Background Information

Climate change is a massive global health and humanitarian crisis, according to the world Health Organization (WHO), climate change will approximately cause 250,000 additional deaths per year between 2030 and 2050 due to increase in heat stress, dengue, malaria and malnutrition. According to IPCC report of 2021, it is estimated that 700,000 to 2.7 millions people die of malaria each year and 75% of those are African children. Malaria incidences are caused by a variety of factors, including poor drug-treatment implementation, drug resistance, land-use change, and various socio-demographic factors such as poverty (Githeko and Ndegwa, 2001; Patz et al., 2002). Malaria's economic burden is estimated to be a 1.3% annual reduction in economic growth for African countries with the highest burden (Gallup and Sachs, 2001).

Tanzania is already experiencing increased climate variability and climate change which resulting in higher temperatures, lower rainfall amounts and shifts in rainfall pattern. Climate change has significant implications for our health, well-being and safety, and it may have an impact on our health and well-being through the effects of extreme weather events, threats to food and water quality and quantity, and worsening air quality (Stacy Sampson, 2020). Weather and climate have a significant impact on human health. Climate change has the potential to exacerbate today's health issues, such as deaths from extreme weather events, cardiovascular and respiratory diseases, infectious diseases, and malnutrition, while undermining water and food supplies, infrastructure, health systems, and social protection systems

Climate change and health in Tanzania

Climate change has an impact on human health and well-being through a variety of mechanisms. According to Menne et al, 2002, climate change has negatively impact on the availability of fresh water supplies, the efficiency of local sewerage systems, and food security. Also, changes in food production and security significantly affect human health in Tanzania.

The distribution and seasonal transmission of several vector borne infectious diseases (such as malaria, dengue and schistosomiasis) may also be affected by climate change. Other climate sensitive diseases include water related diseases (cholera, typhoid, amoebiasis, giardiasis, cryptosporidiasis and leptospirosis) and additional vector borne diseases (filariasis, trypanosomiasis, onchocerciasis, Lyme disease, Rift Valley fever, yellow fever, encephalitis, leishmaniasis and plague). Tanzania has at one time or another suffered the burden of many of these diseases.

Sensitivity of vector-borne disease transmission to weather and climate depends upon (Hainesa et al 2006): rainfall, which affects the availability and suitability of disease vector habitats; and, temperature, which affects the rate of vector and pathogen development and also the vector blood-feeding rates, and, affects the suitability of habitats for disease reservoirs.

Tanzania’s health sector struggles with these many challenges, with the most important possibly being child and maternal death. They have been working to reduce these and so far it has accomplished a reduction in child mortality from 99/ 1000 live births in 1996 to 68/ 1000 live births in 2005. In controlling epidemic diseases, the ministry has successfully reduced death from cholera from 12,266 patients in 1999 to 6,254 patients in 2004. Despite of this success, Tanzania has one of the highest maternal mortality ratios with national estimates as high as 1100 in 1995 (WHO, 2001) increasing to 1500 per 100 000 live births in 2006 (WHO, 2007)

Temperature problem to health

According to the WHO 2015, mean annual temperature is projected to rise by about 4.7°C on average from 1990 to 2100. Temperature rise is limited to about 1.2°C if global emissions fall rapidly. Climate change can cause direct injury and death. Warming until 2090 is projected in range of 1.60C to 5.00C depending on the level of greenhouse gases in the atmosphere (Tanzania NDC, 2021). Weather can devastate housing, contaminate water supplies, hinder food production, and spread infectious diseases. This will exacerbate the existing disease burden, whose successful treatment is already hampered by the health system's inadequate infrastructure. Given these health outcomes and their relationship to climate, it's easy to see how long-term climate change will impact global population health. Extreme thermal activity has long been a threat to public health, and the heatwave period saw an increase in death rates.

Health challenges as a result of climate change

Climate impact on human health

Climate change is already having an impact on health in a variety of ways including the increased frequency of extreme weather events such as heatwaves, floods, the disruption of food systems, water and vector-borne diseases and mental health issues. Moreover, climate change is undermining many of the social determinants of health such as livelihoods, equality, and access to health care. These climate-related health risks disproportionately affect the most vulnerable and disadvantaged people, including women, children, low-income communities and the elderly (WHO, 2021).

Under a high emissions scenario, 808,200 people annually are projected to be affected by flooding due to sea level rise between 2070 and 2100. Flooding causes extensive indirect health effects including impacts on food production, water provision, ecosystem disruption, infectious disease outbreak and vector distribution. Vector-borne diseases, diarrheal diseases and malnutrition are all influenced by seasonal, inter-annual climate variability, and are predicted to increase with increasing temperatures (WHO, 2015).

