An attempt to galvanise UK universities to direct research at global health and neglected diseases while making their findings more available to people in developing countries is being launched next month.

An online index will grade UK universities according to the level and impact of their research on global health and neglected diseases.

It will also rank them according to how accessible their findings are to other researchers, particularly those in low- and middle-income countries. Users will be able to explore the various results and get information on how to use the index to advocate for change.

The project is a collaboration between Medsin-UK, a student global health network, and the UK branch of Universities Allied for Essential Medicines (UAEM), an international student-led NGO that calls for global health research and intellectual property reform at universities.

Dzintars Gotham, UAEM's European coordinator, tells SciDev.Net he hopes the index will encourage universities to "change their research systems to make them more directed by global need".

He adds: "We also hope universities will adopt concrete policies to both make their research accessible in terms of open-access publishing and ensure the drugs they develop are affordable in the developing world through socially responsible licensing policies."

Gotham says that while UK universities do more neglected disease research than those in other countries, they must do more given the global burden of these diseases. He says there is no coherent commitment to this goal across all universities, so "we really want them to systematically embrace this".

Gotham adds that universities are uniquely placed to tackle neglected disease research because they are free from a profit-driven mandate and so have "more flexibility to adopt globally minded strategies".

He says UAEM's North American 'report card' — the forerunner of the UK research index — has brought "concrete changes" to the American research landscape in global health.

"A number of socially responsible licensing policies were adopted, which means that the technologies they [US and Canadian universities] develop are made affordable in developing countries through contractual provisions," he says.

Rachel Cohen, regional executive director for the Drugs for Neglected Diseases initiative (DNDi) in North America, tells SciDev.Net that "universities are among the most important non-profit research institutions on the planet".

"The concept of neglected diseases is about the failure of the market to address public health needs when they predominantly or exclusively affect poor people", and the failure of public policies to correct this imbalance, she says. The Ebola crisis is just one example of the "lack of effective treatments, diagnostics and vaccines for neglected diseases writ large," she adds.

Cohen says universities could be a major part of the solution for neglected diseases.

"They could help dramatically turn the tide against neglected diseases by making serious commitments to innovation and to provisions in licensing agreements that will guarantee affordability and access for patients," she says.

The UAEM Report Card concept is "so important" because it offers "the only comprehensive picture" of academic investment in neglected disease research, she says.

Gotham says that there are currently only plans to look at the research practice of "well-funded research universities" in the United Kingdom, although a team in Germany is also looking into replicating the project.

During his presidential campaign, President Joko "Jokowi" Widodo repeatedly raised concerns about health protection for Indonesians. He raised the concept of the Healthy Indonesia Cards (KIS) that are likely to be incorporated into the national health insurance (JKN) program run by the Social Security Management Agency (BPJS). However, if "Indonesia" means all Indonesian citizens, the program should also cover Indonesian citizens living abroad.

As ASEAN is moving toward a single market with the launch of the ASEAN Economic Community (AEC), more people will be coming and going in the region. There will be more people from ASEAN nations coming to Indonesia, and more Indonesians leaving for work or travel in the other ASEAN countries. This means that Jokowi has limited time to design a policy that provides health protection for Indonesian citizens abroad, as the formation of the AEC is fast approaching.

Law No. 24/2011 on the BPJS stipulates that universal health coverage must be provided for all Indonesians. However, the law does not specify the mechanism for providing such protection for Indonesians abroad.

Therefore, Indonesian migrant workers, professionals, students, or civil servants overseas may not automatically be covered by the law.

This could be unconstitutional and discriminative, since the state's constitutional mandate for ensuring citizens' well-being does not differentiate between Indonesians at home and abroad.

It becomes even more dubious and ironic considering that Article 14 of the law regulates that expatriates working in the country for six months are entitled to health protection program managed by the BPJS.

