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» » » » Climate change and health in Nigeria by Adepoju Andrew Adekunle

With 173 million people, Nigeria is the most populated country in Africa. As the continent’s main exporter of oil, Nigeria faces the challenge of balancing global energy demands and domestic economic stability with the need to address climate and environmental considerations.
The impacts of climate change in Nigeria could include rising temperatures, more intense and frequent extreme weather events and sea level rise. For the population this could result in increased water and food insecurity, higher exposure to heat stress and ultraviolet radiation, changes in infectious and vector-borne disease transmission patterns and an increased threat to coastal communities facing sea level rise. Adequate adaptation and mitigation could help to protect public health, development, security, and land and water resources from the potential threats posed by climate change.
  1. CURRENT AND FUTURE HEALTH RISKS DUE TO CLIMATE CHANGE
Human health is profoundly affected by weather and climate. Climate change threatens to exacerbate today’s health problems – deaths from extreme weather events, cardiovascular and respiratory diseases, infectious diseases and malnutrition – whilst undermining water and food supplies, infrastructure, health systems and social protection systems.
  1. EXPOSURE TO FLOODING DUE TO SEA LEVEL RISE
Source: Human dynamics of climate change, technical report, Met Office, HM Government, UK, 2014.

Under a high emissions scenario, and without large investments in adaptation, an annual average of 548,300 people are projected to be affected by flooding due to sea level rise between 2070 and 2100. If emissions decrease rapidly and there is a major scale up in protection (i.e. continued construction/raising of dikes) the annual affected population could be limited to about 300 people. Adaptation alone will not offer sufficient protection, as sea level rise is a long-term process, with high emissions scenarios bringing increasing impacts well beyond the end of the century.
KEY IMPLICATIONS FOR HEALTH
Nigeria also faces inland river flood risk. It is projected, that by 2030, an additional 801,700 people may be at risk of river floods annually as a result of climate change and 535,700 due to socio economic change above the estimated 621,100 annually affected population in 2010.
In addition to deaths from drowning, flooding causes extensive indirect health effects, including impacts on food production, water provision, ecosystem disruption, and infectious disease outbreak and vector distribution. Longer term effects of flooding may include post-traumatic stress and population displacement.
  1. INFECTIOUS AND VECTOR-BORNE DISEASES
Source: Rocklöv, J., Quam, M. et al. 2015.
By 2070, under both high and low emissions scenarios over 400 million people are projected to be at risk of malaria. Population growth can also cause increases in the population at risk in areas where malaria presence is static in the future.

