ByDr Tayphasavanh Fengthong

Director of Environmental Health DivisionDr Sivixay Thammalangsy

Director of Administrative Division

Climate Change and Health Adaptation Strategy in Lao PDR

The South East Asia Regional Workshop “ The Impact of Climate Change and Health”, 16-18 June 2009, Shangri-La Hotel,

Jakarta,Indonesia

Outlines

Country description

Relationship between climate change and health

Impacts of Climate change on different sectors in Lao PDR

Impacts of Climate change on Health in Lao PDR

What we have done so far?

The way forward

Thailand

Cambodia

Vietnam

China

Myanmar

Country description

Lao PDR is a land-linked country, and shares border with China, Vietnam,

Cambodia, Thailand and Myanmar.

Total area : 236,800 km2

Population: 5.62 mill Density : 24 p/sqkm

17 provinces including Vientiane Capital

Capita income USD 500 /c/y

Total fertility rate: 4.9%,

Crude birth rates: 41% Crude death rates: 16%,

Adult literacy rate: (F: 50%; M:74%)

Population growth rate: 2.5% per year

Life expectancy: 61 years (F: 63; M: 59)

Population leaving in rural area: 72.8%

47 ethnic groups, covering120 ethnic sub-groups and languages

11,000+ small villages and mostly with poor road access

Agriculture = 80% of jobs, mostly subsistence farming in remote areas

Country description

Relationship between climate change and health

Eyes (cataracts, etc.)Skin damage/cancer

Land cover (forest, etc)

Direct impacts

Thermal stress: death, disease events, injuryStorms, cyclones, floods, firesSea-level rise: physical hazards, displacement

Biodiversity changes, & ecosystem disruption

Changes in host species, vectors (mosquitoes, etc.)

Infectious disease risks

Food yields: nutrition and health

Human predation

Stratospheric ozone depletion

Poverty, slum, hygiene; physical hazards; infectious disease risks (mobility, density)

e.g. pollination

Avian ‘flu, Nipah virus, BSE, etc.

Land use

Water–sheds, systems Food-production

systems

Urbanisation; human settlements

Global Climate and Environmental Changespathways, health risks

Climate change

Immune suppression

Regional Weather Changes:

Heat wavesExtreme

weatherTemperaturePrecipitation

Health effectsTemperaturerelated illnesses and deathsExtreme weather eventsrelated healtheffectsAir pollution related healtheffectsWater and foodborn diseasesVector androdent bornediseasesMalnutritionMental health

Microbiological

economics

MicrobiologicalContaminationpathwaysTransmission

dynamicsAgro-ecosystemhydrology Socio-economics

demographics

Climate Climate change

ModulatingModulatinginfluences

Climate change and Health Impacts

Direct impact

Indirect impact

Impacts of Climate change On different sectors in Lao PDR

Vulnerability = (Magnitude, Exposure, Adaptive Capacity)

Why Lao PDR so vulnerable?

- High dependence on NR- Low adaptive capacity as LDC

A most recent study on climate change mapping for Southeast Asia, sponsored by the Economy and Environment Program for Southeast Asia (EEPSEA), ranked Lao PDR as a most vulnerable country.

Note: i) Unit = 1,000 tons; ii) CO2-eq = CO2 equivalent; iii) Conversion factors, 1 ton of CH4 = 21 tons of CO2-eq, 1 ton of N2O = 310 tons of CO2-eq.

GHG in1990CO2 CH4 N2O Total CO2-eq

Energy 414.90 22.70 0.12 928.80

Agriculture 0.00 271.27 0.00 5,696.67

LULUCF 16,628.67 29.50 0.20 17,310.17

Waste 0.00 11.43 0.00 240.03

Total 17,043.57 334.90 0.32 24,175.67

Agriculture sectorGHG in 1990

Land and Forestry changes

Trend of forests in Lao PDR

Released GHG in 1990

Energy sectorEnergy consumption Energy consumption by sector

Trends of energy consumption

Industry sector

Waste management sector• In 1990, CH4 released from landfill site and wastewater treatments equal to 11.20 and 0.23 tons with CO2eq = 2.4 mil tons (1% of National GHG released).

• There were only landfill sites in 5 big urban cities: Vientiane, Luangprabang, Thakek, Savannakhet and Pakse.

• In 2002, Cities in Vientiane Capital discharged yearly wastewater from industries = 8.22 mil m3.