It is true that migrant workers, professionals, students and civil servants abroad have (or should have) been protected by various different health protection schemes: Indonesian migrant workers are covered by compulsory Agency for the Placement and Protection of Indonesian Migrant Workers (BNP2TKI) insurance, professionals and students may purchase private insurance and civil servants can be reimbursed for medical bills.

However, as those groups should join the JKN, their participation in other health protection schemes is redundant and unnecessary.

Why should a migrant worker who has been funding the BPJS while working in Indonesia not be able to enjoy the benefits while he or she is abroad? Must he or she pay for two programs, the JKN and the BNP2TKI, while only enjoying the fruits of the latter?

Worse, our migrant workers rarely use the compulsory BNP2TKI insurance program due to its complicated claims process and the lack of clear information regarding benefits.

We need to learn from the Philippines on providing health protection to citizens abroad.

The Philippines health insurance agency, The PhilHealth, maintains overseas offices to deliver services to Filipino migrant workers, allowing them to claim benefits instantly in the country they're working in.

Collaboration between all related parties is needed to provide citizens abroad with appropriate health protection. The National Social Security Board (DJSN) should seek to amend Law 24 / 2011 to include a health protection mechanism for citizens abroad. The mechanism should be integrated and accessible through the JKN or the KIS. Redundant schemes such as the BNP2TKI should be removed to reduce costs borne by migrant workers.

This amendment of the 2011 Law would enable the BPJS to build cooperation with ASEAN health providers like hospitals, clinics and specialists.

The BPJS must enable cardholders to be accepted by healthcare providers across the region, which would ensure peace of mind for Indonesian citizens abroad, allowing them to focus on their jobs and duties, thus minimizing health worries. By performing better they will help boost economic growth when the AEC begins.

source: http://www.thejakartapost.coml

Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe, a top World Health Organization official said Tuesday.

Dr Marie Paule Kieny, an assistant director general for WHO, said clinical trials that are either underway or planned in Europe, Africa and the U.S. are expected to produce preliminary safety data on two vaccines by December.

If the vaccines are declared safe, she said they will be used in trials in West Africa beginning in January to test their effectiveness among tens of thousands — but not millions — of people.

"I'm not suggesting at this moment that there would be mass vaccination campaigns at population levels starting in 2015," she said, adding that none of the volunteers who take part in the trials could accidentally contract Ebola from the testing.

The Ebola outbreak in West Africa has already killed over 4,500 people, mostly in Liberia, Guinea and Sierra Leone, since it emerged 10 months ago. Experts have said the world could face 10,000 new cases a week in two months if authorities don't take stronger steps to fight the deadly virus.

In Sierra Leone, the government said Tuesday that number of infected people in the country's western region is soaring, with more than 20 Ebola deaths a day. That region is on the opposite side of the country from where the first Ebola cases emerged.

And in Spain, doctors said tests showed that a Spanish nursing assistant infected with Ebola in Madrid was now completely clear of the virus. Teresa Romero, 44, had battled for her life after she tested positive Oct. 6.

One of the two vaccines that Kieny mentioned was developed by the U.S. National Institutes of Health and GlaxoSmithKline from a modified chimpanzee cold virus and an Ebola protein. It is in clinical trials now in the U.K. and in Mali and will be used in trials in Lausanne, Switzerland, by the start of February.

The second front-runner, developed by the Public Health Agency of Canada and known as VSV-EBOV, has been sent to the U.S. Walter Reed Army Institute of Research in Maryland for testing on healthy volunteers, with preliminary results about its safety expected by December. The next stage would be to test it more broadly, including among those directly handling Ebola cases in West Africa.

source: http://www.nwherald.com/

Shortly after his inauguration on Oct. 20, president-elect Joko "Jokowi" Widodo will have to deal with the many health problems besetting Indonesia, one of the largest archipelagic countries in the world and home to 250 million people.

First, there is the problem of the unequal distribution of health workers between Java and the rest of the country. According to Health Ministry data, there were 95,976 registered doctors in the country as of March 2014, but sadly none of them were available for assignment at the 938 community health centers (Puskesmas) located outside of Java. Worse, of nearly 9,600 Puskesmas nationwide, 30.8 percent of them have no sanitarian, 30.2 percent have no dietician and 55 percent are without a laboratory analyst.

