An assessment of the economic and social impacts of climate change on the health sector in the Caribbean

Climate change affects the fundamental bases of good human health, which are clean air, safe drinking water, sufficient food, and secure shelter. Climate change is known to impact health through three climate dimensions: extreme heat, natural disasters, and infections and diseases. The temporal and spatial climatic changes that will affect the biology and ecology of vectors and intermediate hosts are likely to increase the risks of disease transmission. The greatest effect of climate change on disease transmission is likely to be observed at the extremes of the range of temperatures at which transmission typically occurs. Caribbean countries are marked by unique geographical and geological features. When combined with their physical, infrastructural development, these features make them relatively more prone to negative impacts from changes in climatic conditions. The increased variability of climate associated with slow-moving tropical depressions has implications for water quality through flooding as well as hurricanes. Caribbean countries often have problems with water and sanitation. These problems are exacerbated whenever there is excess rainfall, or no rainfall. The current report aims to prepare the Caribbean to respond better to the anticipated impact of climate change on the health sector, while fostering a subregional Caribbean approach to reducing carbon emissions by 2050. It provides a major advance on the analytical and contextual issues surrounding the impact of climate change on health in the Caribbean by focusing on the vector-borne and waterborne diseases that are anticipated to be impacted directly by climate change. The ultimate goal is to quantify both the direct and indirect costs associated with each disease, and to present adaptation strategies that can address these health concerns effectively to benefit the populations of the Caribbean.

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.

An assessment of the economic impact of climate change on the coastal and marine sector in the British Virgin Islands

Owing to their high vulnerability and low adaptive capacity, Caribbean islands have legitimate concerns about their future, based on observational records, experience with current patterns and consequences of climate variability, and climate model projections. Although emitting less than 1% of global greenhouse gases, islands from the region have already perceived a need to reallocate scarce resources away from economic development and poverty reduction, and towards the implementation of strategies to adapt to the growing threats posed by global warming (Nurse and Moore, 2005). The objectives of this Report are to conduct economic analyses of the projected impacts of climate change to 2050, within the context of the IPCC A2 and B2 scenarios, on the coastal and marine resources of the British Virgin Islands (BVI). The Report presents a valuation of coastal and marine services; quantitative and qualitative estimates of climate change impacts on the coastal zone; and recommendations of possible adaptation strategies and costs and benefits of adaptation. A multi-pronged approach is employed in valuing the marine and coastal sector. Direct use and indirect use values are estimated. The amount of economic activity an ecosystem service generates in the local economy underpins estimation of direct use values. Tourism and fisheries are valued using the framework developed by the World Resources Institute. Biodiversity is valued in terms of the ecological functions it provides, such as climate regulation, shoreline protection, water supply erosion control and sediment retention, and biological control, among others. Estimates of future losses to the coastal zone from climate change are determined by considering: (1) the effect of sea level rise on coastal lands; and (2) the effect of a rise in sea surface temperature (SST) on coastal waters. Discount rates of 1%, 2% and 4% are employed to analyse all loss estimates in present value terms. The overall value for the coastal and marine sector is USD $1,606 million (mn). This is almost 2% larger than BVI’s 2008 GDP. Tourism and recreation comprise almost two-thirds of the value of the sector. By 2100, the effects of climate change on coastal lands are projected to be $3,988.6 mn, and $2,832.9 mn under the A2 and B2 scenarios respectively. In present value terms, if A2 occurs, losses range from $108.1-$1,596.8 mn and if B2 occurs, losses range from $74.1-$1,094.1 mn, depending on the discount rate used. Estimated costs of a rise in SST in 2050 indicate that they vary between $1,178.0 and $1,884.8 mn. Assuming a discount rate of 4%, losses range from $226.6 mn for the B2 scenario to $363.0 mn for the A2 scenario. If a discount rate of 1% is assumed, estimated losses are much greater, ranging from $775.6-$1,241.0 mn. Factoring in projected climate change impacts, the net value of the coastal and marine sector suggests that the costs of climate change significantly reduce the value of the sector, particularly under the A2 and B2 climate change scenarios for discount rates of 1% and 2%. In contrast, the sector has a large, positive, though declining trajectory, for all years when a 4% discount rate is employed. Since the BVI emits minimal greenhouse gases, but will be greatly affected by climate change, the report focuses on adaptation as opposed to mitigation strategies. The options shortlisted are: (1) enhancing monitoring of all coastal waters to provide early warning alerts of bleaching and other marine events; (2) introducing artificial reefs or fish-aggregating devices; (3) introducing alternative tourist attractions; (4) providing retraining for displaced tourism workers; and (5) revising policies related to financing national tourism offices to accommodate the new climatic realities. All adaptation options considered are quite justifiable in national terms; each had benefit-cost ratios greater than 1.