An assessment of the economic impact of climate change on the health sector In Jamaica

Climate change is a naturally occurring phenomenon in which the earth‘s climate goes through cycles of warming and cooling; these changes usually take place incrementally over millennia. Over the past century, there has been an anomalous increase in global temperature, giving rise to accelerated climate change. It is widely accepted that greenhouse gas emissions from human activities such as industries have contributed significantly to the increase in global temperatures. The existence and survival of all living organisms is predicated on the ability of the environment in which they live not only to provide conditions for their basic needs but also conditions suitable for growth and reproduction. Unabated climate change threatens the existence of biophysical and ecological systems on a planetary scale. The present study aims to examine the economic impact of climate change on health in Jamaica over the period 2011-2050. To this end, three disease conditions with known climate sensitivity and importance to Jamaican public health were modelled. These were: dengue fever, leptospirosis and gastroenteritis in children under age 5. Historical prevalence data on these diseases were obtained from the Ministry of Health Jamaica, the Caribbean Epidemiology Centre, the Climate Studies Group Mona, University of the West Indies Mona campus, and the Meteorological Service of Jamaica. Data obtained spanned a twelve-year period of 1995-2007. Monthly data were obtained for dengue and gastroenteritis, while for leptospirosis, the annual number of cases for 1995-2005 was utilized. The two SRES emission scenarios chosen were A2 and B2 using the European Centre Hamburg Model (ECHAM) global climate model to predict climate variables for these scenarios. A business as usual (BAU) scenario was developed using historical disease data for the period 2000-2009 (dengue fever and gastroenteritis) and 1995-2005 (leptospirosis) as the reference decades for the respective diseases. The BAU scenario examined the occurrence of the diseases in the absence of climate change. It assumed that the disease trend would remain unchanged over the projected period and the number of cases of disease for each decade would be the same as the reference decade. The model used in the present study utilized predictive empirical statistical modelling to extrapolate the climate/disease relationship in time, to estimate the number of climate change-related cases under future climate change scenarios. The study used a Poisson regression model that considered seasonality and lag effects to determine the best-fit model in relation to the diseases under consideration. Zhang and others (2008), in their review of climate change and the transmission of vector-borne diseases, found that: ―Besides climatic variables, few of them have included other factors that can affect the transmission of vector-borne disease….‖ (Zhang 2008) Water, sanitation and health expenditure are key determinants of health. In the draft of the second communication to IPCC, Jamaica noted the vulnerability of public health to climate change, including sanitation and access to water (MSJ/UNDP, 2009). Sanitation, which in its broadest context includes the removal of waste (excreta, solid, or other hazardous waste), is a predictor of vector-borne diseases (e.g. dengue fever), diarrhoeal diseases (such as gastroenteritis) and zoonoses (such as leptospirosis). In conceptualizing the model, an attempt was made to include non-climate predictors of these climate-sensitive diseases. The importance of sanitation and water access to the control of dengue, gastroenteritis and leptospirosis were included in the Poisson regression model. The Poisson regression model obtained was then used to predict the number of disease cases into the future (2011-2050) for each emission scenario. After projecting the number of cases, the cost associated with each scenario was calculated using four cost components. 1. Treatment cost morbidity estimate. The treatment cost for the number of cases was calculated using reference values found in the literature for each condition. The figures were derived from studies of the cost of treatment and represent ambulatory and non-fatal hospitalized care for dengue fever and gastroenteritis. Due to the paucity of published literature on the health care cost associated with leptospirosis, only the cost of diagnosis and antibiotic therapy were included in the calculation. 2. Mortality estimates. Mortality estimates are recorded as case fatality rates. Where local data were available, these were utilized. Where these were unavailable, appropriate reference values from the literature were used. 3. Productivity loss. Productivity loss was calculated using a human capital approach, by multiplying the expected number of productive days lost by the caregiver and/or the infected person, by GDP per capita per day (US$ 14) at 2008 GDP using 2008 US$ exchange rates. 4. No-option cost. The no-option cost refers to adaptation strategies for the control of dengue fever which are ongoing and already a part of the core functions of the Vector Control Division of the Ministry of Health, Jamaica. An estimated US$ 2.1 million is utilized each year in conducting activities to prevent the post-hurricane spread of vector borne diseases and diarrhoea. The cost includes public education, fogging, laboratory support, larvicidal activities and surveillance. This no-option cost was converted to per capita estimates, using population estimates for Jamaica up to 2050 obtained from the Statistical Institute of Jamaica (STATIN, 2006) and the assumption of one expected major hurricane per decade. During the decade 2000-2009, Jamaica had an average inflation of 10.4% (CIA Fact book, last updated May 2011). This average decadal inflation rate was applied to the no-option cost, which was inflated by 10% for each successive decade to adjust for changes in inflation over time.