Second, there is a high prevalence of preventable diseases, including malaria. Although the incidence of malaria has already declined from 2.9 percent in 2007 to 1.9 percent in 2013, the number of cases remains high in several provinces. As of 2010, malaria-prone regions were West Nusa Tenggara with 20 cases per 1,000 citizens, East Nusa Tenggara with 20-50 and Maluku and Papua with over 50.

Preventable diseases are not just seen in rural areas. Jakarta is also struggling to eradicate preventable diseases, especially dengue hemorrhagic fever (DHF). The capital city is the region with the second-highest dengue prevalence rate with 220 per 100,000 people.

Degenerative diseases are also rising in number. Health Ministry data said that the mortality rate from degenerative diseases had climbed from 49.9 percent in 2001 to 59.5 percent in 2007. Common life-threatening degenerative diseases are stroke, hypertension, diabetes and cancer.

For people with degenerative diseases, curative treatments take a long time and incur high costs. For the government, it will require a bigger health budget, as the majority of patients come from low-income families, which means that their health expenditures must be covered by the government.

Considering disease incidence rates and the budget needed to cure illnesses, Jokowi's government's health program should prioritize prevention. People need to adopt healthy lifestyles and the government could help promote healthy lifestyles by transforming parks into comfortable places to jog, revamping slum areas, increasing taxes imposed on fast food and cigarettes, tightening non-smoking regulations and promoting health screenings for high-risk people.

According to the 2013 National Basic Health Survey, 36 percent of Indonesians smoke, with most of them in the early productive age of 15-19 years old. The survey also found only 26 percent of Indonesians regularly exercised.

With the rise of degenerative and preventable infectious diseases, Indonesia needs more preventive health programs. One solution would be for the government to widen the role of general physicians in Puskesmas by appointing them as family doctors who take care of several families in an area and receive government grants to implement preventive programs at the health centers.

Such a program would allow family doctors to reach out to the grass roots to implement a variety of preventive measures such as immunizations, health screenings and environmental health.

With regard to healthcare costs, all Indonesians should join a health insurance program. President Susilo Bambang Yudhoyono launched social security insurance for all under the Social Security Management Agency (BPJS) earlier this year and his successor Jokowi should follow up and improve it through his Indonesian health card program.

To boost prevention and strengthen BPJS coverage, Jokowi needs to raise the health budget from the current Rp 70 trillion (US$5.78 billion) per year, or 3.7 percent of the total budget. The Health Law mandates that the health budget should account for at least 5 percent of the total budget.

According to the World Health Organization (WHO), 22 of 36 low-income nations allocate 11 percent of their national budget to the health sector.

Jokowi is therefore right to ask the provinces to help the central government meet the minimum health budget and increase the equity of the BPJS.

The current health budget for preventive measures has been set at only Rp 150 billion, which is far lower than curative health spending. Indonesians are waiting for Jokowi to change the orientation of national health care toward prevention, which would not only improve the health standards of Indonesians but also control health spending.

As Jokowi once stated, Indonesia should have a self-supporting economy that provides its people with their basic needs, including education and health. We hope Jokowi fulfills his promises.

source: http://www.thejakartapost.com

The head of the World Health Organization (WHO) says Ebola poses a threat to the governments and societies of West Africa.

Dr. Margaret Chan, director-general of the WHO, said Monday that she has "never seen an infectious disease contribute so strongly to potential state failure."

In a statement to a health conference in the Phillippines, Chan warned the number of cases is "rising exponentially" in Liberia, Guinea and Sierra Leone, and said the outbreak shows how the world is ill-prepared for a severe and sustained public health emergency.

Other U.N. officials, including U.N. chief Ban Ki-moon, have sounded similar warnings about the Ebola epidemic, which has killed more than 4,000 people in West Africa.

