from the ground Up

The Straits Times, Editorial, April 14 2008

SINGAPOREANS should get accustomed to the thinking that environmental warming through climate change can be bad for health. The Government is spending $200,000 a day on vector control to prevent dengue fever from growing into an endemic public health menace. It has been barely weeks since the health authorities managed to stop an outbreak of chikungunya from spreading beyond Little India. Global warming may be implicated in these diseases more than is known. The Aedes mosquito, the vector responsible for both, is highly sensitive to changes in climate, the World Health Organisation (WHO) says. As other determinants have remained constant, WHO says, studies suggest that climate change could expose two billion more people to dengue by the 2080s. Did a chikungunya outbreak in Italy recently mean the vector will establish itself in temperate countries as well on account of warming temperatures, the United States Centres for Disease Control wonders. Climate change is gradual. But the severe weather it brings – storms, floods, droughts and heatwaves – affects everything to do with health, such as air, water, food, shelter. At least 35,000 people died in the European heatwave of 2003. Hurricane Katrina and its aftermath killed 1,800 people, displaced thousands more and destroyed many health facilities in the southern United States in 2005. Warming trends over the last 30 years have created favourable conditions for mosquitoes in East Africa’s highlands and, thus, for malaria transmission. Major outbreaks of Rift Valley fever in Africa will likely increase as rains become more frequent with climate change. Cholera epidemics in Bangladesh usually come after cyclones, made more severe by climate change, that cause flooding and contaminate water supplies. WHO does not attribute all these trends and events solely to global warming, but recognises that they are challenges that strain health-care resources, which in many countries are already under stress. Singaporeans are fortunate to have an environmental health system that is equal to the task of surveillance, prevention and containment, if not eradication. The authorities will do well to continue integrating the health dimension in housing and recreational planning. Singapore is also in a position to participate in WHO and regional efforts to help countries adapt to the effects of climate trends so as to reduce their impact on human health. As the global climate changes, Singaporeans need to recognise the persistence of dengue outbreaks as a warning against complacency.