Editor's Choice

Climate change and health

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7467.0-g (Published 16 September 2004) Cite this as: BMJ 2004;329:0-g
  1. Kamran Abbasi, acting editor (kabbasi{at}bmj.com)

    Sometimes it snows in April, sang Prince—but September? Readers from outside the United Kingdom—and the future, who may have found this week's issue in a time capsule—needn't be confused when they see the cover picture of a frail old lady negotiating a wintry London street. Climate change has brought us unseasonable temperatures, floods, and whirlwinds; it is yet to bring us snow in September. How long before it does though? Among the great issues of our time, the state of our environment has been lost from the political—if not public—agenda.

    This week, Tony Blair showed some concern that our descendants may not have a planet worth inhabiting. Yet many of us find it hard to predict how our actions today will change our lives even a week ahead; a millennium is incomprehensible. Warnings and signs of our hastening doom have been largely ignored—or downplayed. Melting ice caps and rising seas are not immediately noticeable. Floods in South Asia and drought in Africa are someone else's problem. An Alaskan village on the edge of the Arctic Circle and the islands of the Maldives are paradises soon to be lost. But hurricane after hurricane ripping through Florida and devastating the Caribbean is harder to ignore. The rich world and the poor world are united in vulnerability to nature. The war on weather is one that we are hopelessly ill equipped to win; prevention is our only salvation.

    The United Nations Environment Programme acknowledges that deteriorating environmental conditions are a major contributor to poor health and reduced quality of life, directly responsible for 25% of all preventable ill health, particularly diarrhoeal and acute respiratory infections. An estimated 7% of deaths and diseases globally are attributed to inadequate or unsafe water, sanitation, and hygiene, while 5% are caused by air pollution. And then there are the health and economic consequences of major floods and hurricanes.

    The earth's surface temperature, which had dropped 0.2°C over a thousand years, has jumped 0.4°C over the last hundred. The sea level is up 15 cm and the global concentration of atmospheric CO2 has risen by 25% in a century of rapid technological advance but equally rapid environmental destruction. These changes may already be irreversible.

    What of the future? In 1999, experts on the effects of climate change on health argued in the BMJ that the difficulties in predicting the health effects must not be used to delay helpful interventions. Few governments had undertaken research to assess the likely implications of climate change or evaluate methods of minimising the impact on health. Gro Harlem Bruntland emphasised that “erosion of life support systems at a global level has become a serious and pressing public health issue.” Are we any wiser or better prepared than five years ago? And why is there snow on the cover of the BMJ in September? It must be time to plan seriously for bad weather.

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