LAHORE: The World Health Organization (WHO) said that climate crisis and its threat to health cannot be ignored in the pursuit of a polio-free world. Extreme weather events and changes in typical weather patterns will increasingly impact the Global Polio Eradication Initiative (GPEI) staff and activities – from the production and procurement of polio vaccines and supplies to the implementation of campaigns – as well as threaten the health of the communities it serves.
In a technical brief “Building a climate-resilient polio-free world” published by the WHO on behalf of the GPEI said that heatwaves, floods, droughts and storms can expose polio workforces to new occupational hazards, disrupt and damage GPEI operations, and worsen water, sanitation and hygiene (WASH) conditions in affected communities.
WHO said that poor WASH increases the likelihood of ingesting faecal-contaminated water, food or drinks, the most common route of poliovirus transmission.
It is also an underlying cause of malnutrition, which weakens children’s immune systems, making them even more susceptible to diseases like polio it said.
WHO said that weather events, coupled with longer term changes in typical weather patterns, also impact the availability of food, water and other resources, which can trigger increased population movements and, in some cases, conflict.
This can heighten the risk of people encountering and spreading the virus in polio affected areas and beyond while making it harder to reach every child with the polio vaccine.
In addition, poliovirus transmission is highest during the hottest parts of the year, so longer periods of higher temperatures could extend these high transmission seasons.
Countries at high risk for polio are already disproportionately experiencing the impacts of the climate crisis. In 2021, Pakistan and Afghanistan, the last two remaining endemic countries for wild polio, ranked eighth and 17th in the world for countries most affected by extreme weather events from 2000 to 2019.
Between 2030 and 2050, rising temperatures are expected to cause an estimated quarter-million deaths each year from malnutrition, malaria, diarrhea, dengue and heat stress alone.
Extreme weather events ( heatwaves, floods and storms) have become more common and severe while typical weather patterns (e.g. average temperatures and rainfall) continue to drastically change, disrupting global systems and local health services.
Around the world, the poorest and most marginalized communities, particularly children bear the brunt of the climate crisis, exacerbating existing health inequities.
While the health impacts of the climate crisis are vast, the health sector itself has a vital role to play in reducing harmful greenhouse gas (GHG) emissions. The health sector, particularly in the world’s wealthiest economies, is estimated to represent 4.4% of global GHG emissions; if the sector were a country, it would be the fifth-largest emitter on the planet.
At the same time, GPEI activities generate GHG emissions – from carbon dioxide (CO2) to refrigerant gases like hydrofluorocarbons – and thus contribute to rising global temperatures
Of all GPEI activities, the life cycle of producing, transporting, delivering and disposing of polio vaccines and supplies likely accounts for the largest proportion of the GPEI’s overall carbon footprint.
This analysis found that the burning of waste for disposal accounted for 28% of annual emissions, the transportation of vaccines and supplies accounted for 27%, the operation of cold chain equipment for 25%, and the production of vaccines, cold chain equipment and supplies for 20%.
The production and procurement of GPEI immunization campaign materials – from vaccine vials to marker pens – are likely to significantly contribute to the programme’s carbon footprint.
Currently, the programme does not require suppliers to meet criteria related to their climate impact, as it relies on a small number of suppliers, many of which are in low-income countries.
Such requirements must be proposed gradually and mindfully to avoid causing serious disruptions to the global supply chain and thus eradication efforts.
Fossil fuels used to transport vaccines, stool and sewage samples and staff by way of ships, trucks, cars, motorbikes and aero planes contribute to the programme’s carbon footprint.
Infrastructure, including vaccine storage facilities and equipment, as well as surveillance laboratories also use fossil fuels to operate.
Along the cold chain, commonly used refrigeration equipment can emit hydrofluorocarbons, a GHG that can be nearly 2000 times more potent than CO2.
Ways to diminish the use of fossil fuels include the following:
Health services like immunization campaigns produce medical waste, including syringes, empty vaccine vials and pen markers for polio campaigns.
In settings without effective medical waste management systems, waste is often burned, causing dioxin and CO2 emissions
Nearly 1 billion people worldwide access health care facilities that do not have regular or consistent power.
Unreliable energy disrupts routine and emergency care – from interrupting diagnostic tests to preventing vaccines from staying cold. As heatwaves, floods and other extreme weather events become more common, energy disruptions are expected to increase due to events like power outages and heat stress on existing infrastructure.
To address these challenges in the last mile of polio eradication and reduce its carbon footprint, the GPEI and partners have turned to solar power, a more affordable, reliable and climate-resilient energy source to power polio vaccination and surveillance activities.
The climate crisis can threaten global energy supply – from heatwaves causing blackouts to tropical storms wiping out physical energy infrastructure. For polio immunization campaigns and surveillance efforts, consistent energy is vital to ensuring a reliable cold chain to deliver life-saving tools.
Pakistan, one of the last two endemic countries for wild polio, is closer than ever to ending this devastating disease for good. Many experts, however, say Pakistan is among the countries most vulnerable to the climate crisis.
As the world becomes hotter, more frequent and severe heatwaves, intense droughts and devastating floods threaten the incredible progress that has been made against polio.
From May to October 2022, a historic heatwave was followed by heavy monsoon rains and melting Himalayan glaciers, causing the worst flooding in Pakistan’s history; almost one third of the country was under water at its peak.
One in seven people in the country were affected by these floods and close to 8 million people were displaced, including thousands of polio workers themselves.
Critical infrastructure in the country was also damaged, from roads and bridges to health and sanitation systems.
Such devastation following floods and storms leads to wastewater overflow, compromising safe drinking water and spreading pathogens like cholera and polio.
This increases the risk of people encountering these life-threatening diseases while making it even harder to reach every child with the necessary vaccines to protect them.
In response to this climate emergency, the programme activated extreme weather contingency plans to resume immunization activities for polio and other vaccine-preventable diseases as soon as possible.
This included adjusting campaign schedules and strategies, such as conducting vaccinations at health camps, at transit points and in settlements for displaced persons. In some cases, this meant wading through deep water to reach children with life-saving vaccines.