Water related diarrheal diseases including cholera are widespread in areas where water resources are scarce and the majority of diarrheal diseases can be attributed to environmental factors such as unsafe drinking water, poor hygiene and lack of sanitation (Pruss Ustun and Corvalan, 2006). Also, when water is available it is often of poor quality, thus contributing to a range of health problems including diarrhea and intestinal worms (Africa IPCC report, 2022). Diarrheal diseases are more common in both high and low rainfall areas. From a different dimension heavy rains can contaminate water systems by transporting human and animal faecal products and other wastes in the surface and ground water which are associated with diarrheal disease outbreaks (NCCS, 2012). At higher temperatures, diarrheal diseases such as salmonellosis and campylobacteriosis become more common, with patterns varying depending on location and pathogen. Diarrheal diseases are a significant public health issue in the community. Diarrhea is caused by exposure to a wide range of pathogens in food and water. Water temperatures, rainfall patterns, extreme rainfall events, and seasonal fluctuations are all known to influence disease transmission.

Climate effect on animal health

Pastoral communities in Tanzania are extremely vulnerable as climate change shrinks the rangelands required for livestock keeping communities. Currently, it is estimated that about 60% of the total rangeland is infested by tsetse fly, making it unsuitable for livestock pastures and human settlements (NAPA- United Republic of Tanzania, 2007). Climate change has an impact on child development in these livestock-keeping communities as well, as children are forced to migrate indefinitely in search of grazing areas and are unable to attend school. Their future also appears bleak, as they may find themselves without an economic foundation to run their own lives when they reach adulthood.

Existing efforts at national and community levels

So far, Government of Tanzania in collaboration with other stakeholders has recognized the urgent need for addressing the impacts of climate change and in pursuing a climate-resilient development pathway. In 2007, the Government prepared a National Adaptation Programme of Action (NAPA). In 2021 they submitted the Nationally Determined Contribution (NDC), National Climate Change Strategy of 2021, 2021-2026 aims to enable Tanzania to effectively adapt to climate change and participate in global efforts to mitigate climate change, whilst also achieving sustainable development. Both documents identify health as one of the key vulnerable sectors and propose strategic adaptation measures. Currently, the Tanzanian Government is in the process of reviewing its Health National Adaptation Plan (HNAP).

The Government of Tanzania, in collaboration with different stakeholders (Civil Society Organization - CSOs, Private sector, CBOs and activist continues to advocate community sensitization on means of adapting and mitigating with the effect of climate change

Existing challenges

Despite of the efforts made by the Government and other stakeholders, they are some of challenges still existing including:

There are no effective preparedness plans, warning systems, mitigation strategies and public education programmes
ü Lack of weather and climate forecasting information to enable local people at the ground level to predict the sessions
ü No enough research and clear data on how climate change have affected health sector

Recommendations

ü CSOs, Community members, LGAs, Ministries, to improve early warning systems for climate sensitive disease outbreak
ü Government, LGAs, CSOs, emergency managers, local decision makers and media needs to create effective preparedness plans, warning systems, mitigation strategies and public education programmes
ü Weather and climate forecasting, as well as early warning systems, must be developed and implemented. These systems can be used to provide information that enables and persuades people and organizations to protect themselves and their property, reducing the number of deaths, injuries, and property damage caused by the hazard.
ü Most assessment have concentrated on malaria and there are still debates on the attribution of malaria resurgence in some African areas. The need exists to examine the impacts of future climate change on other health problems and their associated vulnerabilities (IPCC, 2022)
ü Promoting vulnerability and risk assessment of climate change risks on human health

References

· United Republic of Tanzania Climate and Health country profile – 2015 World Health Organization
· National Adaptation Programme of Action (NAPA) - 2007 The United Republic of Tanzania, Vice President’s Office, Dar es Salaam, Tanzania.
· Africa Intergovernmental Panel on Climate Change (IPCC) – 2022 · Medically reviewed by Stacy Sampson, D.O. — Written by Jayne Leonard on February 7, 2020 – How does Climate Change affect human health
· Tanzania National Determinant Contribution, July 2021 The United Republic of Tanzania, Vice President’s Office, Dar es Salaam, Tanzania.
· Tanzania National Climate Change Strategy – 2012 The United Republic of Tanzania, Vice President’s Office, Dar es Salaam, Tanzania.
· Climate Change and Health – October 2021 World Health Organization,
· Pruss Ustun A. and C. Corvalan 2006. Preventing disease through healthy environments: Towards an estimate of the environmental burden of disease. World Health Organization. Geneva, Switzerland
· World Health Organization, 2016 – Disasters and mental health
· Gallup, J.L. and Sachs, J.D. (2001) The Economic Burden of Malaria. American Journal of Tropical Medicine and Hygiene, 64, 85-96
· A. Hainesa, R.S. Kovatsa, D. Campbell-Lendrumb, C. Corvalan 2006. Climate change and human health: Impacts, vulnerability and public health