RESEARCH%20NEEDS%20%20%20%20for%20BETTER%20HEALTH%20RESILIENCE%20%20to%20WEATHER%20HAZARDS - PowerPoint PPT Presentation

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RESEARCH%20NEEDS%20%20%20%20for%20BETTER%20HEALTH%20RESILIENCE%20%20to%20WEATHER%20HAZARDS

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world weather open science climate conference 2014 montr al users, application, & social science joint plenary session 21 august 2014 – PowerPoint PPT presentation

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Title: RESEARCH%20NEEDS%20%20%20%20for%20BETTER%20HEALTH%20RESILIENCE%20%20to%20WEATHER%20HAZARDS


1
WORLD WEATHER OPEN SCIENCE CLIMATE
CONFERENCE 2014 MONTRÉAL
USERS, APPLICATION, SOCIAL SCIENCE
Joint Plenary Session 21 August 2014
2
RESEARCH NEEDS for BETTER HEALTH
RESILIENCE to WEATHER HAZARDS
  • MICHEL JANCLOES
  • MD, MPH, DPH
  • Assisted by NICHOLAS CHONG

Joint Plenary User, Applications, and Science
Program WWOSC Montreal 21 August 2014
3
A Story Malaria in Pikine
  • Early acute malaria cases
  • Longitudinal prospective study
  • Findings Humidity changes transmission
    shift
  • New warning messages and interventions against
    malaria

4
A new health proverb
  • When baobabs blossom, use your mosquito bed nets

Science is beautiful when open to community
knowledge and action
5
Our agenda today
  • This plenary
  • Health Issues and Research Perspectives
  • Later, a special panel!
  • Climatic information data to improve public
    health

6
Plenary presentation outline
  1. Need for Operational Research
  2. Experience sharing
  3. Current trends
  4. Strategic Research tracks

7
Plenary presentation outline
  1. Need for Operational Research
  2. Experience sharing
  3. Current trends
  4. Strategic Research tracks

8
Need for Operational Research
  • In the future more frequent, longer and more
    severe weather hazards.
  • Predicted health impact due to
  • Water/food/shelter conditions
  • Spread of diseases
  • Access to Health infrastructure and services

9
Need for Operational Research
  • Potential use of new Climate IC Technologies
  • Demand for informed decision making on
  • Response preparedness
  • Early warning
  • Alert
  • Request of scientific evidence for investment pre
    appraisal and capacity building

10
Plenary presentation outline
  1. Need for Operational Research
  2. Experience sharing
  3. Current trends
  4. Strategic Research tracks

11
Experience 1 MERIT
  • Meningitis
  • Environment
  • Risk
  • Information
  • Technologies

12
Meningitis belt
  • What shape today?
  • Tomorrow?
  • Thomson et al., 2013

13
MERIT purposes
  • A network of public health and climate/environment
    scientists to
  • Improve response timeliness to meningococcal
    meningitis outbreaks
  • AND
  • Influence decisions related the introduction a
    new preventive vaccine.

14
Rationale for a Research Network
  • Cyclic outbreaks due to conjunction of risks
    factors
  • Root cause still not fully understood
  • Meningitis belt in Africa is extending
  • Urgent need to better capture the influence of
    environmental factors on epidemics
  • Attention is given to
  • Climate changes
  • New climate technologies
  • Services are available 

15
Epidemiological pattern
Climate factors Humidity, dust, winds,
temperature
Season Dry season December to June
Social behavioural factors Crowded
housing Displacements Social gathering
Biological factors Damaged mucosa Co-infections
Causal pathogen
Person to person transmission
Carriers
Preventive vaccine
Reactive vaccination

Seasonal annual epidemic pattern Major
cyclic outbreaks every 5-12 Y
16
Thresholds for saving lives
  • Alert threshold (5/100 000/wk)
  • Alinical samples lab confirmation
  • Epidemic threshold (10/100 000/wk)
  • Immediate mass vaccination
  • Strengthen case management

17
MERIT 7 years work
  • From coordinated research works ( more than 30
    institutions)
  • Retrospective review of existing data
    (epidemiological, environmental and climatic)
  • Several models developed and validated during two
    years in five countries.
  • Predictive value of models in countries with and
    without vaccines.

18
MERITs merits
  • Working with a Network of research institutions
    and country officers.
  • Strengthening epidemiological surveillance.
  • Validating strategies between several countries.

19
FIND OUT MORE WWW.HC-FOUNDATION.ORG
20
Plenary presentation outline
  1. Need for Operational Research
  2. Experience sharing
  3. Current trends
  4. Strategic Research tracks

21
Experience 2 GLEAN
  • Global
  • Leptospirosis
  • Environmental
  • Action
  • Network

22
GLEAN Participants
23
Leptospirosis a neglected disease
  • Endemic epidemic disease
  • Increasing severity post-disaster
  • Adjusted due to potential underreporting
  • gt1,500,000 cases
  • gt100,000 deaths
  • A serious global zoonosis

24
Rationale for a Research network
  • Major human and animal disease
  • YET neglected, non-detected, and under-reported
  • Absence of control strategy due to
  • Non-specific symptoms
  • Complex transmission
  • Complex pathogen agent with multiple variants
  • gt250 sero-variants
  • Economic impact
  • Probable impact of climate change
  • Increasing concerns at country level and request
    for technical support

25
A complex epidemiology
26
GLEAN network components
  • PREDICT
  • Baseline Incidence?
  • Main drivers and predictive value?
  • Climate
  • Environment
  • Vector demography
  • Predictive models and risk stratification
  • (to be validated at risk sites)

INTERVENE Informing public health
decision Outbreak investigation
guidelines Operational Guidance for outbreak
control
  • PREVENT
  • Evaluation of
  • Rodent controls?
  • Chemoprophylaxis in humans?
  • Impact of animal vaccination ?

