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THE world health Organization (WHO), established in 1948 by the United Nations (UN), has a mission to promote international cooperation for improved health conditions of all peoples. The headquarters for WHO are in Geneva, Switzerland. Operations fall under the World Health Assembly (the policymaking body holds annual meetings), an executive board of health (specialists elected for three-year terms by the assembly) and a secretariat with regional offices and staff throughout the world. Financing for the services provided by WHO comes from member governments based on ability to pay and, since 1951, from an allocation from the technical assistance program of the UN.

The auspices of the WHO include providing a central clearinghouse for information and research as relates to health, sponsoring measures for the control of disease, and strengthening and expanding the public health administrations of member nations.

Overall health depends on potable water for drinking and washing, sufficient nutrition, and shelter and protection from weather extremes. Increased temperatures, rising sea levels, and changing weather patterns are factors affecting food, water, and shelter. Excellent health services and living conditions would have a protective or palliative effect on those populations. Substandard health services and living conditions would have a negative effect on populations in poverty or in disaster situations.

For prevention and preparedness, the WHO coordinates review of scientific evidence on the links between climate, climate change, and health. On the basis of the information available, WHO established a list of possible health effects resulting from rapid climate change, especially in vulnerable populations. The effect of warmer temperatures would increase the incidence of heat-related illnesses and lead to higher concentrations of ground-level ozone pollution, causing respiratory illnesses (diminished lung function, asthma, and respiratory inflammation). Flooding associated with storms and rising sea levels could increase the risk of contracting certain infectious diseases from water contamination or disease-carrying vectors, especially for the malnourished.

world health programs and activities

WHO supports actions to reduce human influence on the global climate while still recognizing the effect past emissions and human action have on the likelihood of warming and more variable climate for at least several decades. To alleviate this issue as well as reduce health vulnerability to future climate change, WHO supports programs for combating infectious diseases, improving water and sanitation, and ensuring response to natural disasters. In addition, research and effort are being put into building the capacity of health services and information to help adapt to climate changes.

Primary prevention includes actions to prevent the onset of disease from environmental disturbances in an otherwise unaffected population (mosquito nets, vector control, early weather-watch warning systems). Secondary prevention includes early-response action (disease surveillance). Tertiary prevention includes diagnosis and treatment to lessen the morbidity or mortality caused by disease.

Adaptation refers to actions taken to lessen the effects of the anticipated changes in climate. The ultimate goal of adaptation interventions is the reduction, with the least cost, of diseases, injuries, disabilities, suffering, and death from climate change. Public health programs should anticipate the health effects of climate change such as, for instance, those on infectious diseases. For example, surveillance systems could be improved in sensitive geographic areas. Such regions include those bordering areas of current distribution of vector-borne diseases that could themselves experience epidemics under certain climatic conditions. Vaccination programs could be intensified, and pesticides for vector control and drugs for prophylaxis and treatment could be stockpiled.

To prepare for climate change, the WHO encourages and fosters international cooperation through collaborating with partners (UN agencies and other international organizations, donors, civil society, and the private sector). WHO provides support to countries to implement programs using best technical guidelines and practices and helping to establish health priorities and strategy.

To prepare appropriately for climate change, climate and environmental monitoring are essential. To be most effective, health professionals must interact with the environmental sectors to evaluate the changing climate and assess risks. Researchers and monitoring organizations interested in health impact assessment have requested assistance from health researchers to ensure an accurate risk assessment. Health researchers must also be encouraged to access environmental data or be given the tools necessary to find the information on air and water pollution levels. Additional monitoring should include food contamination and identification of emission sources or contamination sites. The WHO/ECEH (European Centre for Environment and Health) is developing a Health and Environment Geographic Information System (HEGIS) to identify areas and issues of priority for the environment and health. With an initial focus on demographics and air quality, the information system has the potential for expansion to include climate change data and health effects.

The agenda of WHO includes promoting development of health-promoting activities, fostering health security, strengthening health systems, and collecting and disseminating research information.

Health development is directed by the ethical principle of equity: access to lifesaving or health-promoting interventions should not be denied for unfair (economic or social) reasons. Despite how health has become a

Children in Uganda: The World Health Organization coordinates review of scientific evidence on the links between climate change and health. Increased temperatures, rising sea levels, and changing weather patterns would affect food, water, and shelter.

standard factor in perception of social and economic progress, as well as receiving additional resources and funding, poverty and poor health are still widespread around the world. WHO activities are aimed at health development and at making health outcomes in poor, disadvantaged, or vulnerable groups a priority. The organization's agenda is to focus on the prevention and treatment of chronic disease in all populations and to research and address tropical diseases as part of their Millennium Development goals.

WHO intends to foster health security even for vulnerable populations by demanding action from the international community in addressing preventable diseases. Forty percent of the global population is very poor, many suffer from water shortages, more than a billion lack safe drinking water, and water-related diseases cause between 2 and 5 million deaths each year. Public health and preventive measures are available, and action is justified, including vaccination or control measures such as improved sanitation and temperature control of foods. In addition there is the risk of outbreaks from emerging and epidemic-prone disease.

Such outbreaks are occurring in increasing numbers, fuelled by such factors as rapid urbanization, environmental mismanagement, the way food is produced and traded, and the way antibiotics are used and misused. The threat of climate change also demands action for building capacity and adaptabilities to climate change. WHO provides workshops in vulnerable countries and works with policymakers to ensure adequate healthcare is available for treatment. These activities have a twofold benefit: action taken now both improves current health conditions and provides a foundation for additional adaptation measures in the future to address climate changes.

As an ultimate measure for ensuring adequate health care not only in the future but in the present as well, health systems around the world must be strengthened. To function as a method for reducing poverty, health services must be available to all populations, including those that are now underserved because of economic reasons. WHO works with countries to ensure an adequate number of trained professional and additional staff to meet the healthcare needs, funding to provide services, and access to medication and supplies as well as the technology to provide appropriate care.

For collecting and disseminating research information, the WHO maintains a searchable database on the Web on a broad range of health subjects including links to journal articles, research undertaken, and recommendations. As mentioned before, the WHO/ ECEH also is developing a HEGIS to identify areas and issues of priority for environment and health. With an initial focus on demographics and air quality, the information system has the potential for expansion to include climate change data and health effects.

sEE ALso: Food Production; Population; United Nations.

BIBLioGRAPHY. World Health Organization, Early Human Health Effects of Climate Change and Stratospheric Ozone Depletion in Europe (WHO, April 9, 1993); World Health Organization, "The WHO Agenda,"; Intergovernmental Panel on Climate Change, "Potential Impacts of Climate Change," docs/001-011/001-011.html; Worldwatch Institute, Vital Signs 2006-2007 (Norton, 2006).

LYN MlCHAUD Independent Scholar

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