Climate change, including climate variability, has multiple influences on human health. Both direct and indirect impacts are expected. These include alterations in the geographic range and intensity of transmission of vector-, tick-, and rodent-borne diseases and food- and waterborne diseases, and changes in the prevalence of diseases associated with air pollutants and aeroallergens. Climate change could alter or disrupt natural systems, making it possible for diseases to spread or emerge in areas where they had been limited or had not existed, or for diseases to disappear by making areas less hospitable to the vector or the pathogen. The World Health Organization (WHO) estimates that climate change may already be causing over 150,000 deaths globally per year. While direct and immediate impacts such as deaths in heat waves and floods can often be dramatic and provoke immediate policy-responses, the most important long-term influences will likely act through changes in natural ecosystems and their impacts on disease vectors, waterborne pathogens, and contaminants. Reviewing these concerns overall, climate change has recently been identified as “the biggest global health threat of the 21st Century”. Moreover, Africa already experiences an extremely high burden of climate-sensitive diseases, including 90% of the global burden of malaria, and the highest per capita burden of malnutrition and diarrhea.
Given the significance of health-related climate change impacts, and the combination of Ghana’s vulnerability to climate change and the existing disease burden, Ghana has sought SCCF funding for the development of a Full-Size Project (FSP) to implement climate change adaptation priorities in Ghana, in order to secure the health-related Millennium Development Goals (MDGs) under changing climatic conditions. The PIF was endorsed by the GEF Operational focal Point in Ghana and approved by the GEF board in the second half of 2009. The current proposal follows GEF and SCCF guidelines to provide the additional information to be submitted to the GEF Board for approval in May 2010.
Ghana experiences a number of environmental problems that impact on the achievement of development goals, and there are indications that the country is being affected by an increasing incidence of climate-related natural disasters. The precursor study to Ghana’s Country Environmental Profile showed that the basis for Ghana’s economic growth is being achieved only at high cost to the environment, conservatively estimated at around 6% of GDP, or around $500 million annually. This estimate excludes the health and environmental costs arising from industrial and artisanal mining, inadequate urban sanitation and waste, and indoor and outdoor air pollution. It also does not include costs arising from social conflicts over access to increasingly scarce resources. Nor do these costs include the predicted impacts on these and other variables of the climate change impacts described below.
Recent examples of increasing natural disasters include the 2007 floods, which struck the three Northern regions and parts of the Western region. The major incidence of disasters in Ghana is from floods, epidemics, fire, pests and diseases and conflicts. As there is a very high reliance on rainfed agriculture for food security in Ghana, drought is a top natural disaster risk. In recent times these disasters have caused major disruptions in the economic and social development of the country, due to the inability to cope effectively with natural hazards. The main sources of vulnerability include poverty and development pressures (including rising population pressures and unplanned urbanization). Other factors include fragile and degraded environments, epidemic diseases (especially malaria and HIV/AIDS), and governance issues. These factors can interact with climate change to exacerbate current disease burdens.
As noted in the 2006-2010 United Nations Development Assistance Framework (UNDAF), health care in Ghana remains poor with a national average of just over 50% with access to health care. The proportion of people with access to health care is far lower in the three northern regions and some of the coastal areas. The health burden in Ghana falls significantly on children under five years of age: while this age group comprises approximately 20% of the population, among this group constitutes over 50% of all recorded deaths. Neonatal mortality (death occurring among infants aged less than 28 days) is particularly significant as it contributes over 50% of all infant deaths. Under-five mortality rates are three times as high in the northern regions (at 177 per 1000) than in the Greater Accra Area. By comparison, the mortality rate for under age five in Japan is 4 per 1000.
Like other countries in the early phases of health transition, the pattern of disease in Ghana demonstrates a preponderance of communicable diseases, under-nutrition, and poor reproductive health. Epidemics of cerebrospinal meningitis (CSM), yellow fever and diarrheal disease remain a significant threat while the effort to eradicate guinea worm is yet to be fully realized. Emerging and re-emerging diseases of increasing magnitude and threat include the HIV/AIDS menace, tuberculosis, buruli ulcer and filariasis. Malaria has been identified as one of the leading causes of death in Ghana, with diarrheal disease a major cause of childhood mortality and morbidity. Taken together, malaria, guinea worm infestation, diarrheal disease, and meningitis account for about 50% of the country’s total disease burden. Malaria is still the leading cause of outpatient morbidity in all ages and sex groups, and the cause of 20% of all deaths in children under five. The disease is responsible for a substantial number of miscarriages among pregnant women and low birth weight babies. Malaria accounts for 13.8% of outpatient department (OPD) attendance among pregnant women, 10.6% of admissions and 9.4% of deaths.
Source: UNDP Ghana Project Document (August 12, 2010)