KEY IMPLICATIONS FOR HEALTH
Some of the world’s most virulent infections are also highly sensitive to climate: temperature, precipitation and humidity have a strong influence on the life-cycles of the vectors and the infectious agents they carry and influence the transmission of water and foodborne diseases.
Socioeconomic development and health interventions are driving down burdens of several infectious diseases, and these projections assume that this will continue. However, climate conditions are projected to become significantly more favourable for transmission, slowing progress in reducing burdens, and increasing the populations at risk if control measures are not maintained or strengthened.
  1. ESTIMATED NUMBER OF DEATHS DUE TO DIARRHOEAL DISEASE IN CHILDREN UNDER 15 YEARS IN NIGERIA (BASE CASE SCENARIO FOR ECONOMIC GROWTH)
Source: Lloyd, S., 2015.
In Nigeria, there were an estimated 137,600 diarrhoeal deaths in children under 15 years old in the baseline period of 2008. Under a high emissions scenario, diarrhoeal deaths attributable to climate change in children under 15 years old is projected to be about 9.8% of the over 76,000 diarrhoeal deaths projected in 2030. Although diarrhoeal deaths are projected to decline to approximately 43,500 by 2050 the proportion of deaths attributable to climate change will rise to approximately 14.2%.
  1. HEAT-RELATED MORTALITY
Source: Honda et al., 2015.
Under a high emissions scenario heat-related deaths in the elderly (65+ years) are projected to increase to almost 80 deaths per 100,000 by 2080 compared to the estimated baseline of about 3 deaths per 100,000 annually between 1961 and 1990. A rapid reduction in emissions could limit heat-related deaths in the elderly to under 15 deaths per 100,000 in 2080.
KEY IMPLICATIONS FOR HEALTH
Climate change is expected to increase mean annual temperature and the intensity and frequency of heat waves resulting in a greater number of people at risk of heat-related medical conditions.
The elderly, children, the chronically ill, the socially isolated and at-risk occupational groups are particularly vulnerable to heat-related conditions.
  1. UNDERNUTRITION
Climate change, through higher temperatures, land and water scarcity, flooding, drought and displacement, negatively impacts agricultural production and causes breakdown in food systems. These disproportionally affect those most vulnerable to hunger and can lead to food insecurity. Vulnerable groups risk further deterioration into food and nutrition crises if exposed to extreme weather events.
Without considerable efforts made to improve climate resilience, it has been estimated that the risk of hunger and malnutrition globally could increase by up to 20 percent by 2050.
In Nigeria, the prevalence of child malnutrition in children under age 5 was 31% in 2013.
  1. CURRENT EXPOSURES AND HEALTH RISKS DUE TO AIR POLLUTION
Many of the drivers of climate change, such as inefficient and polluting forms of energy and transport systems, also contribute to air pollution. Air pollution is now one of the largest global health risks, causing approximately seven million deaths every year. There is an important opportunity to promote policies that both protect the climate at a global level, and also have large and immediate health benefits at a local level.
  1. OUTDOOR AIR POLLUTION EXPOSURE AND SHORT LIVED CLIMATE POLLUTANTS
KEY IMPLICATIONS FOR HEALTH
Outdoor air pollution can have direct and sometimes severe consequences for health. Fine particles which penetrate deep into the respiratory tract subsequently increase mortality from respiratory infections, lung cancer and cardiovascular disease.
Short-lived climate pollutants (SLCPs) such as black carbon, methane and tropospheric ozone are released through inefficient use and burning of biomass and fossil fuels for transport, housing, power production, industry, waste disposal (municipal and agricultural) and forest fires. SLCPs are responsible for a substantial fraction of global warming as well as air-pollution related deaths and diseases.
Since short lived climate pollutants persist in the atmosphere for weeks or months while CO2 emissions persist for years, significant reductions of SLCP emissions could result in immediate health benefits and health cost savings, and generate very rapid climate benefits – helping to reduce near-term climate change by as much as 0.5oC before 2050.
In Nigeria, it is projected that a reduction in SLCPs could prevent over 69,000 premature deaths per year from outdoor air pollution, from 2030 onwards (Source: Shindell, D., Science, 2012].
  1. HOUSEHOLD AIR POLLUTION
Percentage of population primarily using solid fuels for cooking (%), 2013
Source: Global Health Observatory, data repository, World Health Organisation, 2013.


Per cent of total deaths from ischaemic heart disease, stroke, lung cancer, chronic obstructive pulmonary disease (18 years +) and acute lower respiratory infections (under 5 years) attributable to household air pollution, 2012
Source: Global Health Observatory, data repository, World Health Organization, 2012.
KEY IMPLICATIONS FOR HEALTH
Air pollution in and around the home is largely a result of the burning of solid fuels (biomass or coal) for cooking.
Women and children are at a greater risk for disease from household air pollution. Consequently, household air pollution is responsible for a larger proportion of the total number of deaths from ischaemic heart disease, stroke, lung cancer and COPD in women compared to men.
In Nigeria, 57% percent of an estimated 130, 900 child deaths due to acute lower respiratory infections is attributable to household air pollution (WHO, 2012).

