries can focus on improving their public health financial management, avoid wastage through strategic purchasing, and prioritize allocations to comprehensive primary health care with a focus on health promotion and disease prevention.
In order to prepare health systems for sudden surges in demand for healthcare services and goods or sudden disruptions in supply of these or a combination of both as witnessed during the COVID-19 pandemic, there is a need for monitoring current healthcare capacity and its utilization across health systems at every level. The capacity to undertake simulation modeling for a variety of public health emergency scenarios including pandemics, natural disasters like earthquakes and floods, nuclear and industrial accidents, wars, terror attacks, etc., is vital to prepare the health systems to face health crises. Slowly emerging crises are as important as shock-inducing acute crises in preparedness.
Tsunamis forced many vulnerable countries to put national disaster response systems in place. Few countries that faced SARS1, MERS, Ebola, etc., have instituted similar public health emergency response systems in place. These countries were prepared enough to mount an appropriate response to the Covid-19 pandemic. Singapore, Taiwan, South Korea, etc., are exemplars of pandemic preparedness. Hence, there is a need to build public health emergency response systems to face mounting public health crises, including those resulting from climate change.
Not all countries have the needed finances and capacities to strengthen their weak health systems and prepare them to face future crises. No one in the world is safe unless everyone is safe. Hence, there should be a global compact amongst all nations to prepare every nation to face the health consequences of climate change. The compact should encompass not only financial resources, but also knowledge, human, and technology resources. How to bring that compact to fruition in an increasingly divisive and multipolar world is the big question. Nations express intent, but never translate that into action and there is no legal way to enforce it, except through universal morality and ethics.
The human race gained mastery over the world through collaboration. When the human race is facing an existential threat on account of climate change, it can overcome it only through collaboration and not through competition. Nations that believe in universalism, and that treat every being in the world as one family have to join together to change those that do not believe in it to extinguish the existential threats.
Krishna Reddy Nallamalla
President, ACCESS Health International, ASIA
President, InOrder – The Health Systems Institute
Photo Credits: – Commonweath Fund