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Reports stoke up evidence for health effects of global warming
THE LANCET
POLICY AND PEOPLE
Reports stoke up evidence for health effects of global warming
A
ny vestiges of doubt regarding the process of global warming are likely to be dispelled by two reports put before the Geneva conference on July 8–19 of the 159 nations that have ratified the UN Framework Convention on Climate Change. The aim is to stabilise greenhouse gas emissions at their 1990 level. The reports are Climate Change and Human Health, issued under the auspices of WHO, the World Meteorological Organization, and the UN Environment Programme, and Climate Change in Southern Africa, commissioned by the World Wide Fund for Nature from the Climate Research Unit at the University of East Anglia, UK. Both build on last month’s report of the Intergovernmental Panel on Climate Change with its consensus on a temperature rise on 1·7°C by the 2050s as most probable in the absence of distinctly more energetic measures to limit emissions, especially CO2. In addition, both cite evidence already apparent indicating that climate change with rising temperatures is gaining momentum. Sea level has risen by some 18 cm over the past century resulting from melting of the polar ice caps and shrinking glaciers—in Switzerland they have even lost half their volume and one-third of their length over the past 10 years as the temperature rose by an (exceptional) 0·5°C—in conjunction with expansion of the warmed water. The average rate of warming over the past 25 years has
been between 0·1 and 0·2°C per decade. With 1995 as the warmest ever, the 7 warmest years on record have all happened since 1980. According to the IPCC, sea level 100 years hence looks like being as much as 1 m higher than today. The point is made that even if CO2 emissions were stabilised immediately at current levels, concentrations in the atmosphere would still increase for at least the next 100 years, perhaps much longer. The UN report, compiled over the past 3 years by scientists and doctors, outlines the complex relations between environmental change and risks to human health: “By causing alterations in ecosystem functioning and in the components of biodiversity, climate change could upset the ecological balance between parasites, intermediate hosts, vectors and humans, thereby creating new and unusual transmission cycles”. Most emerging diseases, it says, are caused by changes in “microbial traffic”. Examples include dengue hantavirus pulmonary syndrome, and some haemorrhagic fevers. Although he compared those who still contend that further measures to curb emissions should be postponed until the impact of climate change is
ascertained with the beleaguered tobacco propagandists, Prof Anthony McMichael, one of the Climate Change and Human Health report editors was philosophical about legitimate doubters. “It’s not surprising that we’re all having difficulty coming to terms with the potential scale, the enormity of these issues. It does sound melodramatic, but the reality is that, as far as we can tell, it’s during our lifetime that, for the first time ever, the scale of human numbers and economic activity has reached the point where those global levels of worldwide natural systems upon which we depend are starting to falter . . . By and large, we have systems of government attuned to making decisions within a very short timeframe, re-elected every 3 or 4 years. Such a timeframe is almost irrelevant when one is thinking about processes unfolding over 50, 100, or several hundred years. We’re not well structured in a political sense to quickly understand and respond to these issues. All of us should stand back and say ‘maybe we haven’t got it right in the world, maybe there’s an alternative way of going about it’.” Alan McGregor
Germany’s cost-conscious health minister inflexible over yoga
A
dispute between German Health Minister Horst Seehofer and the health-insurance companies over their capacity to cut costs has cast a shadow over current legislative activities. Despite major political efforts, the health-insurance companies will probably not be able to lower their customers’ contributions next year, as Seehofer had intended. In fact, there might even be substantial increases in fees. Nevertheless, Seehofer is insisting on cuts in treatments of unproven worth. His latest legislation should save about DM7·5 billion, he says, but the companies claim that only about 4·5 billion will be saved. The
188
bills have been passed by the Christian Democrat/Liberal majority in parliament, but might not get the necessary approval by the Social Democrat opposition, which holds the majority in the council of German states (Bundesrat). Seehofer’s target is preventive medicine, which has been financed by the insurance companies since 1989. Under the bill, they may offer only vaccination and cancerscreening programmes; offers of free yoga, sports, or cooking courses will be abolished. Insurance companies advertise these offers to attract new customers, who are almost entirely free to choose the scheme they join.
