IN the aftermath of the floods, hundreds of thousands of displaced people are living in makeshift camps next to stagnant water. Outbreaks of diarrhoeal diseases, skin infections, respiratory tract infections, malaria and dengue are compounding existing health threats, including cholera, typhoid, measles, leishmaniasis, HIV and polio, and could lead to a full-scale health disaster. Critical health infrastructure such as Basic Health Units have been destroyed by the floods, limiting the access of flood-affected communities to primary healthcare.

Besieged by weak macroeconomic indicators, and as the world’s sixth most populous country, Pakistan is particularly vulnerable to climate-related reversals in development gains. The rate of stunting is around 40 per cent (the highest among regional peers) and there has been a resurgence in polio cases. Pakistan slipped down seven places on the Human Development Index 2021-22 and currently ranks 161 out of 192 countries.

The 2021 Report of The Lancet Countdown on Health and Climate Change confirms climate change as the greatest global health threat facing the world this century. Its burden on human health and consequently health systems is increasing rapidly. Ironically, those who have contributed the least to the climate crisis and were already living below the poverty line are bearing the brunt.

The WHO estimates an additional 250,000 annual climate-associated deaths between 2030 and 2050 from preventable causes such as malnutrition, malaria, diarrhoea and heat stress. Climate change impacts agricultural productivity and water availability directly, threatening food and water security. A study conducted by the Aga Khan University has found a link between rising temperatures and reduced protein and micronutrient content in staple food crops like wheat and rice.

Climate-proofing of healthcare facilities is necessary.

Malnutrition in infants can permanently impact their productivity. Children are also more susceptible to severe diarrhoeal disease and dengue fever. Due to changing weather patterns, the frequency and duration of dengue transmission is increasing.

Temperature extremes impact labour productivity. Senior citizens are particularly vulnerable to heat stress. Finally, the downstream impact of climate change, such as migration, poverty exacerbation, violent conflict and mental illness, affect people of all ages.

The World Bank and the Asian Develop­ment Bank’s climate risk profile for Pakistan affirms that the mean annual temperature and precipitation have increased across the country. By 2100, the average rise in Pakistan’s temperature is expected to be between three degrees Celsius and 5°C higher than the global average.

In order to ensure the physical, mental and social well-being of Pakistan’s citizens, there is an urgent need to invest in climate-resilient health systems. This includes climate-proofing healthcare facilities and infrastructure in vulnerable areas, increasing awareness about the health risks of climate change, promoting community-based health adaptation, building the capacity of the healthcare workforce to respond to climate-specific health issues and ensuring access to life-saving medicines in climate-related emergencies.

Although a joint inter-ministerial taskforce was set up by the ministries of health and climate change to develop a National Health Adaptation Plan (NHAP), the process stalled due to the Covid-19 pandemic. Authorities should reprioritise the strengthening of essential public health services and emphasise coordination among government agencies (federal, state and local), academia, the private sector and NGOs to respond to future climate crises.

Building on existing policies, the NHAP should be able to anticipate and prepare for the health impacts of climate change and promote integration of climate chan­­ge and health risks into national health planning, programming and monitoring strategies. Priority climate-sensitive health ou­tcomes to be explored could include: vector-borne diseases (kala-azar, dengue and malaria); water-borne diseases (cholera and diarrhoea); impact of extreme weather eve­n­­ts including heat stress, undernutrition, food insecurity, mental health and effects on water, sanitation and hygiene. In the immediate term, public-private partnerships could be leveraged to provide improved shelters to limit the spread of infectious disease and scale up mobile health clinics to deliver tim­ely medical treatment to displaced communities.

At the upcoming COP27 in Egypt, Pakistan must make a strong case for technical and financial resources to tackle the altered and increased healthcare burden and to invest in strengthening healthcare capacity in order to be better prepared for future calamities. Failure to act now risks the health and safety of our youth and future generations and could become an existential threat to the nation.

The writer is CEO of Zero-Point Partners and a member of the Leadership Council of the Sustainable Development Solutions Network, Pakistan.

Published in Dawn, September 29th, 2022