Photo: Thaths
Health governance and the impact of climate change on Pacific small island developing states 51
regular intrusion of salt water into the fresh water lens of an atoll. Many of the anticipated health effects of climate change in Pacific SIDS are anticipated to be indirect, connected to the increased stress and declining well-being that comes with property damage, loss of economic livelihood, and threatened communities (LANCET & UNIVERSITY COLLEGE LONDON INSTITUTE FOR GLOBAL HEALTH COMMISSION 2009). Vulnerability is a concept of particular resonance to Pacific SIDS as colonial legacies, aid dependency, growing remittance levels, and little diversification of exports tie the well-being of Pacific SIDS to the success of overseas economies (BROWNE & MINESHIMA 2007; KALY ET AL. 2002). The potential for climate change to undermine economic development, and in turn worsen poverty and its antecedents, is a very real concern for Pacific governments and for the health of their populations (KOVATS ET AL. 2005; McMICHAEL ET AL. 2008; MORRELL ET AL.
2009). From a governance perspective, this landscape of vulnerability makes the agendas of aid agencies, NGOs and national governments integral to promoting health sector resilience to the effects of climate change. This article draws on preliminary findings from interviews undertaken with experts across Pacific SIDS and a growing body of literature on global health governance to relate our current scientific understanding of the health impacts of climate change to health sector action. I examine the action experts believe is necessary to prepare Pacific SIDS health systems for the effects of climate change addressing the following 1. Are the health effects of climate change currently being experienced in Pacific SIDS and how are health sectors responding? 2. Which actors are shaping health sector adaptation to the effects of climate change?
Governance and the health effects of climate change Supported by a rapidly growing body of evidence the health implications of climate change are widely cited at international meetings as a reason to demand action on climate change (KOVATS ET AL. 2005:140910; McMICHAEL ET AL. 2006; McMICHAEL ET AL. 2008). Efforts to mitigate the effects of climate change are, however, anticipated to largely take place outside the domain of the health sector, thereby limiting health sector response to adaptation initiatives. Adaptation for climate change is equated by FRUMKIN ET AL. (2008) with the well established concept of public health preparedness and necessitates that traditional public health initiatives, such as vaccination programmes, disease surveillance and monitoring, be integrated with weather warning systems, climate forecasts and disaster preparedness. Health system strengthening must be
IHDP Update Issue 1, 2011