Sick pay has also been affected; this payment made by the insurances after 6 weeks of illness, which covers most of the lost earnings, has been cut by 10%. There have also been cut backs on contributions to spectacles and dental implants, and patients will have to pay more towards the cost of drugs. The health insurances are arguing that the abolition of preventive measures might, in the long run, increase the costs for treatment and rehabilitation. They complain that Seehofer insists on savings, but has not given them the ability to cut costs, especially in hospitals. Annette Tuffs
Vol 348 • July 20, 1996
POLICY AND PEOPLE
Reports stoke up evidence for health effects of global warming
A
ny vestiges of doubt regarding the process of global warming are likely to be dispelled by two reports put before the Geneva conference on July 8–19 of the 159 nations that have ratified the UN Framework Convention on Climate Change. The aim is to stabilise greenhouse gas emissions at their 1990 level. The reports are Climate Change and Human Health, issued under the auspices of WHO, the World Meteorological Organization, and the UN Environment Programme, and Climate Change in Southern Africa, commissioned by the World Wide Fund for Nature from the Climate Research Unit at the University of East Anglia, UK. Both build on last month’s report of the Intergovernmental Panel on Climate Change with its consensus on a temperature rise on 1·7°C by the 2050s as most probable in the absence of distinctly more energetic measures to limit emissions, especially CO2. In addition, both cite evidence already apparent indicating that climate change with rising temperatures is gaining momentum. Sea level has risen by some 18 cm over the past century resulting from melting of the polar ice caps and shrinking glaciers—in Switzerland they have even lost half their volume and one-third of their length over the past 10 years as the temperature rose by an (exceptional) 0·5°C—in conjunction with expansion of the warmed water. The average rate of warming over the past 25 years has
been between 0·1 and 0·2°C per decade. With 1995 as the warmest ever, the 7 warmest years on record have all happened since 1980. According to the IPCC, sea level 100 years hence looks like being as much as 1 m higher than today. The point is made that even if CO2 emissions were stabilised immediately at current levels, concentrations in the atmosphere would still increase for at least the next 100 years, perhaps much longer. The UN report, compiled over the past 3 years by scientists and doctors, outlines the complex relations between environmental change and risks to human health: “By causing alterations in ecosystem functioning and in the components of biodiversity, climate change could upset the ecological balance between parasites, intermediate hosts, vectors and humans, thereby creating new and unusual transmission cycles”. Most emerging diseases, it says, are caused by changes in “microbial traffic”. Examples include dengue hantavirus pulmonary syndrome, and some haemorrhagic fevers. Although he compared those who still contend that further measures to curb emissions should be postponed until the impact of climate change is
ascertained with the beleaguered tobacco propagandists, Prof Anthony McMichael, one of the Climate Change and Human Health report editors was philosophical about legitimate doubters. “It’s not surprising that we’re all having difficulty coming to terms with the potential scale, the enormity of these issues. It does sound melodramatic, but the reality is that, as far as we can tell, it’s during our lifetime that, for the first time ever, the scale of human numbers and economic activity has reached the point where those global levels of worldwide natural systems upon which we depend are starting to falter . . . By and large, we have systems of government attuned to making decisions within a very short timeframe, re-elected every 3 or 4 years. Such a timeframe is almost irrelevant when one is thinking about processes unfolding over 50, 100, or several hundred years. We’re not well structured in a political sense to quickly understand and respond to these issues. All of us should stand back and say ‘maybe we haven’t got it right in the world, maybe there’s an alternative way of going about it’.” Alan McGregor
Germany’s cost-conscious health minister inflexible over yoga
A
dispute between German Health Minister Horst Seehofer and the health-insurance companies over their capacity to cut costs has cast a shadow over current legislative activities. Despite major political efforts, the health-insurance companies will probably not be able to lower their customers’ contributions next year, as Seehofer had intended. In fact, there might even be substantial increases in fees. Nevertheless, Seehofer is insisting on cuts in treatments of unproven worth. His latest legislation should save about DM7·5 billion, he says, but the companies claim that only about 4·5 billion will be saved. The
188
bills have been passed by the Christian Democrat/Liberal majority in parliament, but might not get the necessary approval by the Social Democrat opposition, which holds the majority in the council of German states (Bundesrat). Seehofer’s target is preventive medicine, which has been financed by the insurance companies since 1989. Under the bill, they may offer only vaccination and cancerscreening programmes; offers of free yoga, sports, or cooking courses will be abolished. Insurance companies advertise these offers to attract new customers, who are almost entirely free to choose the scheme they join.
Sick pay has also been affected; this payment made by the insurances after 6 weeks of illness, which covers most of the lost earnings, has been cut by 10%. There have also been cut backs on contributions to spectacles and dental implants, and patients will have to pay more towards the cost of drugs. The health insurances are arguing that the abolition of preventive measures might, in the long run, increase the costs for treatment and rehabilitation. They complain that Seehofer insists on savings, but has not given them the ability to cut costs, especially in hospitals. Annette Tuffs
Vol 348 • July 20, 1996