Report of the seminar on Caribbean development thinking the path covered and the way forward

The Economic Commission for Latin America and the Caribbean (ECLAC), Subregional Headquarters for the Caribbean, and secretariat of the Caribbean Development and Cooperation Committee (CDCC) convened a Seminar on Caribbean Development Thinking: The Path Covered and the Way Forward, in Port of Spain on 21 October 2009. The meeting was attended by representatives of the following CDCC member countries: Dominica, Grenada, Guyana, Jamaica, Saint Lucia, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Suriname and Trinidad and Tobago. Representatives of the following organizations of the United Nations system also attended: the International Labour Organisation (ILO); Joint United Nations Project on HIV/AIDS (UNAIDS); and the United Nations Development Programme (UNDP). The following intergovernmental organizations were represented: the Caribbean Community (CARICOM); the Caribbean Development Bank (CDB); the Caribbean Regional Negotiating Mechanism/Caribbean Community (CRNM/CARICOM); Delegation of the European Commission in Trinidad and Tobago; the Organisation of American States (OAS); and the Organisation of Eastern Caribbean States (OECS). The University of the West Indies (UWI) also participated. The list of participants appears as annex I to this report.

Preliminary report on the implementation of the ECLAC work programme subregional activities for the Caribbean. 2008-2009 biennium (Covering the period 1 Janurary 2008- 31 August 2009)

Eighteen months into the implementation of the 2008-2009 biennial strategic work programme, the Economic Commission for Latin America and the Caribbean (ECLAC) Subregional Headquarters for the Caribbean continues to focus on strengthening the delivery of activities through regular internal meetings with programme and research staff and consultations with member countries and other partner institutions. The scaling up of efforts advocating for more evidence-based development policy-making is being advanced utilizing the resources provided through the implementation of an additional seven extrabudgetary-funded projects. This effort is being undertaken in collaboration and in consultation with our major international and regional development partners – United Nations Development Programme (UNDP), United Nations Development Fund for Women (UNIFEM), United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF), Caribbean Community (CARICOM), Caribbean Development Bank (CDB), Organisation of Eastern Caribbean States (OECS), Association of Caribbean States (ACS), Inter-American Development Bank (IDB), World Bank, Department for International Development (DFID), Caribbean Community Climate Change Centre (CCCCC). and others. In

Report of the AD HOC Expert Group meeting on social exclusion, poverty, inequality, crime and violence: Towardsa research agenda for informed public policy for Caribbean SIDS

The Economic Commission for Latin America and the Caribbean (ECLAC), Subregional Headquarters for the Caribbean convened an expert group meeting on Social Exclusion, Poverty, Inequality – Crime and Violence: Towards a Research Agenda for informed Public Policy for Caribbean SIDS on Friday 4 April 2008, at its conference room in Port of Spain. The meeting was attended by 14 experts drawn from, the University of the West Indies (UWI), St. Augustine, Trinidad and Tobago; and Mona Campus, Jamaica; the St. Georges University, Grenada; the Trinidad and Tobago Crime Commission and the Ministry of Social Development, Government of Trinidad and Tobago and representative of Civil Society from Guyana. Experts from the United Nations System included representatives from the United Nations Fund for Women (UNIFEM), Barbados; the United Nations Development Programme (UNDP), Port of Spain and UNDP Barbados/SRO and the Organisation of Eastern Caribbean States (OECS). The list of participants appears as an annex to this report. The purpose of the meeting was to provide a forum in which differing theories and methodologies useful to addressing the issues of social exclusion, poverty, inequality, crime and violence could be explored. It was expected that at the end of the meeting there would be consensus on areas of research which could be pursued over a two to four-year period by the ECLAC Subregional Headquarters for the Caribbean and its partners, which would lead to informed public policy in support of the reduction of the growing violence in Caribbean society.

Summary report of the Caribbean meeting of experts on Implementation of the SIDS Plan of Action

The Caribbean Meeting of Experts on Implementation of the SIDS Programme of Action, held at the Holiday Inn Hotel, Port of Spain, Trinidad and Tobago, 17-19 May 1995 was convened to review progress towards implementation of the SIDS Programme of Action (SIDS-POA), to discuss constraints on the effective implementation of the Programme and to agree on priority areas for action. It was organized by the Economic Commission for Latin America and the Caribbean/Caribbean Development and Cooperation Committee (ECLAC/CDCC), in collaboration with the United Nations Development Programme’s Special Unit for Technical Cooperation among Developing Countries (UNDP/TCDC), the United Nations Environment Programme (UNEP), the University of the West Indies Centre for Environment and Development (UWICED), and the Caribbean Community (CARICOM). A copy of the programme and a list of documents are attached to this report as Annex I and II respectively.