Industrial Wastewater

1.4%2.5%

5.6%

90.5%

textile industrybeverage industrypulp & paper industrymeat processing industry

Annual Mean Temperature Trend in Major Cities for 1971 - 2007

24

25

26

27

28

29

1970 1975 1980 1985 1990 1995 2000 2005 2010Year

Tem

pera

ture

(Cel

sius

)

PakseSavannakhetVientiane CapitalVientiane ProvinceLuangprabangXayaboury

Temperature increased

Annual Mean-Maximum Precipitation Trend in Major Cities from 1971 - 2007 (mm in 24 hours)

10

20

30

40

50

60

70

1970 1975 1980 1985 1990 1995 2000 2005 2010

Year

Prec

ipita

tions

(mm

)

PakseSavannakhetVientiane CapitalVientiane ProvinceLuangprabangXayaboury

Flooding on July 2008 in Lao PDR, more than 200,000 people and 75,000 ha affected

Impact of climate change

ແຫ່ຼງຂໍ ້ ມູນ: ກົມແຜນການ, ກະຊວງກະສິ ກໍາ ແລະ ປ່າໄມ້ ປີ 2005

Impacts of Climate change On Health in Lao PDR

Health situations

Considerable progress has been achieved over the pastten years in improving the health system in the Lao PDR

which are Maternal, infant and under five infant mortality rates (MMR, IMR and U5MR, respectively) have dropped

significantly

MMR

IMR

U5MR

1995 2000 2005

656

104

170

530 405

82 70

106 98

Child and maternal malnutrition

The malnutrition rate in children under five in Lao PDR is very high compared to other countries in South East Asia and Asia in

general.

Almost two in every five children under age five in Lao PDR are moderately and severely

underweight (37.9 percent)

Stunting: 41.2% Wasting: 7.4%

13774

3968

3

9176

21

17638

63

3414

10

5495

13

6349

6

6853

17

4185

22

02000400060008000

1000012000140001600018000

Number

2000 2001 2002 2003 2004 2005 2006 2007 2008

Cases and deaths of DF, DHF and DSS by year from 200-2008 in Lao PDR

cases deaths

12440

520

2941

152042

31572

7

176110

2018

01886

2

2931

6

7444

7

0

2000

4000

6000

8000

10000

12000

14000

Number

2000 2001 2002 2003 2004 2005 2006 2007 2008Year

Cases and deaths of severe diarrhea by year from 2000-2008 in Lao PDR

cases deathsSource: Epidemiology Division, Center for Laboratory and Epidemiology

Department of Hygiene andd Prevention, Ministry of Health

Comparison of severe diarrhea from 2005-Œ2007

In 2005

2018 cases

02 deaths

In 2006

1886 cases

No death

In 2007

2931 cases

06 deaths

Source: Epidemiology Division, Center for Laboratory and EpidemiologyDepartment of Hygiene andd Prevention, Ministry of Health

343

3

1361

20

1237

0

1278

0

1846

7

1576

1

1868

0

1429

1

1736

0

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Number

2000 2001 2002 2003 2004 2005 2006 2007 2008Year

Cases and deaths of typhoid by year from 2000-2008 in Lao PDR

cases deathsSource: Epidemiology Division, Center for Laboratory and Epidemiology

Department of Hygiene andd Prevention, Ministry of Health

Comparison of typhoid from -2005 Œ- 2007

In 2005

1576 cases

01 death

In 2006

1868 cases

No death

In 2007

1429 cases

01 death

Source: Epidemiology Division, Center for Laboratory and EpidemiologyDepartment of Hygiene andd Prevention, Ministry of Health

799

4

899

0

959

1

790

1

878

0

1108

0

942

0

1103

0

1732

1

0

200

400

600

800

1000

1200

1400

1600

1800

Number

2000 2001 2002 2003 2004 2005 2006 2007 2008Year

Cases ad deaths of dysentery by year from 2000-2008 in Lao PDR

cases deathsSource: Epidemiology Division, Center for Laboratory and Epidemiology

Department of Hygiene andd Prevention, Ministry of Health

296

8

239

1

615

0

300

3

334

0

1108

0

345

0

436

2

763

0

0

200

400

600

800

1000

1200

Number

2000 2001 2002 2003 2004 2005 2006 2007 2008

Year

Cases and deaths of food poisoning by year from 2000-2008 in Lao PDR

cases deathsSource: Epidemiology Division, Center for Laboratory and EpidemiologyDepartment of Hygiene andd Prevention, Ministry of Health

394

3

366

2

451

0

382

2

391

3

488

0

453

0

644

0

966

00

100

200

300

400

500

600

700

800

900

1000

Number

2000 2001 2002 2003 2004 2005 2006 2007 2008Year

Cases and deaths of hepatitis by year from 2000-2008 in Lao PDR

cases deathsSource: Epidemiology Division, Center for Laboratory and EpidemiologyDepartment of Hygiene andd Prevention, Ministry of Health

