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“First came the rain. It didn’t stop for several days. Water filled the areas around our home. Then came the mosquitoes. I was bitten but didn’t think much of it. Not long after my body began to ache. I was sweating and had to go to the hospital. They said it was dengue. I was scared for myself, but I also wondered, ‘who will take care of my daughter if I’m sick?’
I recently met Som, a 21-year-old Lao mother. Her story was heartbreaking.
As I listened to her recover from a potentially fatal illness, I thought of the increasing rainfall and temperatures for Lao PDR in the coming years caused by climate change. Unfortunately, they provide the perfect environment for increasing numbers of mosquitoes and vector-borne infections like dengue – just one of the many ways climate change threatens human health.
In November, leaders from around the world met at COP27, the world’s largest climate change summit. We have seen some significant commitments on climate action, unfortunately, and overall funding and prioritization for health have fallen short. Each will have a significant impact on our well-being.
Each year these obligations become more critical. Some of the climate impacts that have already occurred are irreversible, some can be reversed if action is taken now. Unfortunately, the health effects are less known. People like Som, and all of us, don’t just have to worry about dengue or disasters.
Globally, between 2030 and 2050, climate change is expected to cause 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress. The cost of healthcare services and infrastructure is estimated to be US$2-4 billion per year by 2030.
Lao PDR is particularly vulnerable, with projections of more extreme weather, a temperature rise of 2–3 °C by 2050 and a 10–30% increase in precipitation, especially in the south.
The direct results are clear—increased natural disasters, injuries, and destruction—but there are far fewer obvious health effects, making action all the more urgent.
Agriculture and food systems are under threat—70% of Lao PDR’s population relies on subsistence agriculture, vulnerable to extreme weather and disasters—and food insecurity could lead to children like Somov being forced to skip or limit meals, with increase in malnutrition and the many health problems they bring.
Rising temperatures cause heat stress, causing a range of health problems. In Lao PDR, under the high emissions scenario, heat-related deaths among older people are expected to increase to approximately 72 per 100,000 by 2080.
And, we must consider the additional pressure these situations bring to an already overburdened health care system. The health system here is not ready to provide high-quality services for the rapidly increasing demands due to changes in climate conditions and extreme weather events.
Fortunately, we can mitigate this threat. Important steps are already being taken. The Ministry of Health is making ambitious progress towards a climate-resilient and low-carbon health system in line with the commitments made under the COP26 health agenda.
The new National Health Adaptation Plan outlines the way forward. Lao PDR and WHO are piloting an early warning and response system to predict climate-sensitive diseases. With support from WHO, the Global Environment Facility and the European Union, more than 70 hospitals have joined the Safe Clean, Green and Climate Resilient Initiative – introducing practical support to assess, improve and manage climate-related risks to health, water and sewage, in areas threatened by floods or droughts.
But these are just the initial steps. Solving the crisis requires commitment, investment and a new level of cooperation with the Government, the health sector and international partners.
A key component is a strong climate policy with a focus on protecting people’s health. We must ensure that climate policies—indeed, all policies—deliver both climate and health benefits.
Globally, ending our reliance on fossil fuels will reduce air pollution and the seven million annual premature deaths it causes. Higher vehicle emission standards will save approximately 2.4 million lives and reduce global warming by around 0.5 °C by 2050. Commitments at COP27 to phase out coal would save lives – reducing land burning for crop preparation in Lao PDR would do the same.
In order to develop and effectively implement such policies, high-income and high-emitting countries must meet their pledges to finance climate adaptation for developing countries. The commitments made at events like COP27 are a step in the right direction, but they must be backed up with concrete actions and the necessary funding.
Beyond these steps, there are several key actions to take.
We must ensure that climate change and adaptation measures are reflected in national policies and translated into actions and our daily lives. Unless the problem is recognized, it cannot be properly addressed.
We need to mainstream climate adaptation into existing public health programs and equip our health workers, volunteers, communities and other sectors with the knowledge to address climate events and impacts. And provide strong systems for collecting health and weather data and information. We need the full picture and people able to respond properly.
Finally, it is essential to improve health facilities by incorporating climate resilience into current water, sanitation and hygiene efforts and infrastructure—for example, protecting water sources most likely to be affected by flooding. The recent floods in August showed how vulnerable infrastructure can be and how urgent mitigation efforts are needed.
After all, these steps are not optional. We must protect health from the effects of climate change.
Lao PDR is a low carbon country. It has done little to contribute to the global climate crisis and, like many low-emission countries, has limited capacity to deal with the threats ahead.
Addressing this crisis by righting the wrongs of our polluting history is non-negotiable and requires support to ensure that mitigation efforts occur at the scale and pace required. If not, the gap between health service availability and demand will only worsen, affecting income, productivity and lives.
WHO is trying to solve the problem at all levels. We have and will continue to support the Government to develop and implement plans for adaptation and mitigation in the health sector, as well as to build resilience at the level of hospitals and health centres. We will continue to lead multisectoral collaboration to achieve health benefits across sectors.
Events like COP27 are a key opportunity for the world to come together and recommit to maintaining the Paris Agreement’s 1.5°C target, and putting health front and centre. We can’t afford to wait.
We may not be able to stop the rain entirely, but we can make changes now to be prepared to weather the storm ahead.
Dr Jing-Ru Lo is the WHO representative in Lao PDR. An infectious disease doctor from Germany, he has more than 30 years of experience as an expert in public health.
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