  1. CO-BENEFITS TO HEALTH FROM CLIMATE CHANGE MITIGATION: A GLOBAL PERSPECTIVE
Health co-benefits are local, national and international measures with the potential to simultaneously yield large, immediate public health benefits and reduce the upward trajectory of greenhouse gas emissions. Lower carbon strategies can also be cost-effective investments for individuals and societies.
Presented here are examples, from a global perspective, of opportunities for health co-benefits that could be realised by action in important greenhouse gas emitting sectors.
  1. TRANSPORT
Transport injuries lead to 1.2 million deaths every year, and land use and transport planning contribute to the 2–3 million deaths from physical inactivity. The transport sector is also responsible for some 14% (7.0 GtCO2e) of global carbon emissions. The IPCC has noted significant opportunities to reduce energy demand in the sector, potentially resulting in a 15%–40% reduction in CO2 emissions, and bringing substantial opportunities for health: A modal shift towards walking and cycling could see reductions in illnesses related to physical inactivity and reduced outdoor air pollution and noise exposure; increased use of public transport is likely to result in reduced GHG emissions; compact urban planning fosters walkable residential neighbourhoods, improves accessibility to jobs, schools and services and can encourage physical activity and improve health equity by making urban services more accessible to the elderly and poor.
  1. HOUSEHOLD HEATING, COOKING AND LIGHTING
Household air pollution causes over 4.3 million premature deaths annually, predominantly due to stroke, ischaemic heart disease, chronic respiratory disease, and childhood pneumonia. A range of interventions can both improve public health and reduce household emissions: a transition from the inefficient use of solid fuels like wood and charcoal, towards cleaner energy sources like liquefied petroleum gas (LPG), biogas, and electricity could save lives by reducing indoor levels of black carbon and other fine particulate matter; where intermediate steps are necessary, lower emission transition fuels and technologies should be prioritized to obtain respiratory and heart health benefits; women and children are disproportionately affected by household air pollution, meaning that actions to address household air pollution will yield important gains in health equity; replacing kerosene lamps with cleaner energy sources (e.g. electricity, solar) will reduce black carbon emissions and the risk of burns and poisoning.
  1. ELECTRICITY GENERATION
Reliable electricity generation is essential for economic growth, with 1.4 billion people living without access to electricity. However, current patterns of electricity generation in many parts of the world, particularly the reliance on coal combustion in highly polluting power plants contributes heavily to poor local air quality, causing cancer, cardiovascular and respiratory disease. Outdoor air pollution is responsible for 3.7 million premature deaths annually, 88% of these deaths occur in low and middle income countries. The health benefits of transitioning from fuels such as coal to lower carbon sources, including ultimately to renewable energy, are clear: Reduced rates of cardiovascular and respiratory disease such as stroke, lung cancer, coronary artery disease, and COPD; cost-savings for health systems; improved economic productivity from a healthier and more productive workforce.
  1. HEALTHCARE SYSTEMS
Health care activities are an important source of greenhouse gas emissions. In the US and in EU countries, for example, health care activities account for between 3–8% of greenhouse gas (CO2-eq) emissions. Major sources include procurement and inefficient energy consumption. Modern, on-site, low-carbon energy solutions (e.g. solar, wind, or hybrid solutions) and the development of combined heat and power generation capacity in larger facilities offer significant potential to lower the health sector’s carbon footprint, particularly when coupled with building and equipment energy efficiency measures. Where electricity access is limited and heavily reliant upon diesel generators, or in the case of emergencies when local energy grids are damaged or not operational, such solutions can also improve the quality and reliability of energy services. In this way, low carbon energy for health care could not only mitigate climate change, it could enhance access to essential health services and ensure resilience.
  1. EMISSIONS AND COMMITMENTS
Global carbon emissions increased by 80% from 1970 to 2010, and continue to rise. Collective action is necessary, but the need and opportunity to reduce greenhouse gas emissions varies between countries. Information on the contribution of different sectors, such as energy, manufacturing, transport and agriculture, can help decision-makers to identify the largest opportunities to work across sectors to protect health, and address climate change.
Nigeria ANNUAL GREENHOUSE GAS EMISSIONS (metric tonnes CO2 equivalent)
Source: UNFCCC Greenhouse Gas Data Inventory, UNFCCC (2015)
The most recent greenhouse gas emissions data for Nigeria is from the year 2000. At that time, the largest contributions of carbon emissions were from the agriculture and ‘other’ sectors. Through intersectoral collaboration, the health community can help to identify the best policy options not only to eventually stabilize greenhouse gas emissions, but also to provide the largest direct benefits to health.
A 2ºC upper limit of temperature increase relative to pre-industrial levels has been internationally agreed in order to prevent severe and potentially catastrophic impacts from climate change. Reductions are necessary across countries and sectors. In order to stay below the 2ºC upper limit it is estimated that global annual CO2-energy emissions, currently at 5.2 tons per capita, need to be reduced to 1.6 tons per capita.

  1. OPPORTUNITIES FOR ACTION
Nigeria has an approved National Health Adaptation Strategy, and is currently implementing projects on health adaptation to climate change. Country reported data indicate there are further opportunities for action in the following areas:
  1. ADAPTATION
  • Conduct a comprehensive vulnerability and adaptation assessment with a focus on health that includes relevant stakeholders from all sectors.
  • Implement actions to build institutional and technical capacities to work on climate change and health.
  • Implement activities to increase climate resilience of health infrastructure.
  • Estimate the costs to implement health resilience to climate change.
  1. MITIGATION
  • Initiate actions for greening the health sector, such as promoting the use of renewable energy.
  • Conduct a valuation of the co-benefits to health of climate mitigation policies.

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