Defying calls for a strike

Chan spke as most health workers in Liberia reported to work Monday, ignoring calls for a strike that could have weakened efforts to fight the Ebola epidemic.

The country's Health Workers Association had told members to stay home unless they received higher hazard pay promised by the Liberian government. But hospitals and health officials say the majority of nurses and physician's assistants came to work, and medical facilities were operating.

The secretary-general of the union, George Williams, accused the government of pressuring workers to defy the strike.

In an interview with VOA, Liberia's assistant health minister, Tolbert Nyensuah, said the government can't meet all the health workers' demands because it needs to keep opening Ebola treatment centers.

"So it's negotiation," he said. "And we understand that their leadership have understood this. We have to put all of our differences aside. Unite. Come together as a country. Solve this problem and then we can continue to discuss those issues."

Alphonsus Wiah, a hygienist with the Island Clinic Ebola Treatment Unit, the largest government-run Ebola center in the capital, Monrovia, said the workers were demanding $700 in monthly hazard pay on top of their monthly salaries of $200 to $300.

"This [Ebola] epidemic is not just a normal hospital disease," Wiah said. "... As I speak to you, some of our colleagues, the health workers, are dying. So, our demand was the salary structure that [the] government offered was too low, and we believe there should be an increment in the salary structure."

Workers also have complained about a lack of protective gear.

The extra money promised to workers is being paid, Reuters news service quoted Health Minister Walter Swenigale as saying.

Liberia has endured the largest number of Ebola infections of any country, according to the World Health Organization, with 4,076 confirmed cases as of October 8. The virus has killed at least 2,316, including 95 health workers out of 201 infected. The regional outbreak had infected almost 8,400 people and killed more than 4,000.

Government position

President Ellen Johnson Sirleaf reportedly toured Ebola treatment units around Monrovia Saturday and asked health workers to remain on the job, according to assistant health minister Tolbert Nyenswah.

Health Minister Walter Gweningale referred VOA to Minister of Information Lewis Brown for comment. Brown has not responded to VOA's requests for comment for the past week.

Health workers

Wiah said that although the health workers took an oath to save lives, they need protection from Ebola while making a living.

He said that when the first Ebola cases were confirmed in Guinea in March, the government agreed to pay $700 a month for hazard pay. But, Wiah said, the government soon changed its mind and reduced the monthly allowance.

"We projected, according government's first announcement, that doctors will make $1,500. Nurses will make $750, plus their government salary, then hygienists will make $750," Wiah said.

"Later on, it came to as low as 250 US dollars. So, we are saying the $250 is very small, and those that go in the ETUs [Ebola treatment units] $300 is also very small."

Vaccine clinical trials begin

Meanwhile, the Public Health Agency of Canada said Monday that phase one clinical trials for an experimental Ebola vaccine have begun.

It says the vaccine has shown great promise in animal research and will be tested at the Walter Reed Army Institute of Research in the U.S. state of Maryland.

source: http://www.voanews.com

As the nation welcomes a new leader, the future of Indonesian health policy has become a hotly debated topic among medical professionals and the public alike. The upcoming administration will have to tackle numerous obstacles to implement the promised universal healthcare coverage to improve the health of Indonesians. However, the incoming government must not lose sight of the bigger picture on health.

So far, most of the conversations about health policies have been constrained to the provision of medical care: how to develop adequate facilities, allocate resources, deploy medical professionals and certainly how to finance the whole operation. While they are real problems facing our healthcare system right now, our policymakers must also take into account other determinants that have a real and measurable impact on health. These include socioeconomic environment, physical environment and individual characteristics and behaviours.

For example, experiencing unbearable psychological stress at work may lead to troublesome physical symptoms. A lack of open green spaces means children spend more time indoors, deprived of healthy physical activities. Smokers feel free to puff in public spaces thanks to weak law enforcement. Neglecting to manage these determinants will put a heavy burden on even the most developed healthcare system, let alone our fledgling system.