DETECT Case definition? Outbreak
threshold? Early diagnosis tests and case
confirmation (specificity-sensitivity) Algorithms
for outbreak detection ?
27
Linking extreme events and outbreaks
  • Compounding impacts of floods (AR4, IPCC)
  • Proving more than just a correlation to increase
    and/or shifts in disease epidemiology.
  • Identifying the specific link will be crucial for
    targeting the most appropriate health
    determinant
  • Role of animal hosts (esp. rodents) in disease
    spread.
  • Need for understanding different patterns of
    outbreaks
  • Local transmission dynamics
  • Important for intervention program focused on
    control
  • Especially since post-outbreak management is
    costly

28
Linking extreme events and outbreaks
Philippines, 2009
680 cases of leptospirosis /yr with seasonal peak
during the rainy season
Typhoon Pepeng 3 October
Typhoon Ondoy 26 September
Thousands of people displaced and housed in
emergency evacuation centers
In the 2 following weeks, 505 suspect cases and
15 deaths in Manila alone !
29
GLEAN Way forward
  • New partnerships and new working areas
  • Public Health-Veterinarians-Biotechnology
    Industry
  • Economic analysis of outbreaks
  • Detection strategies
  • Vaccine development
  • Public health and Research Institutions
  • Prediction and Early case detection surveillance
    and public health intelligence
  • Improved coordination with meteo/climate services

30
Lessons learnt
  1. Prerequisite Understand the knowledge and
    capacity gaps
  2. Move from impact assessment towards risk
    management with a focus on vulnerability
    understanding.
  3. Time and space downscale for developing
    adaptation strategies and involve the local
    communities
  4. Enhance quality of data sets , in particular
    epidemiological surveillance .
  5. Develop interaction between Health and
    MET/Climate services on a need based approach
  6. Validate the relevance of new knowledge and
    identify backup required for implementation

31
Still some Research traps
  1. Weather/Climate kills?
  2. Impact assessment leads to risk management?
  3. Research meets user needs when findings are
    shared?

32
Plenary presentation outline
  1. Need for Operational Research
  2. Experience sharing
  3. Current trends
  4. Strategic Research tracks

33
Current Research trends
  • Policy background and recommendations from the
    international community
  • WMO/GFCS, WHO, the UN Summit,
  • Several world conferences such as ICCS, One
    Health
  • Advocacy for health at the center of adaptation
    strategies.
  • Research needs for backing up short and long term
    policy decisions.

34
Current Research trends
  • Using new technologies, in particular
    tele-information and communication.
  • Scaling down to local contexts with participative
    process.
  • Integrating research into Resilience development
    including awareness on solution gaps,
    vulnerability risk analysis and incremental
    capacity building towards anticipative
    interventions awareness.

35
Plenary presentation outline
  1. Need for Operational Research
  2. Experience sharing
  3. Current trends
  4. Strategic Research tracks

36
Strategic Research tracks
  • Patterns of health resilience challenges due to
    extreme events ( as amplified by climate change
    and vulnerability shift)
  • Synergy of observations, experiments and modeling
    for policy guidance
  • Water Safety, Food security Risks linked with
    extreme events and vulnerability predictions
  • Specificity and sensitivity Early Warning, Alert
    thresholds linked with vulnerability
  • Space Downscaling (new modeling methods)

37
Some institutional issues
  • Considering other determinants of health, should
    it be a priority to link meteorology and
    climatology for better health resilience against
    future weather hazards?
  • Who should be involved in the design of research
    proposals? Who should be the key actors?
  • How can we develop a sustained cooperation
    between met/climate offices, research institutes
    and public health related services?

38
Conclusion
Science is beautiful when open to community
knowledge and action A political MUST An Applied
Research Opportunity
39
FIND OUT MORE WWW.HC-FOUNDATION.ORG
40
References
  • Bertherat E. 2007. Meningococcal Meningitis in
    Africa Overview Response Strategies and Current
    Challenges. WHO
  • Global Frame Work for Climate Services. Available
    online http//www.gfcs-climate.org (accessed on
    31 July 2014)
  • Jancloes M, et al. 2014. Climate services to
    improve public health. Int. J. Environ. Res.
    Public Health. 11, p. 4555-4559.
  • Jancloes M. 2013. Climate Services for Health
    (Presentation). WMO GFCS
  • MERIT Report of the 4th MERIT technical meeting
    (2010).
  • Rogers, D.P. Tsirkunov, V. 2013. Weather and
    Climate Resilience Effective Preparedness through
    National Meteorological and Hydrological
    Services The World Bank Washington, DC, USA.
  • Thomson MC, et al. 2013. A climate and health
    partnership to inform the prevention and control
    of meningoccocal meningitis in sub-Saharan
    Africa the MERIT initiative. Climate Science for
    Serving Society Research, Modeling and
    Prediction Priorities. Geneva (Switzerland)
    World Health Organization p.459484.
  • 3rd Global Leptospirosis Environmental Action
    Network (GLEAN) Meeting (2013).
  • One Health Summit. Available online
    http//glean-lepto.org/component/k2/item/95-one-he
    alth-summit-17-20-november-2013-in-davos-switzerla
    nd (accessed on 31 July 2014).
  • Committee on Climate, Ecosystems, Infectious
    Diseases, and Human Health. Under the Weather
    Climate, Ecosystems, and Infectious Disease.
    2001National Academies Press.
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