Research on climate change and health: looking ahead

Abstract

Next year the Intergovernmental Panel on Climate Change (IPCC) will start its Fifth Assessment Report. The role of the IPCC is to evaluate the peer reviewed literature on current and future impacts of anthropogenic climate change and synthesise the findings for governments. The IPCC has three working groups. Working Group I (WGI) addresses the climate science including an assessment of observed warming due to human activities and projections of future warming and regional climate change. Working Group II assesses the scientific evidence for impacts, adaptation and vulnerability—in all regions, in all ecosystems, for all outcomes, for all population groups. Working Group III evaluates the evidence with respect to options for mitigation (reducing carbon emissions and enhancing carbon sinks). The IPCC authors only include peer-reviewed articles published since the last assessment and have a strict policy regarding the use of grey literature. Public health science contributed to WGII (Confalonieri et al. 2007) and WGIII (Barker et al. 2007) in the Fourth Assessment report. It is likely that public health research will make an even more important contribution to the next Assessment—but only if the appropriate research studies have been undertaken. The IPCC assessments are scientific assessments and the IPCC process prohibits including any policy prescriptive statements. Global scientific assessments are becoming more common (we now have the Millennium Ecosystem Assessment and the International Assessment of Agricultural Knowledge, Science and Technology for Development). The IPCC was the first of its kind and represents a fantastic and unique achievement to science and policy (and world peace). Scientific rigour is maintained across diverse research disciplines and from observational studies to modelled projections. The IPCC has its origins in the physical sciences—as it started with the climate system. As the input from social scientists is increasing—in recognition of the complex social and economic determinants of vulnerability to climate change—the IPCC authors will increasingly face familiar issues regarding the synthesis and evaluation of qualitative and quantitative social research. Fortunately, public health has some established methods for reviewing and evaluating research results. These now need to be applied to the climate–health research questions. The IPCC will require many comprehensive and systematic reviews—to demonstrate a causal role of climate for a relevant health outcome and to quantify the attributable fraction. Systematic reviews of the effectiveness of adaptation measures (interventions) are also needed. As yet, few systematic reviews are conducted in the sphere of environment and health. In effect, climate change–health research is suffering from the legacy of reductionism in the health sciences and its clinical bias. Too few researchers are working on the environmental determinants of disease, even for major climate-sensitive causes of death such as malaria and malnutrition. The climate change research agenda is moving forward. An expert meeting organised by WHO last year identified the following research needs (WHO 2009): This paper belongs to the special issue ‘‘Climate changes health’’.