One important determinant of health is education. Research findings show that better education brings better health outcomes. More years of schooling translates into a lower mortality rate, better physical health conditions and higher life
expectancy.
Education exerts its effects through many channels: the better educated are less likely to engage in unhealthy behaviour, are more likely to adopt preventive healthcare and to utilise available healthcare more optimally. In short, educated people have better health literacy, or "the capacity to obtain, process and understand basic health information and the services needed to make appropriate health decisions," a study report stated.

Furthermore, those with higher education land better-paid jobs – and income still plays a huge role in one's health status.

Implementing a high-quality education system, therefore, is a requirement to achieve the goals of "Indonesia Sehat" (Healthy Indonesia). Sadly, recent examples show the inadequacy of our schools in educating the masses, especially in health literacy.

Quack healers are still attracting clients all over the country, including those selling dubious "natural remedies", even though there is simply no physiological or pharmacological basis for the therapy. People are spending exorbitant amounts of money to pay for a placebo effect at best, or even worse, potentially harmful treatments.

Indonesian children are being increasingly victimised by the anti-vaccination movement that has sprung up in recent years, an unwelcome import from misguided Western cultures as well as conspiracy-loving religious extremists. These "anti-vaxxers" rely on pseudo-science and mass hysteria, instead of sound medical evidence affirming the safety and benefits of immunisation.

Two examples of their malicious handiwork are the 2005 polio outbreak in Sukabumi, West Java, and the 2011 diphtheria outbreak in East Java; not to mention the steady rise of previously-rare vaccine-preventable diseases.

The use of long-term contraception methods, such as the intrauterine device (IUD), praised for its effectiveness and convenience, is hampered by myths about its side effects. Many women still reject the IUD in fear of exaggerated risk of uterine damage or the baseless rumour that it causes congenital defects in the baby should it fail in preventing pregnancy. Couple this trend with the fact that less-educated women tend to have more children and we still have a long way to go in reducing the maternal mortality rate that disproportionately affects those with a high number of children.

Thus, investing in quality education and health literacy is as pressing an issue as building hospitals and training new physicians. Education is more than a job requirement; it serves a higher purpose as the key to leading a fruitful life by opening up precious opportunities. By providing quality education, we are giving our next generations an opportunity to grow up and live healthily.

Additionally, educated people make empowered patients who realise that their health is their responsibility and are ready to collaborate with the medical system to achieve good health. Patient and community empowerment to maintain one's own health is vital because physicians and other health professionals can only influence the health of their patients up to a certain degree.

As health itself depends on various factors, there are many parts of the curriculum that can contribute to improving health literacy. The education system should properly equip students with critical thinking skills so that they will be able to navigate the flood of information in the digital era. Successful science education, like biology and chemistry, will build a strong foundation of health knowledge. Reading is crucial, as many health information sources are written.

Oral language skills are as influential to allow people to describe their health condition more accurately to the doctor, a starting point to better care. Basic math will always come in handy, whether to calculate one's body mass index or to take the correct drug dosage. Finally, students must develop analytical thinking to select relevant information and apply it in health-related decision making.

A chain is only as strong as its weakest link; building the medical system alone will not suffice in achieving Indonesia Sehat. An understanding of the close connection between education and health should serve as yet another wake-up call for stakeholders to evaluate, and to redesign if necessary, the national education system.

The fresh air president-elect Joko "Jokowi" Widodo brought to politics should also make its way into our education policies. The government must not hesitate to overhaul our school system and curricula, and give the national education system a fresh start. Nevertheless, these changes must be carefully thought through with sufficient time, unlike the last decade's rushed curriculum changes that have become more like knee-jerk reflex reactions instead of deliberately planned actions.

If the government is serious about improving the health of the nation, the quality of our education must also take centre stage, considering that its success or failure will affect the health of generations of Indonesians to come. – Jakarta Post, October 10, 2014.

* Adhitya S. Ramadianto graduated from the faculty of medicine of the University of Indonesia and is a former executive committee member of Asian Medical Students' Association International.