0 0 4 0

37

0

75

0

100

00

102030405060708090

100

Number

< 1 1 to 5 6 to 10 11 to 15 > 15

Age group

Cases and deaths of hepatitis outbreak by age group in Vientiane Province, 2008, Lao PDR

Cases Deaths

83

0

53

0

42

0

30

0 4 0 1 00

102030405060708090

Number

Viengkham KeoOudom Phonhong Thoulakhom Hinheub Vanvieng

District

Cases and deaths of hepatitis outbreak by district in Vientiane Province, 2008, Lao PDR

Case Death

Source: Epidemiology Division, Center for Laboratory and EpidemiologyDepartment of Hygiene andd Prevention, Ministry of Health

What we have done so far?

Regional Weather Changes:

Heat wavesExtreme

weatherTemperaturePrecipitation

Health effects

Mental health

Health effectsTemperaturerelated illnesses and deathsExtreme weather eventsrelated healtheffectsAir pollution related healtheffectsWater and foodborn diseasesVector androdent bornediseasesMalnutritionMental health

MicrobiologicalContaminationpathwaysTransmission

dynamicsAgro-ecosystemhydrology Socio-economics

demographics

Climate Climate change

ModulatingModulatinginfluences

Evaluation of adaptation

Health specific adaptation measuresResearch

needs

Driving forces

• Populationdynamics

• UnsustainableEconomic

development

Natural causes

GHG emissions

Adaptivecapacity

Mitigative capacity

Mitigation measures

1.First National Communication on Climat Change-FNC (completed)

2.Technology need Assessment for Mitigating Greenhouse Gases (completed)

3.Public Awareness on Climate Change (completed)4.National Adaptation Programmes of Action-NAPA (On

going)5.National Capacity Self Assessment (NCSA) (On going) 6.Clean Development Mechanism –CDM (on going) 7.Second National Communication on Climat Change-SNC)

(Start implementation)

Projects under Projects under UNFCCCUNFCCC

88. Draft Policy/Strategy and National . Draft Policy/Strategy and National Environment and Health Action PlanEnvironment and Health Action Plan--NEHAPNEHAP

1.1. TWG on TWG on Air QualityAir Quality2.2. TWG on Water, Hygiene and SanitationTWG on Water, Hygiene and Sanitation3.3. TWG on Solid and Hazardous WasteTWG on Solid and Hazardous Waste4.4. TWG on Toxic Chemical and Hazardous SubstancesTWG on Toxic Chemical and Hazardous Substances5.5. TWG on Climate Change, Ozone Depletion and Ecosystem ChangeTWG on Climate Change, Ozone Depletion and Ecosystem Change6.6. TWG On Preparedness And Response In Environment Health EmergenciesTWG On Preparedness And Response In Environment Health Emergencies..

Draft National Strategy and Action Plan on Climate Change

Draft Strategy on Climate Change and Health Adaptation

Plan Implementation

NSCCC Chair

NSCCC Secretariat(DOE)

MPIVice Chair

WREAStanding Vice Chair

MAFVice Chair

Climate Change Office

8 TWGsMin. of Agriculture & Forest

Min. of Energy & MinesMin. of Public Works & Transport

Water Resources Environment AuthorityMin. of Planning & InvestmentLand Administration Authority

Min. of HealthMin. of Finance

UniversitiesPrivate sectors

International Organizations

TA

Vice Minister of Health

DOHP

EHD NEW HEC MC LEC

CD FDDPIDC

1. Finalize Draft Strategy on Climate Change and Health Adaptation:

– Educate and aware public and policy makers about climate change and health impacts including co-benefits with concerned sectors

– Enhance risk communication and management– Improve disaster public health preparedness,

planning and emergency response.– Undertaking vulnerability studies of existing water

supply and sanitation systems and ensuring that new systems are built to reduce vulnerability

– Strengthen food safety program

The Way Forward

– Enhance surveillance system– Conduct a study on health impact of climate change– Encourage active participation of concerned agencies to

mitigate climate change and Work in partnership with other agencies.

– Thermal stress management– Strengthen health care services at different levels

2. Disseminate and Implement Policy/Strategy and Policy/Strategy and National Environment and National Environment and ntHealth Action Health Action PlanPlan--NEHAPNEHAP

3. Disseminate National Nutrition Policy/Strategy and Finalize and Implement Nutrition Action Plan

The Way Forward