* This is the personal opinion of the writer or publication and does not necessarily represent the views of The Malaysian 

source: http://www.themalaysianinsider.com

Ebola could cost the global economy over $32 billion by the end of 2015 if the viral infection spreads into countries that neighbour those already affected by the outbreak

That's according to the most recent estimates from the World Bank, the UN's global financial arm, which is tasked with handling loans to poorer nations.

To get the $32.6-billion estimate, the organization charted two scenarios.

• In the first, which they call the "low Ebola" scenario, the group assumed officials manage to contain the outbreak in the three most heavily impacted countries: Guinea, Liberia and Sierra Leone.
• In the second, known as "high Ebola," they assume the outbreak takes longer to get a lid on in those countries, and has meanwhile spread to new ones in the region.

In the first scenario, the financial impact might be limited to about $9 billion. In the latter, it would be more than $32 billion.

For context, the U.S. government estimates that the SARS outbreak in 2003 which killed almost 800 people and infected more than 8,000 cost the world economy about $40 billion.

Beyond the deadly and more serious human toll, one of the factors having an impact on Ebola's financial toll is what the World Bank calls "aversion behaviour," or fear factor, whereby neighbouring countries close their borders to humans as well as commercial goods, and international airlines cancel flights.

David Evans, a senior economist at the World Bank and co-author of the report, said fear prompts flights to be cancelled, mining operations to halt, businesses to close, and farming and investment to slow as people try to avoid putting themselves and their employees at risk. That behaviour has a larger economic impact than sickness and death, he said.

"Closing borders and halting flights has a huge impact," he said. "These economies trade with the outer world. They have international investment in mining. Liberia imports food. So as we close borders and cancel flights, there is a real impact on the food security and the incomes of the households in these countries."

Minimizing financial impact

It's possible to minimize the financial impact if those types of behaviour aren't unnecessarily continued.

"The successful containment of Ebola in Nigeria and Senegal so far is evidence that this is possible, given some existing health system capacity and a resolute policy response," the World Bank said.

Part of the problem of the Ebola outbreak is it's attacking areas that already had insufficient and underfunded health-care infrastructure.

"The international community now must act on the knowledge that weak public health infrastructure, institutions and systems in many fragile countries are a threat not only to their own citizens, but also to their trading partners and the world at large," World Bank president Jim Yong Kim said.

The latest estimates from the World Health Organization indicates the Ebola outbreak, already the worst confirmed in the disease's history, has killed more than 3,400 people.

News on Wednesday emerged that the first victim to make landfall in the U.S., Thomas Eric Duncan, died in a Dallas hospital on Thursday morning.

It's worth noting that neither scenario considered the financial impact if the disease were to spread in any significant way to wealthier nations with much bigger GDPs. Under that scenario, the financial toll would presumably be much higher.

In a release, the World Bank also said it is mobilizing $400 million in emergency financing for the three countries hardest hit by the crisis.

source: http://www.cbc.ca/

A very recent study released in JAMA (Climate Change: Challenges and Opportunities for Global Health) provides a very thorough review showing how climate change affects human health. Perhaps more importantly, the paper also describes how tackling climate change leads to many health and economic benefits.

Authors Jonathan Patz, Howard Frumkin and colleagues combined a survey of the current literature with measured and projected changes to climate to assess health risks associated with climate change. They report many things that we already know. For instance, some of the adverse health effects from climate change are heat-related (such as heat stress, increased cardiac arrests, reductions in work productivity, to name a few).

Others, such as decreased respiratory health (from changes to ground level pollution associated with climate change or increases in pollens for example), increases in infectious diseases, decreased food security, and more mental stress are just some of the lesser reported effects we are seeing and will continue to see. The authors conclude,

Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the co-benefits from reducing greenhouse gas emissions.

First let's talk more about these health impacts, then we will get to so-called co-benefits.

It's clear that some changes are happening to our climate and weather. For instance, heat waves, floods, extreme precipitation, and droughts are happening with greater severity in different parts of the globe. These changes, associated with human emissions of greenhouse gases, can be dealt with by either mitigation (stopping climate change), adaptation (dealing with climate change as it occurs), or both. The authors propose various adaptation strategies including more robust infrastructure, increased public green spaces, and white roofs (as just three examples).

Information about extreme heat waves was determined from downscaled climate models that take global or regional climate information and bring it to a more local level. They also obtained ground level temperature and ozone measurements from the US Environmental Protection Agency and nicely show that temperature and ground-level ozone are tightly connected. It should be noted here that ozone in the upper part of the atmosphere (often termed the ozone layer) helps us by blocking high-energy solar radiation which can cause a variety of health effects. However, near the ground, in the air we breathe, ozone is a harmful pollutant.

With the information described above and from other literature, the authors report that the health impacts of a warming planet can be significant – they can also be under-reported. For instance, during very hot episodes, deaths recorded to cardiac arrest may actually be caused initially by elevated body temperatures – although the officially reported cause of death may not reflect this fact. But, even with the under-reporting of heat-related health impacts, we learn that these deaths exceed fatalities from all other weather events combined. This was an astonishing finding; I work in the area of biological heat transfer and yet I was surprised by the numbers.

The authors report that by the end of the century, "more than 2000 excessive heat-wave related deaths per year may occur in Chicago." They also report that mega-heat waves may increase by 500-1000% in Europe over the next few decades. Likewise, days with high temperatures (above 90–100°F) will increase significantly in major cities.

But it isn't just heat, there are many other health impacts that should concern us. For instance, the broad category of respiratory disorders has seen a lot of recent research. Most of that research has focused on either ozone (mentioned already) or airborne particulates which can be inhaled during respiration. The authors of the paper discuss how changes to emissions and temperatures affect these pollution levels. In fact, even if we reduce particulate pollution, the changing climate will cause a respiratory "climate penalty" that must be prepared for.

Other health issues discussed are allergens and pollen, increases in infectious diseases, and vector-borne diseases, reduced food security, mental health, and climate-displacement problems. I was particularly interested in the report on water-borne diseases because it is an area of my own research. I am involved in projects to provide pasteurized water to impoverished areas or regions hit by disasters or civil strife.

What we have found, and what the research shows, is that it is difficult to keep pathogens out of a community water source. Some sources, like surface waters, streams, lakes, rivers, or shallow wells can be expected to contain bacteria, viruses, protozoa, and other pathogens which can cause diarrhea and death, particularly in small children. However, when extreme precipitation events occur and short-term flooding results, otherwise clean water sources become contaminated. While estimates vary widely, each year more than 1 million children die from diarrhea and the number is likely far higher. Reducing greenhouse gas emissions while simultaneously improving water infrastructure will help alleviate flood-related water contamination.

But as with other studies, this is not all doom-and-gloom. The important point is there is something we can do about the problems. Of course, we can rapidly implement smart policies that encourage more efficiency in our energy systems. We can also speed the implementation of clean and renewable energies. But too often, the cost-benefit analysis is focused solely on the energy costs with such plans. Rarely do we think of the other benefits that might be achieved by taking smart actions.

As an example, the study finds that increases in energy efficiency and renewable energy generation will cause a reduction in other pollutants such as nitrogen oxide and sulfur dioxide (aside from carbon dioxide). Such reductions would result in human health benefits that must be considered in the calculus. Additionally, dealing with black carbon or other short-term greenhouse gases would reduce premature deaths and improve crop yields. Putting in urban green spaces and cooling cities with white surfaces would increase worker productivity and urban life quality and improve health by promoting exercise.

The point of all this is, these so-called co-benefits must be added to the ledger as we think about dealing with climate change. We often hear that mitigating and adapting to climate change is too expensive. We are now learning that doing nothing is very costly and an unwise choice. What this latest work shows us is that taking action will provide hidden auxiliary benefits that should encourage us to act faster.

source: http://www.theguardian.com/